ArticleJournal of affective disorders2020
Focusing on insomnia symptoms to better understand depression: A STAR*D report.
Article in Journal of affective disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of each class of sleep medication for major depressive disorder with insomnia symptoms: A systematic review and meta-analysis of double-blind randomized controlled trials.Psychiatry and clinical neurosciences · 2025Pooled it
- Efficacy and safety of lemborexant in subjects with insomnia disorder receiving medications for depression or anxiety symptoms.Neuropsychopharmacology reports · 2025Trial
- Trial
- The Association between Intranasal Esketamine and Treatment-emergent Insomnia in the Treatment of Treatment-resistant Major Depression: A Meta-analysis.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2025Article
- Advances in the research of comorbid insomnia and depression: mechanisms, impacts, and interventions.Frontiers in psychiatry · 2025Review
- The Pathogenesis and Treatment of Insomnia Combined with Depression.International journal of general medicine · 2025Review
- Insomnia and Alexithymia in Chinese Adolescents with Major Depressive Disorder: A Cross-Sectional Study of Sex Differences and Associations.Psychology research and behavior management · 2024Article
- The Relationship between Insomnia and the Pathophysiology of Major Depressive Disorder: An Evaluation of a Broad Selection of Serum and Urine Biomarkers.International journal of molecular sciences · 2023Article
- Effect of insomnia in the major depressive disorder.BMC neurology · 2022Article
- The Acute Effects of Aerobic Exercise on Nocturnal and Pre-Sleep Arousal in Patients with Unipolar Depression: Preplanned Secondary Analysis of a Randomized Controlled Trial.Journal of clinical medicine · 2021Article
- Potential Genetic Overlap Between Insomnia and Sleep Symptoms in Major Depressive Disorder: A Polygenic Risk Score Analysis.Frontiers in psychiatry · 2021Article
- Effect of Sleep Disturbance on Efficacy of Esketamine in Treatment-Resistant Depression: Findings from Randomized Controlled Trials.Neuropsychiatric disease and treatment · 2021Article
- Prevalence of Depression in Older Nursing Home Residents in High and Low Altitude Regions: A Comparative Study.Frontiers in psychiatry · 2021Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundDisturbed sleep is a core symptom of major depressive disorder (MDD), with nearly 90% of those with MDD reporting disturbed sleep. However, combining insomnia and hypersomnia into a single diagnostic domain ignores distinct biological differences between those symptom presentations. To better understand depression it may be necessary to explore these symptoms independently, beginning with the more prevalent insomnia.
methodThe present study evaluated global insomnia symptom severity in a broad sample of MDD outpatients from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, excluding patients who reported hypersomnia symptoms. The three insomnia-related symptoms from the 16-item Quick Inventory of Depressive Symptomatology- clinician rated (QIDS-C) were combined to create a global insomnia score to classify baseline insomnia severity. A modified depression severity score was then used to assess depression severity (mQIDS-C), excluding sleep-related items.
resultsA repeated measures ANCOVA revealed a significant improvement in insomnia score over the acute phase treatment (F = 33.1, d.f. = 6, 9897, p < 0.0001). Improvement in insomnia score over the acute phase treatment remained statistically significant even after controlling for change in depression severity (p = 0.0004). Participants with one point higher insomnia score at baseline were significantly less likely to remit at study exit (odds ratio = 0.88, 95% confidence interval = 0.85, 0.92, p < 0.0001) even after controlling for baseline depression severity. LIMITATIONS: Objective confirmation of sleep profiles was not available.
conclusionGreater severity of insomnia reduces likelihood of MDD remission, and insomnia symptoms improved independent of depression remission.
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