TY - JOUR
T1 - Polysomnographic features of early-onset depression
T2 - A meta-analysis
AU - Augustinavicius, Jura L.S.
AU - Zanjani, Anosha
AU - Zakzanis, Konstantine K.
AU - Shapiro, Colin M.
N1 - Funding Information:
No financial support was provided for the present research.
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/4
Y1 - 2014/4
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
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U2 - 10.1016/j.jad.2013.12.009
DO - 10.1016/j.jad.2013.12.009
M3 - Review article
C2 - 24655760
AN - SCOPUS:84894149759
SN - 0165-0327
VL - 158
SP - 11
EP - 18
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -