Dados do Trabalho

Título

Sleep complaints in depressed youth: the severity of the illness recognized by diagnostic interview for children and adolescents

Introdução

Affective disorders are common forms of mental illness. In adults, sleep disturbances have been linked to greater depression severity associated with suicidal behavior. However, the prevalence of sleep complaints among children with depression remains unclear. Additionally, these complaints may impose a significant and potentially lifelong burden on the developing child.

Objetivo

This study aimed to investigate whether depressed youth with more sleep complaints exhibit higher depression scores and how these sleep issues impact their overall functioning.

Métodos

The study's target population consisted of 142 youths with current major depressive disorder (MDD) and sleep complaints, as identified using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria and Diagnostic Interview for Children and Adolescents (DICA-IV), from two research databases, consecutively referred to an outpatient clinic. The severity of depression in these youths was measured using the 16- item Children's Depression Rating Scale (CDRS). The level of functioning over the past month was evaluated with the Children's Global Assessment Scale (CGAS). A one-way ANOVA was conducted to compare the CDRS T-scores and CGAS scores among youths with 1 to 4 sleep complaints.

Resultados

All subjects (n=142) in this sample reported sleep complaints (mean age = 11 ± 8.1 years; 54.9% boys), with 57% of the sample younger than 12 years (n=81). The average Children's Depression Rating Scale (CDRS) T-score was 78.7 ± 7.1. Among the participants, 88.7% experienced initial insomnia, 54.2% had night awakenings, 34.5% had early awakenings, and 31% exhibited hypersomnia. Youths with three or more sleep complaints had significantly higher CDRS T- scores [F(3, 138) = 5.7, p = 0.001], particularly among adolescent boys [F(3, 138) = 3.1, p = 0.027]. The presence of multiple sleep problems did not significantly affect the overall behavioral dysfunction according to the Children's Global Assessment Scale (CGAS) score [F (3, 138) = .96, p = 0.41].

Conclusões

We identified an association between severe depression and disrupted sleep processes that was not linked to overall daytime behavioral dysfunction. Specific sleep complaints may have differential impacts on the daytime function of depressed youth, increasing the risk of suicidal behavior. A detailed assessment of sleep complaints in youths with depressive episodes and the prevalence of sleep complaints in depressed youths needs further clarification.

Palavras -chave

Afective Disorders, Sleep, Youth