title: Obstructive sleep apnea (OSA) and clinical depression-prevalence in a sleep center.
abstract: BACKGROUND
  This study aimed to determine the prevalence of clinical depression as defined by ICD-10 criteria in all patients with obstructive sleep apnea (OSA) referred to a sleep center.
  
  
  METHODS
  Prospective general and sleep evaluations were conducted in 447 consecutive patients referred to our sleep center during the first quarter of 2008. Inclusion criteria were Apnea Hypopnea Index (AHI) > 9, completion of the Beck Depression Inventory (BDI-II) with a score ≥14 and World Health Organization WHO-5 Well-Being Index (WHO-5) ≤ 13. The subsequent psychiatric examination according to ICD-10 criteria was performed by in-house clinical sleep specialists.
  
  
  RESULTS
  A total of 447 patients were surveyed, of whom 322 had an AHI > 9. Out of these, 85 met the combined screening criterion BDI II ≥ 14 and WHO-5 ≤ 13. Eighty-one patients underwent a psychiatric examination by psychiatric sleep specialists. In 21.5 % of the sample, clinical depression was diagnosed. Other complaints existed in 12 % (n = 10); 7 % (n = 6) of patients had a different psychiatric diagnosis.
  
  
  CONCLUSIONS
  The prevalence of clinical depression according to ICD-10 criteria in a selected clinical sample (referred to the sleep center) was 21.5 %. Mood scales tend to overestimate complaints as compared to psychiatric consultation. Interdisciplinary cooperation is recommended for both OSA patients with symptoms of depression and depressed patients with treatment resistance.
authors.affiliation: Clinic for sleep medicine, Badstrasse 33, 5330, Bad Zurzach, Switzerland. jens.acker@gmx.ch.
authors.forename: Jens
authors.identifier: http://orcid.org/0000-0002-5875-656X
authors.initials: J
authors.lastname: Acker
authors.affiliation: University Clinic for Psychiatry and Psychotherapy, Paracelsus Private Medical University, Nuremberg, Germany.|Faculty of Social Sciences, University of Applied Sciences Georg Simon Ohm, Nuremberg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Richter
authors.affiliation: University Clinic for Psychiatry and Psychotherapy, Paracelsus Private Medical University, Nuremberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Piehl
authors.affiliation: Group practice for Respiratory Medicine Dr. J. Herold und A. Kaa, Roth, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Herold
authors.affiliation: University Clinic for Respiratory Medicine, Allergology and Sleep Medicine, Paracelsus Private Medical University, Nuremberg, Germany.
authors.forename: J H
authors.initials: JH
authors.lastname: Ficker
authors.affiliation: University Clinic for Psychiatry and Psychotherapy, Paracelsus Private Medical University, Nuremberg, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Niklewski
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005858:Germany; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D017286:Polysomnography; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D013223:Statistics as Topic
keywords: Comorbidity; Depressive disorder; Obstructive sleep apnea; Polysomnography; Sleep disorders