ArticleBrain and behavior2023
The clinical, economic, and patient-centric burden of insomnia symptom severity in adults with major depressive disorder in the United States.
Article in Brain and behavior, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- The troy sleep scale: clinical validation and establishment of a screening cut-off.BMC psychology · 2026Article
- A new direction for adjunctive therapy of difficult-to-treat depression: examining the role of orexin receptor antagonists.European archives of psychiatry and clinical neuroscience · 2025Review
- Economic costs associated with insomnia in adults with subthreshold depression or major depressive disorder.BJPsych open · 2025Article
- Socioeconomic status and sleep duration among a representative, cross-sectional sample of US adults.BMC public health · 2024Article
- Quality of life impacts associated with comorbid insomnia and depression in adult population.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Article
- 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 clinical, economic, and patient-centric burden of insomnia symptom severity in adults with major depressive disorder in the United States.Brain and behavior · 2023Article
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5 authors.
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Abstract
introductionInsomnia is prevalent in adults with major depressive disorder (MDD) and is a key diagnostic criterion of MDD; however, little is understood about the burden of insomnia symptom severity in MDD. We evaluated the relationship between insomnia symptom severity and the clinical, economic, and patient-centric burden among community-dwelling individuals with MDD.
methodsRespondents with diagnosed depression who reported insomnia symptoms in the past 12 months (N = 4402) were identified from the 2019 United States National Health and Wellness Survey. Multivariable analyses assessed the association of Insomnia Severity Index (ISI) with health-related outcomes while controlling for sociodemographic and health characteristics. Further analyses also controlled for depression severity (9-item Patient Health Questionnaire).
resultsMean ISI score was 14.3 ± 5.6. Higher ISI was associated with greater depression severity (r = .51, p < .001). After adjustments, a one-standard deviation (5.6-point) increase in ISI score was significantly associated with higher depression (rate ratio [RR] = 1.36), anxiety (RR = 1.33) and daytime sleepiness (RR = 1.16) levels, more healthcare provider (RR = 1.13) and emergency room visits (RR = 1.31), hospitalizations (RR = 1.21), work productivity and activity impairment (RRs = 1.27 and 1.23, respectively), and poorer mental and physical health-related quality of life (β = -3.853 and -1.999, respectively) (p < .001). These findings remained statistically significant when controlling for concurrent depression severity.
conclusionIn adults with MDD, greater insomnia symptom severity is associated with worse health-related outcomes, which suggests the importance of addressing insomnia symptoms as a clinical target for treating MDD.
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