University Psychiatric Services Bern (UPD), Bern, Switzerland.
Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine University of Freiburg, Germany.
Sleep Med Rev. 2019 Feb;43:96-105. doi: 10.1016/j.smrv.2018.10.006. Epub 2018 Nov 16.
Previous research has identified insomnia as a predictor for the onset of depression. The aim of this meta-analysis is to investigate whether insomnia also predicts the onset of other mental disorders. Longitudinal studies were eligible for inclusion if they investigated insomnia at baseline (including nighttime- and daytime-symptoms) as a predictor of the later onset of psychopathology within a follow-up time-frame of at least 12 mo. Thirteen primary studies were included. The results suggest that insomnia is a significant predictor for the onset of depression (10 studies, OR 2.83, CI 1.55-5.17), anxiety (six studies, OR 3.23, CI 1.52-6.85), alcohol abuse (two studies, OR 1.35, CI 1.08-1.67, and psychosis (one study, OR 1.28, CI 1.03-1.59). The overall risk of bias in the primary studies was moderate. This meta-analysis provides evidence that insomnia increases the risk for psychopathology. A future research agenda should include more prospective studies using established diagnostic criteria, assessing insomnia at baseline and including long-term follow-up intervals evaluating a wider range of mental disorders. In addition, prospective long-term interventional studies investigating the efficacy of insomnia treatment for the prevention of mental disorders are called for.
先前的研究已经确定失眠是抑郁症发病的一个预测因素。本荟萃分析旨在调查失眠是否也可以预测其他精神障碍的发病。如果纵向研究在基线时（包括夜间和日间症状）将失眠作为预测因子，在至少 12 个月的随访时间内，调查失眠与随后发生精神病理学之间的关系，则符合纳入标准。共纳入 13 项主要研究。结果表明，失眠是抑郁症发病的一个显著预测因子（10 项研究，OR 2.83，CI 1.55-5.17）、焦虑症发病（6 项研究，OR 3.23，CI 1.52-6.85）、酒精滥用（2 项研究，OR 1.35，CI 1.08-1.67）和精神病发病（1 项研究，OR 1.28，CI 1.03-1.59）。主要研究的总体偏倚风险为中度。本荟萃分析提供了证据表明失眠增加了患精神障碍的风险。未来的研究议程应包括更多使用既定诊断标准的前瞻性研究，在基线时评估失眠，并包括长期随访间隔，以评估更广泛的精神障碍。此外，还需要开展前瞻性长期干预性研究，以调查失眠治疗对预防精神障碍的疗效。
