Insomnia and hypersomnia associated with depressive phenomenology and comorbidity in childhood depression.
OBJECTIVE
To examine sleep disturbance (insomnia and hypersomnia) and associated clinical profiles among depressed children and adolescents in terms of illness history, depressive severity, depressive phenomenology, and psychiatric comorbid disorders.


METHODS
Clinical profiles from standardized clinical evaluations were compared.


METHODS
Twenty-three mental health facilities in Hungary between April 2000 and December 2004.


METHODS
Five hundred fifty-three children with a current episode of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition major depressive disorder: 55% were boys, mean age was 11.7 years (SD = 2.0, range = 7.3-14.9), and 94% were Caucasian. Sleep and depressive symptoms were assessed with the Interview Schedule for Children and Adolescents-Diagnostic Version.


METHODS
N/A.


RESULTS
Of the total sample, 72.7% had sleep disturbance: 53.5% had insomnia alone, 9.0% had hypersomnia alone, and 10.1% had both disturbances. Depressed girls were more likely to have sleep disturbance than boys (77.0% vs 69.2%, p < .05), but age had no significant effects. Compared with children without sleep disturbance, sleep-disturbed children were more severely depressed and had more depressive symptoms and comorbid anxiety disorders. Across sleep-disturbed children, those with both insomnia and hypersomnia had a longer history of illness, were more severely depressed, and were more likely to have anhedonia, weight loss, psychomotor retardation, and fatigue than were those with either insomnia or hypersomnia.


CONCLUSIONS
Clinical profiles differ between depressed children without and with sleep disturbance, with those presenting insomnia plus hypersomnia being most severely depressed. Differentiating depressed children with different sleep disturbances may have important implications for research efforts on the etiology and therapeutics of child depression.
Liu
Xianchen
X
Department of Psychiatry, University of Pittsburgh School of Medicine and WPIC, PA 15213, USA. xcliu@pitt.edu
Buysse
Daniel J
DJ
Gentzler
Amy L
AL
Kiss
Eniko
E
Mayer
László
L
Kapornai
Krisztina
K
Vetró
Agnes
A
Kovacs
Maria
M
D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D006814:Hungary; D008297:Male; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D013223:Statistics as Topic