title: Relationship between sleep disturbance and depression, anxiety, and functioning in college students.
abstract: BACKGROUND
  Sleep disturbance (SD) has complex associations with depression, both preceding and following the onset and recurrence of depression. We hypothesized that students with depressive symptoms with SD would demonstrate a greater burden of comorbid psychiatric symptoms and functional impairment compared to students with depressive symptoms without SD.
  
  
  METHODS
  During a mental health screening, 287 undergraduate students endorsed symptoms of depression (Beck Depression Inventory [BDI] ≥ 13) and filled out the following self-report measures: demographic questionnaire, BDI, Anxiety Symptom Questionnaire-intensity and frequency (ASQ), Beck Hopelessness Scale (BHS), Beck Anxiety Inventory (BAI), Quality of Life Enjoyment and Satisfaction Questionnaire (QLESQ), and the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ). SD was measured using the BDI sleep item #16 dichotomized (score 0: no SD; or score > 0: some SD).
  
  
  RESULTS
  Students with depressive symptoms and SD (n = 220), compared to those without SD (n = 67), endorsed significantly more intense and frequent anxiety and poorer cognitive and physical functioning. Students with depressive symptoms with and without SD did not significantly differ in depressive severity, hopelessness, or quality of life.
  
  
  CONCLUSIONS
  College students with depressive symptoms with SD may experience a greater burden of comorbid anxiety symptoms and hyperarousal, and may have impairments in functioning, compared to students with depressive symptoms without SD. These findings require replication.
authors.affiliation: Depression Clinical & Research Program, Massachusetts General Hospital, Boston, MA 02114, USA. mnyer@partners.org
authors.forename: Maren
authors.initials: M
authors.lastname: Nyer
authors.forename: Amy
authors.initials: A
authors.lastname: Farabaugh
authors.forename: Kiki
authors.initials: K
authors.lastname: Fehling
authors.forename: David
authors.initials: D
authors.lastname: Soskin
authors.forename: Daphne
authors.initials: D
authors.lastname: Holt
authors.forename: George I
authors.initials: GI
authors.lastname: Papakostas
authors.forename: Paola
authors.initials: P
authors.lastname: Pedrelli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
authors.forename: Angela
authors.initials: A
authors.lastname: Pisoni
authors.forename: Ottavio
authors.initials: O
authors.lastname: Vitolo
authors.forename: David
authors.initials: D
authors.lastname: Mischoulon
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D017281:Cost of Illness; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology / Q000523:psychology*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult
keywords: anxiety; college students; depression; functioning; hopelessness; hyperarousal; mental health screening; quality of life; sleep