Advertisement

Psychiatric Comorbidity: The Case for Treating Insomnia

      Insomnia is commonly associated with other psychiatric disorders. In fact, persons who have insomnia are approximately three times more likely to meet diagnostic criteria for another psychiatric disorder than those who do no have a sleep disturbance [
      • Ford D.
      • Kamerow D.
      Epidemiologic study of sleep disturbances in psychiatric disorders.
      ,
      • Ohayon M.
      Prevalence of DSM-IV diagnostic criteria of insomnia: distinguishing insomnia related to mental disorders from sleep disorders.
      ]. Although this predilection indicates that there is a special relationship between insomnia and other psychiatric disorders, the nature of that relationship has been a matter of some confusion.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Sleep Medicine Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ford D.
        • Kamerow D.
        Epidemiologic study of sleep disturbances in psychiatric disorders.
        JAMA. 1989; 262: 1479-1484
        • Ohayon M.
        Prevalence of DSM-IV diagnostic criteria of insomnia: distinguishing insomnia related to mental disorders from sleep disorders.
        J Psychiatr Res. 1997; 31: 333-346
        • NIH
        Consensus conference: drugs and insomnia: the use of medications to promote sleep.
        JAMA. 1984; 251: 2410-2414
        • Tsuno N.B.A.
        • Ritchie K.
        Sleep and depression.
        J Clin Psych. 2005; 66: 1254-1269
        • Belanger L.
        • Morin C.M.
        • Langlois F.
        • et al.
        Insomnia and generalized anxiety disorder: effects of cognitive behavior therapy for GAD on insomnia symptoms.
        J Anxiety Disord. 2004; 18: 561-571
        • American Psychiatric Association
        Diagnostic and statistical manual of mental disorders.
        4th edition, text revision. American Psychiatric Association, Washington (DC)2001
        • Breslau N.
        • Roth T.
        • Rosenthal L.
        • et al.
        Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults.
        Biol Psychiatry. 1996; 39: 411-418
        • Weissman M.M.
        • Greenwald S.
        • Nino-Murcia G.
        • et al.
        The morbidity of insomnia uncomplicated by psychiatric disorders.
        Gen Hosp Psychiatry. 1997; 19: 245-250
        • Roberts R.E.
        • Shema S.J.
        • Kaplan G.A.
        • et al.
        Sleep complaints and depression in an aging cohort: a prospective perspective.
        Am J Psychiatry. 2000; 157: 81-88
        • Livingston G.B.B.
        • Mann A.
        Does sleep disturbance predict depression in elderly people? A study in inner London.
        Br J Gen Pract. 1994; 44: 445-448
        • Ford D.
        • Cooper-Patrick L.
        Sleep disturbances and mood disorders: an epidemiologic perspective.
        Depress Anxiety. 2001; 14: 3-6
        • Reynolds III, C.F.
        • Frank E.
        • Houck P.R.
        • et al.
        Which elderly patients with remitted depression remain well with continued interpersonal psychotherapy after discontinuation of antidepressant medication?.
        Am J Psychiatry. 1997; 154: 958-962
        • Fawcett J.
        • Scheftner W.A.
        • Fogg L.
        • et al.
        Time-related predictors of suicide in major affective disorder.
        Am J Psychiatry. 1990; 147: 1189-1194
        • Fava G.
        • Grandi S.
        • Canestrari R.
        • et al.
        Prodromal symptoms in primary major depressive disorder.
        J Affect Disord. 1990; 19: 149-152
        • Koren D.
        • Arnon I.
        • Lavie P.
        • et al.
        Sleep complaints as early predictors of posttraumatic stress disorder: a 1-year prospective study of injured survivors of motor vehicle accidents.
        Am J Psychiatry. 2002; 159: 855-857
        • Currie Sr., C.S.
        • Rimac S.
        • Malhotra S.
        Comprehensive assessment of insomnia in recovering alcoholics using daily sleep diaries and ambulatory monitoring.
        Alcohol Clin Exp Res. 2003; 27: 1262-1269
        • Brower K.J.
        • Aldrich M.S.
        • Robinson E.A.
        • et al.
        Insomnia, self-medication, and relapse to alcoholism.
        Am J Psychiatry. 2001; 158: 399-404
        • Drummond S.P.
        • Gillin J.C.
        • Smith T.L.
        • et al.
        The sleep of abstinent pure primary alcoholic patients: natural course and relationship to relapse.
        Alcohol Clin Exp Res. 1998; 22: 1796-1802
        • National Institutes of Health
        National Institutes of Health State of the Science Conference Statement. Manifestations and management of chronic insomnia in adults, June 13–15, 2005.
        Sleep. 2005; 28: 1049-1057
        • Nierenberg A.A.
        • Keefe B.R.
        • Leslie V.C.
        • et al.
        Residual symptoms in depressed patients who respond acutely to fluoxetine.
        J Clin Psychiatry. 1999; 60: 221-225
        • Manber R.
        • Rush A.J.
        • Thase M.E.
        • et al.
        The effects of psychotherapy, nefazodone, and their combination on subjective assessment of disturbed sleep in chronic depression.
        Sleep. 2003; 26: 130-136
        • Asnis G.M.
        • Chakraburtty A.
        • DuBoff E.A.
        • et al.
        Zolpidem for persistent insomnia in SSRI-treated depressed patients.
        J Clin Psychiatry. 1999; 60: 668-676
        • Nierenberg A.A.
        • Adler L.A.
        • Peselow E.
        • et al.
        Trazodone for antidepressant-associated insomnia.
        Am J Psychiatry. 1994; 151: 1069-1072
        • Londborg P.D.
        • Smith W.T.
        • Glaudin V.
        • et al.
        Short-term cotherapy with clonazepam and fluoxetine: anxiety, sleep disturbance and core symptoms of depression.
        J Affect Disord. 2000; 61: 73-79
        • Fava M.
        • McCall W.V.
        • Krystal A.
        • et al.
        Eszopiclone co-administered with fluoxetine in patients with insomnia coexisting with major depressive disorder.
        Biol Psychiatry. 2006; 59: 1052-1060
        • Monti J.
        • Monti D.
        Sleep disturbance in generalized anxiety disorder and its treatment.
        Sleep Med Rev. 2000; 4: 263-276
        • Rosenthal M.
        Tiagabine for the treatment of generalized anxiety disorder: a randomized, open-label, clinical trial with paroxetine as a positive control.
        J Clin Psych. 2003; 64: 1245-1249
        • Fontaine R.
        • Beaudry P.
        • Le Morvan P.
        • et al.
        Zopiclone and triazolam in insomnia associated with generalized anxiety disorder: a placebo-controlled evaluation of efficacy and daytime anxiety.
        Int Clin Psychopharmacol. 1990; 5: 173-183
        • Agnoli A.
        • Manna V.
        • Martucci N.
        Double-blind study on the hypnotic and antianxiety effects of zopiclone compared with nitrazepam in the treatment of insomnia.
        Int J Clin Pharmacol Res. 1989; 9: 277-281
        • Saletu B.
        • Anderer P.
        • Brandstatter N.
        • et al.
        Insomnia in generalized anxiety disorder: polysomnographic, psychometric and clinical investigations before, during and after therapy with a long- versus a short-half-life benzodiazepine (quazepam versus triazolam).
        Neuropsychobiology. 1994; 29: 69-90
        • Lejoyeux M.
        • Solomon J.
        • Ades J.
        Benzodiazepine treatment for alcohol-dependent patients.
        Alcohol Alcohol. 1998; 33: 563-575
        • Currie S.R.
        • Clark S.
        • Hodgins D.C.
        • et al.
        Randomized controlled trial of brief cognitive-behavioural interventions for insomnia in recovering alcoholics.
        Addiction. 2004; 99: 1121-1132
        • Le Bon O.
        • Murphy J.R.
        • Staner L.
        • et al.
        Double-blind, placebo-controlled study of the efficacy of trazodone in alcohol post-withdrawal syndrome: polysomnographic and clinical evaluations.
        J Clin Psychopharmacol. 2003; 23: 377-383
        • Karam-Hage M.
        • Brower K.J.
        Open pilot study of gabapentin versus trazodone to treat insomnia in alcoholic outpatients.
        Psychiatry Clin Neurosci. 2003; 57: 542-544