Jur Nal Depress i

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Quarterly scientific, online publication by Department of Nursing A,

Technological Educational Institute of Athens

Insomnia and


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depression in primary psychiatric care

ngeliki Statharou, !hristina Taka"

# $N, %Sc, ADepartment of &sychiatry clinic, 'ni(ersity of Athens, Aiginitio )ospital

"#$N, %S*c+, ADepartment of &sychiatry clinic, 'ni(ersity of Athens, Aiginitio )ospital

AST$A!T

-$E.IE/-

ackground0 Insomnia

is most often 1ust a

symptom of depression#

)o2e(er, a gro2ing

body of e(idence

suggests that insomnia

is not 1ust a symptom

of depression, but that

it may actually precede

depression#

Aim0 The aim of the

present study 2as to

e3plore relation

bet2een insomnia and

depression#

%aterial and method0

$esearch 2as carried

out 2ithin the 4reek

and international

bibliography# /e used

the /eb data base

including 5

medline6pubmed,

2ikipedia, medscape7

2ith key72ords0

insomnia,

relationship,

depression, primary

care#

$esults0 Insomnia is an

e3tremely common

condition 2ith ma1or

social and economic

conse8uences

2orld2ide# In spite of

its pre(alence and

significant negati(e

impact on the 8uality of

life, insomnia

recei(es inade8uate

attention from health

authorities and

physicians#


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!onclusion0 The ne2 findings are especially significant because they suggest that targeted treatment for

insomnia 2ill increase the likelihood and speed of reco(ery from depression#

9ey 2ords0 Insomnia, relationship, depression, primary care#

!:$$ES&:NDIN4 A'T):$

Statharou Angeliki

Theoklitou ;

!#0;?"?@>"B,@>B", ;BInsomnia and depression in primary psychiatric care


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)EAT)S!IEN!EF:'$NAG.olume , Issue > *Fuly 5 September "?"+

&atients usually find it difficult to sleep

Sleep Disorders

Sleep is of (ital significance for the body

and constitutes a normal condition# Hor

e3ample, a " year old child sleeps

around B hours, a person "=7


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only treat pain but sleep disturbances as

2ell#

Depression

The rate of depression, 2orld2ide, is

8uite high and usually both depression

and depressi(e symptoms are not

diagnosed in some situations, especially

in the elderly# The diagnostic criteria for

depression in the elderly ha(e certain

characteristics such as0 the depressi(e

mood is not the ma1or symptom

manifested by the elderly, and the se(ere

reduction in functioning caused by

insomnia is sometimes misinterpreted as

a result of old age# Depressi(e

or bulimia, increased or decreased body

2eight, impaired concentration and

psychomotor slo2ing, psychological and

somatic distress, and negati(e affect

*ideas 6 thoughts of guilt, 2orthlessness,

death 2ishes+# *Fuly 5 September "?"+

factor for depression,

but can perpetuate

the disorder in the long run#

Fules Angsts

studied a sample of =@patients 2ith psychiatric, somatic

symptoms as 2ell as sleep disorders# The

study 2as conducted 2ithin "? years

during 2hich the patients 2ere e(aluated

in a series of inter(ie2s# The results

sho2ed that insomnia is a common

symptom of depression, most often

manifested before depression and is a

risk factor e(en after a long period of

time# Another epidemiological study

reported that people 2ith insomnia are

at a high risk for a depressi(e episode

2ithin >#= years, e(en if they dont ha(e

a psychiatric history#;

et2een "??? and "??> in Italy t2o

obser(ational studies on insomnia 2ere

conducted, the %orfeo I and %orfeo II#

The results sho2ed a high incidence of

insomnia, as 2ell as a high impact in

health and public resources and

conse8uently e3cessi(e use of health

ser(ices#B, @

:ther studies report that patients from

non7/estern cultures and de(eloping

countries e3press somatic complaints

and deny any psychological problems,

more often than patients from /estern

cultures# This can be e3plained by the

fact that they are not 2illing to e3pose

their psychiatric problem, or they cannot

e3ternaliPe their emotional distress#"?

$esearchers report that although

insomnia and depression coe3ist,ho2e(er, it is important to understand

the reason for this coe3istence# 'ntil

recently it 2as considered that

depression causes insomnia# )o2e(er,

studies sho2ed that in cases 2here

patients manifested depression and

insomnia 2hen they 2ere gi(enpharmacological treatment although

their depressi(e symptoms 2ere

ameliorated this 2as not the case for

their insomnia# %ichael &erlis, director

of the Sleep $esearch aboratory of the

'ni(ersity of $ochester, reported that

the focus should be in treating insomnia

2hich 2ill increase the treatment

outcome of depression# :ngoing

in(estigation of the connection bet2een

insomnia and depression through clinical

trials and research can help impro(e

sleep disorders#"

Sleep disturbances are common in

bipolar disorder# Ele(en studies *sample0

> patients, diagnosis0 bipolar disorder+

sho2ed that insomnia 2as the most

common symptom precursor of mania

*;; of patients+ and the si3th most

common symptom of bipolar disorder

*"B

E7ISSN0 ;@7B?@M )ealth Science Fournal All rights reser(ed 222#hs1#gr


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hippomanic symptoms in a large number

of patients#"> In addition to the fact that

it is a risk factor for a depressi(e

episode, 2hen insomnia is not treated

early, it can perpetuate depression in

elderly patients, especially those 2ho

ha(e been treated only for depression#""B0>7"@#

"#Daley %E, elanc %, %orin !%, The

impact of insomnia on absenteeism

producti(ity, and accident rates,

&rogram and abstracts of the

doctor# Therapy can impro(e 8uality of Association &rofessional Sleep

life for many patients# Sleep disturbances

are a precursor to mental and physical

illness or both# In some patients,

Societies @thAnnual %eeting, Fune

B7">, "??=#

>#ynch H, !larke 4N, Estimating the

economic burden of depression in

&age >B"

Insomnia and depression in primary psychiatric care


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)EAT)S!IEN!EF:'$NAG.olume , Issue > *Fuly 5 September "?"+

children and

adolescents# Am

F &re(

%ed# "??>* Suppl +0S7=#

; 8uiP


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E7ISSN0 ;@7B?@M )ealth Science Fournal All rights reser(ed 222#hs1#gr


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#/ebsite



0 Insomnia And Depression $e(ealed,

222#medicalne2stoday#com6ne2slett

ers#php, ink et2een Insomnia And

Depression In oung Adults 7 Ne2

Study In The Fournal SEE&, "??B#

Accessed 0 7?7"??B#

;#reslau N, $oth T, $osenthal ,

Adrenski Sleep disturbance and

psychiatric disorders0 a longitudinal

epidemiological study of young

adults# iol &sychiatry# @@>*+0

;


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Insomnia and depression in primary psychiatric care

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