Polysomnographic features of early-onset depression: A meta-analysis

Jura Augustinavicius, Anosha Zanjani, Konstantine K. Zakzanis, Colin M. Shapiro

Research output: Contribution to journalReview article

Abstract

Background: Undiagnosed major depressive disorder (MDD) is associated with increased morbidity in children and adolescents. This study evaluated features of sleep macro- and microarchitecture assessed by polysomnography (PSG) as diagnostic markers for MDD in children and adolescents. Methods: MEDLINE, PSYCINFO, EMBASE and PUBMED were searched from their availability dates to March 1st, 2013. The literature search identified 932 abstracts of which 51 studies were retrieved and 28 were included in the analysis. Study design, features of sleep macro- and microarchitecture, demographic and clinical characteristics of study groups were extracted for each study. Results: There were modest differences on sleep macroarchitecture between children and adolescents with MDD and healthy controls. The most robust difference was found in sleep latency, 31% of adolescents with MDD had increased sleep latency. Age, suicidal ideation, suicidal behavior, and psychiatric comorbidities were significant predictors of sleep macroarchitecture. Modest differences were found for sleep microarchitecture, intrahemispheric and interhemispheric temporal coherence was decreased in a third of patients with MDD. Age was a significant predictor of sleep microarchitecture. Limitations: This meta-analysis is limited by the small number of studies on sleep macroarchitecture in children with MDD and studies on sleep microarchitecture overall and by the heterogeneity in methodology between studies. Conclusions: This synthetic review of the existing literature is among the largest to quantitatively assess impaired sleep as a diagnostic marker for MDD in children and adolescents. Knowledge of sleep macro- and microarchitecture in early-onset MDD may aid the clinician in developing a treatment strategy for MDD-related sleep symptoms in a subset of patients.

Original languageEnglish (US)
Pages (from-to)11-18
Number of pages8
JournalJournal of Affective Disorders
Volume158
DOIs
StatePublished - Apr 1 2014
Externally publishedYes

Fingerprint

Meta-Analysis
Sleep
Major Depressive Disorder
Depression
Suicidal Ideation
Polysomnography
MEDLINE
Psychiatry
Comorbidity
Demography
Morbidity

Keywords

  • Depression
  • Major depressive disorder
  • Pediatrics
  • Polysomnography
  • Sleep
  • Sleep electroencephalography

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Polysomnographic features of early-onset depression : A meta-analysis. / Augustinavicius, Jura; Zanjani, Anosha; Zakzanis, Konstantine K.; Shapiro, Colin M.

In: Journal of Affective Disorders, Vol. 158, 01.04.2014, p. 11-18.

Research output: Contribution to journalReview article

Augustinavicius, Jura ; Zanjani, Anosha ; Zakzanis, Konstantine K. ; Shapiro, Colin M. / Polysomnographic features of early-onset depression : A meta-analysis. In: Journal of Affective Disorders. 2014 ; Vol. 158. pp. 11-18.
@article{8fda044e80814c119c49b59c3e91644f,
title = "Polysomnographic features of early-onset depression: A meta-analysis",
abstract = "Background: Undiagnosed major depressive disorder (MDD) is associated with increased morbidity in children and adolescents. This study evaluated features of sleep macro- and microarchitecture assessed by polysomnography (PSG) as diagnostic markers for MDD in children and adolescents. Methods: MEDLINE, PSYCINFO, EMBASE and PUBMED were searched from their availability dates to March 1st, 2013. The literature search identified 932 abstracts of which 51 studies were retrieved and 28 were included in the analysis. Study design, features of sleep macro- and microarchitecture, demographic and clinical characteristics of study groups were extracted for each study. Results: There were modest differences on sleep macroarchitecture between children and adolescents with MDD and healthy controls. The most robust difference was found in sleep latency, 31{\%} of adolescents with MDD had increased sleep latency. Age, suicidal ideation, suicidal behavior, and psychiatric comorbidities were significant predictors of sleep macroarchitecture. Modest differences were found for sleep microarchitecture, intrahemispheric and interhemispheric temporal coherence was decreased in a third of patients with MDD. Age was a significant predictor of sleep microarchitecture. Limitations: This meta-analysis is limited by the small number of studies on sleep macroarchitecture in children with MDD and studies on sleep microarchitecture overall and by the heterogeneity in methodology between studies. Conclusions: This synthetic review of the existing literature is among the largest to quantitatively assess impaired sleep as a diagnostic marker for MDD in children and adolescents. Knowledge of sleep macro- and microarchitecture in early-onset MDD may aid the clinician in developing a treatment strategy for MDD-related sleep symptoms in a subset of patients.",
keywords = "Depression, Major depressive disorder, Pediatrics, Polysomnography, Sleep, Sleep electroencephalography",
author = "Jura Augustinavicius and Anosha Zanjani and Zakzanis, {Konstantine K.} and Shapiro, {Colin M.}",
year = "2014",
month = "4",
day = "1",
doi = "10.1016/j.jad.2013.12.009",
language = "English (US)",
volume = "158",
pages = "11--18",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",

}

TY - JOUR

T1 - Polysomnographic features of early-onset depression

T2 - A meta-analysis

AU - Augustinavicius, Jura

AU - Zanjani, Anosha

AU - Zakzanis, Konstantine K.

AU - Shapiro, Colin M.

PY - 2014/4/1

Y1 - 2014/4/1

N2 - Background: Undiagnosed major depressive disorder (MDD) is associated with increased morbidity in children and adolescents. This study evaluated features of sleep macro- and microarchitecture assessed by polysomnography (PSG) as diagnostic markers for MDD in children and adolescents. Methods: MEDLINE, PSYCINFO, EMBASE and PUBMED were searched from their availability dates to March 1st, 2013. The literature search identified 932 abstracts of which 51 studies were retrieved and 28 were included in the analysis. Study design, features of sleep macro- and microarchitecture, demographic and clinical characteristics of study groups were extracted for each study. Results: There were modest differences on sleep macroarchitecture between children and adolescents with MDD and healthy controls. The most robust difference was found in sleep latency, 31% of adolescents with MDD had increased sleep latency. Age, suicidal ideation, suicidal behavior, and psychiatric comorbidities were significant predictors of sleep macroarchitecture. Modest differences were found for sleep microarchitecture, intrahemispheric and interhemispheric temporal coherence was decreased in a third of patients with MDD. Age was a significant predictor of sleep microarchitecture. Limitations: This meta-analysis is limited by the small number of studies on sleep macroarchitecture in children with MDD and studies on sleep microarchitecture overall and by the heterogeneity in methodology between studies. Conclusions: This synthetic review of the existing literature is among the largest to quantitatively assess impaired sleep as a diagnostic marker for MDD in children and adolescents. Knowledge of sleep macro- and microarchitecture in early-onset MDD may aid the clinician in developing a treatment strategy for MDD-related sleep symptoms in a subset of patients.

AB - Background: Undiagnosed major depressive disorder (MDD) is associated with increased morbidity in children and adolescents. This study evaluated features of sleep macro- and microarchitecture assessed by polysomnography (PSG) as diagnostic markers for MDD in children and adolescents. Methods: MEDLINE, PSYCINFO, EMBASE and PUBMED were searched from their availability dates to March 1st, 2013. The literature search identified 932 abstracts of which 51 studies were retrieved and 28 were included in the analysis. Study design, features of sleep macro- and microarchitecture, demographic and clinical characteristics of study groups were extracted for each study. Results: There were modest differences on sleep macroarchitecture between children and adolescents with MDD and healthy controls. The most robust difference was found in sleep latency, 31% of adolescents with MDD had increased sleep latency. Age, suicidal ideation, suicidal behavior, and psychiatric comorbidities were significant predictors of sleep macroarchitecture. Modest differences were found for sleep microarchitecture, intrahemispheric and interhemispheric temporal coherence was decreased in a third of patients with MDD. Age was a significant predictor of sleep microarchitecture. Limitations: This meta-analysis is limited by the small number of studies on sleep macroarchitecture in children with MDD and studies on sleep microarchitecture overall and by the heterogeneity in methodology between studies. Conclusions: This synthetic review of the existing literature is among the largest to quantitatively assess impaired sleep as a diagnostic marker for MDD in children and adolescents. Knowledge of sleep macro- and microarchitecture in early-onset MDD may aid the clinician in developing a treatment strategy for MDD-related sleep symptoms in a subset of patients.

KW - Depression

KW - Major depressive disorder

KW - Pediatrics

KW - Polysomnography

KW - Sleep

KW - Sleep electroencephalography

UR - http://www.scopus.com/inward/record.url?scp=84894149759&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84894149759&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2013.12.009

DO - 10.1016/j.jad.2013.12.009

M3 - Review article

C2 - 24655760

AN - SCOPUS:84894149759

VL - 158

SP - 11

EP - 18

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -