Sleep Med Psychophysiol.  2012 Dec;19(2):84-88.

Effect of Major Depressive Disorder and Insomnia on Somatization

Affiliations
  • 1Settlement Support Center for North Korean Refugee (Hanawon), Ministry of Unification, Ansung, Korea.
  • 2Department of Medicine, Seoul National University College of Medicine, Seoul, Korea. psychical@hanmail.net
  • 3Department of Psychiatry, Gachon Medical School, Incheon, Korea.

Abstract

INTRODUCTION
The objective of the present study was to investigate the independent effects of major depressive disorder (MDD) and insomnia on somatization, respectively.
METHODS
A total of 181 participants (73 males and 108 females ; mean age 41.59+/-8.92) without serious medical problem were recruited from a community and a psychiatric clinic in Republic of Korea. Subjects were divided into 4 groups based on the Structured Clinical Interview for DSM-IV axis I disorder (SCID-IV) and sleep questionnaire : 1) normal controls (n=127), 2) primary insomnia (n=11), 3) MDD without insomnia (n=14), and 4) MDD with insomnia (n=29). All participants were requested to complete the somatization subscores of the Symptom Checklist-90-Revised (SCL-90-R).
RESULTS
There were significant between-group differences in somatization score (F=25.30, p<0.001). Subjects with both MDD and insomnia showed higher somatization score compared to normal control (p<0.001), subjects with primary insomnia (p=0.01), or MDD subjects without insomnia (p<0.001). Subjects with primary insomnia had higher somatization score than normal controls (p<0.01), while there was no significant difference between MDD subjects without insomnia and normal controls. In multiple regression, presence of insomnia predicted higher somatization score (beta=0.44, p<0.001), while there was only non-significant association between MDD and somatization (beta=0.14, p=0.08).
CONCLUSION
In the current study, insomnia was associated with somatization independently from major depression. Subjects with primary insomnia showed higher somatization. Within MDD patients, presence of insomnia was related to higher somatization. Our finding suggests that insomnia may partly mediate the relationship between depression and somatization.

Keyword

Depression; Insomnia; Somatization

MeSH Terms

Axis, Cervical Vertebra
Depression
Depressive Disorder, Major
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Male
Surveys and Questionnaires
Republic of Korea
Sleep Initiation and Maintenance Disorders
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