title: Ongoing or re-emerging subjective insomnia symptoms after full/partial remission or recovery of major depressive disorder mainly with the selective serotonin reuptake inhibitors and risk of relapse or recurrence: a 52-week follow-up study.
abstract: BACKGROUND
  Many patients who remit fully/partially or recover from an episode of major depression continue to suffer from sleep problems, mainly insomnia. Our study assesses the frequency and types of ongoing or re-emerging subjective insomnia symptoms and their relationship to subsequent depressive relapse or recurrence in a group of full/partial remitters or recoverers.
  
  
  METHODS
  Sixty patients, 18 to 65 years of age, with current MDD defined using DSM-IV-TR criteria were participated in the study. They began a 24-week course of open-label acute plus continuation phase treatment mainly with SSRIs. Maintenance treatment was not planned for not affecting natural relapse or recurrence rates. All participants were evaluated by CGI-S, BDI, HAMD-17, PSQI, and ISI at weeks 0, 4, 12, 24, and 52.
  
  
  RESULTS
  Majority of the participants (83.33%) had subjective sleep disturbance, insomnia prior to relapse or recurrence. Repeated measures ANOVA was used to evaluate changes in scores of depression and sleep scales over time between recurred (N = 12) and non-recurred groups (N = 48). Differences between means were calculated with post hoc Bonferroni comparison test. The changes in scores of entire clinical scales over time between recurred and non-recurred groups were statistically significant.
  
  
  CONCLUSIONS
  The limitations of this study include the use of a relatively small, mostly young female sample and the lack of an objective sleep measure to corroborate self-report scales.
  
  
  CONCLUSIONS
  Early recognition and treatment of disturbances of the sleep-wake cycle may be important for treatment and prevention of recurrence of depression.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Ataturk University, Erzurum, Turkey. mustafagulec78@yahoo.com
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gulec
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Selvi
authors.forename: Murat
authors.initials: M
authors.lastname: Boysan
authors.forename: Adem
authors.initials: A
authors.lastname: Aydin
authors.forename: Lutfullah
authors.initials: L
authors.lastname: Besiroglu
authors.forename: Mehmet Yucel
authors.initials: MY
authors.lastname: Agargun
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D055502:Secondary Prevention; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors