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Affective symptoms associated with the onset of major depression in the community: findings from the US National Institute of Mental Health Epidemiologic Catchment Area Program
Abstract
This study examined the strength of relationships between forms of depressive symptoms over a one‐year period and the onset of major depression. The data analyzed were collected in 4 sites of the US National Institute of Mental Health Epidemiologic Catchment Area Program (NIMH‐ECA, 1981–1985). The Diagnostic Interview Schedule's specifications of DSM‐III criteria for major depression were employed. Overall, the results indicated a strong positive association between an onset episode and the following depressive symptoms over 1 year: diminished sexual drive, feelings of worthlessness or excessive guilt and trouble concentrating or thinking. Sleep disturbance among women and fatigue among males were also significantly associated with experiencing an onset of major depression. The implications of the findings for secondary prevention efforts are explored.
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“or is one of the first clinical signs of a depressive disorder (Dryman and Eaton, 1991).”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Dryman and Eaton, 1991
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“…the role of insomnia in the onset of depression (for a review, see Riemann 2010), with meta-analytic findings showing that sleep disturbance yields a twofold increased risk of depression (Baglioni et al. 2011) or is one of the first clinical signs of a depressive disorder (Dryman & Eaton 1991).”
BackgroundDiscovering Endophenotypes for Major Depression
Hasler, G., Drevets, W. C., Manji, H. K., & Charney, D. S. (2004) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300506 · Cited by 1,123
“For example, anhedonia symptoms often precede the onset of MDD (Dryman and Eaton, 1991) and seem to be relatively stable over time (Oquendo et al, 2004).”
BackgroundEpidemiology of Insomnia, Depression, and Anxiety
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“Since the prodromal period of a first episode of major depression or anxiety disorder may be up to 8-10 years, 15,16 studies with shorter follow-up intervals do not cover a sufficient time span to distinguish between prodromal symptoms and putative risk factors.”
BackgroundCircadian rhythm disturbances in depression
Germain, A., & Kupfer, D. J. (2008) · Human Psychopharmacology: Clinical and Experimental · doi:10.1002/hup.964 · Cited by 644
“The risk of developing major depression is significantly increased in individuals complaining of insomnia (e.g., Breslau et al., 1996; Dryman and Eaton, 1991; Mallon et al., 2000; Weissman et al., 1997).”
Gregory, A. M., & O’Connor, T. G. (2002) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200208000-00015 · Cited by 667
“Similar findings have been reported by other investigators (Breslau et al., 1996; Dryman and Eaton, 1991; Livingston et al., 1993; Weissman et al., 1997).”
ResultSleep health: Reciprocal regulation of sleep and innate immunity
Irwin, M. R., & Opp, M. R. (2017) · Neuropsychopharmacology · doi:10.1038/npp.2016.148 · Cited by 624
“…in the onset of depression (for a review, see (Riemann, 2010)) and meta-analytic findings show that sleep disturbance independently predicts a twofold increased risk of depression (Baglioni et al, 2011) or is one of the first clinical signs of a depressive disorder (Dryman and Eaton, 1991).”
BackgroundInflammation-Induced Anhedonia: Endotoxin Reduces Ventral Striatum Responses to Reward
Eisenberger, N. I., Berkman, E. T., Inagaki, T. K., Rameson, L. T., Mashal, N. M., & Irwin, M. R. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.06.010 · Cited by 596
Self-reported sleep disturbance as a prodromal symptom in recurrent depression
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Self-citationAtlantis, E., & Sullivan, T. (2012) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2012.02709.x · Cited by 472
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“Dryman and Eaton used the NIMH Diagnostic Interview Schedule and the DSM-III criteria; we used a symptom checklist and the DSM-IV symptom criteria.”
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“…psychiatric disorders in general or psychic distress (d = .20–.53; Breslau, Roth, Rosenthal, & Andreski, 1996; Chang, Ford, Mead, Cooper-Patrick, & Klag, 1997; Dryman & Eaton, 1991; Ford & Kamerow, 1989; Roberts, Shema, Kaplan, & Strawbridge, 2000; Weissman, Greenwald, Nino-Murcia, & Dement, 1997).”
Insomnia as a Risk Factor for Onset of Depression in the Elderly
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“This has been shown in nine separate studies (Breslau, Roth, Rosenthal, & Andreski, 1996; Chang, Ford, Mead, Cooper-Patrick, & Klag, 1997; Dryman & Eaton, 1991; Ford & Kamerow, 1989; Livingston, Blizard, & Mann, 1993; Mallon, Broman, & Hetta, 2000; Roberts, Shema, Kaplan, & Strawbridge, 2000;…”
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“Anhedonia is a hallmark symptom of major depressive disorder (MDD), which precedes the onset of a depressive episode (Dryman and Eaton, 1991), influences its severity, and predicts the course of depression (Spijker et al.”
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“Dryman and Eaton analyzed data from 49 individuals enrolled in the US National Institute of Mental Health Catchment Area Program (NIMH-ECA) during the period 1981 to 1985, and found that anhedonia often precedes the onset of MDD [184].”
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“Anhedonia is an important symptom because, although pervasive negative affect is a feature of most emotional disorders, anhedonia is quite specific for depression (Dryman and Eaton 1991).”
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“To address the need to identify subgroups within high-risk populations which are at imminent high risk, the field should consider conceptualizing depressive symptoms as attributable risk factors for major depression ( Dryman & Eaton, 1991; Horwath, Johnson, Klerman, & Weissman, 1992), and, as the recent report by the…”
BackgroundNormal and abnormal sleep in the elderly
Cooke, J. R., & Ancoli‐Israel, S. (2010) · Handbook of clinical neurology · doi:10.1016/b978-0-444-52006-7.00041-1 · Cited by 204
“…of depressed mood may predict insomnia and, conversely, untreated insomnia may result in depression (Buysse et al. 1994; Cole & Dendukuri 2003; Dryman & Eaton 1991; Livingston, Blizard, & Mann 1993), and having insomnia at baseline is a significant predictor of developing depression one to…”
Insomnia and comorbid psychiatric disorders
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“[26-31] For example, Ford and Kamerow demonstrated that individuals with persistent insomnia were more likely to develop MDD than those without persistent insomnia.”
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Blunted reward responsiveness in remitted depression
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“In addition, anhedonia and/or reduced reward responsiveness have been found to precede the onset of depression (Dryman and Eaton, 1991), shows temporal stability (Oquendo et al., 2004), and predicts a variety of clinically important variables, including poor outcome in naturalistic studies (Spijker…”
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“Other studies based on the ECA have investigated the incidence of major depression in relation to current (13) and past symptoms (14).”
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“For adults, there is evidence from longitudinal studies suggesting that sleep disturbances may be prodromal for future risk of depression ( Dryman and Eaton, 1991; Ford and Kamerow, 1989; Rodin et al., 1988).”
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Carter, P. A., & Chang, B. L. (2000) · Cancer Nursing · doi:10.1097/00002820-200012000-00002 · Cited by 168
Etiology and Pathophysiology of Insomnia
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Etiologies of Associations Between Childhood Sleep and Behavioral Problems in a Large Twin Sample
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Circadian rhythms and depression: Human psychopathology and animal models
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“Generalized sleep disturbances are demonstrated to be associated with the development of depression [e.g., (Breslau et al., 1996; Dryman and Eaton, 1991; Mallon et al., 2000; Weissman et al., 1997)].”
BackgroundSmoking to self-medicate attentional and emotional dysfunctions
Gehricke, J., Loughlin, S. E., Whalen, C. K., Potkin, S. G., Fallon, J., Jamner, L. D., Belluzzi, J. D., & Leslie, F. M. (2007) · Nicotine & Tobacco Research · doi:10.1080/14622200701685039 · Cited by 169
Prospective Associations of Insomnia Markers and Symptoms With Depression
Szklo‐Coxe, M., Young, T. B., Peppard, P. E., Finn, L. A., & Benca, R. M. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwp454 · Cited by 151
Hickie, I. B., Naismith, S. L., Robillard, R., Scott, E. M., & Hermens, D. F. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-79 · Cited by 159
“Daytime fatigue and sleepiness [132,134,135]”
The Complex Role of Sleep in Adolescent Depression
Clarke, G. N., & Harvey, A. G. (2012) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2012.01.006 · Cited by 143
Corral-Frías, N. S., Nikolova, Y. S., Michalski, L. J., Baranger, D. A. A., Hariri, A. R., & Bogdan, R. (2015) · Psychological Medicine · doi:10.1017/s0033291715000525 · Cited by 132
“Evidence suggesting that anhedonia precedes the development of depression (Dryman & Eaton, 1991) and that hedonic impairments can be induced by stress (Pizzagalli, 2014) provide further support for this model.”
BackgroundSaletu-Zyhlarz, G. M., Abu‐Bakr, M. H., Anderer, P., Gruber, G., Mandl, M., Strobl, R., Gollner, D., Prause, W., & Saletu, B. (2002) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/s0278-5846(01)00262-7 · Cited by 133
“Insomnia might not only be a symptom of depression, but also occur prior to and even presage the development of a full clinical syndrome (Dryman and Eaton, 1991; Breslau et al., 1996; Roberts et al., 2000).”
BackgroundPrevalence, Correlates, and Predictors of Insomnia in the US Army prior to Deployment
Taylor, D. J., Pruiksma, K. E., Hale, W. J., Kelly, K., Maurer, D., Peterson, A. L., Mintz, J., Litz, B. T., & Williamson, D. E. (2016) · SLEEP · doi:10.5665/sleep.6156 · Cited by 134
Efficacy markers in depression
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“Anhedonia appears to be specific to depression (Dryman and Eaton, 1991) and has also been reported to persist outside periods of clinical remission (Hasler et al., 2004) While to some extent, anhedonia could occur as a response to the kinds of negative bias seen in the emotional processing tasks…”
BackgroundMajor depressive disorder in adolescence: the role of subthreshold symptoms
GEORGIADES, K., LEWINSOHN, P. M., MONROE, S. M., & SEELEY, J. R. (2006) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000223313.25536.47 · Cited by 118
“These findings are consistent with studies examining risk associated with specific subthreshold symptoms and onset of MDD in adults (Dryman and Eaton, 1991; Eaton et al., 1995; Roberts et al., 2000).”
BackgroundResultInfluentialWhich depressive symptoms are related to which sleep electroencephalographic variables?
Perlis, M. L., Giles, D. E., Buysse, D. J., Thase, M. E., Tu, X. M., & Kupfer, D. J. (1997) · Biological Psychiatry · doi:10.1016/s0006-3223(96)00439-8 · Cited by 120
Is there evidence for a male depressive syndrome in inpatients with major depression?
Möller-Leimkühler, A. M., Ronald Bottlender, A., Strauß, A., & Rutz, W. (2003) · Journal of Affective Disorders · doi:10.1016/s0165-0327(03)00051-x · Cited by 115
“Empirical data show consistently that men report fewer depressive symptoms than women, and little or no gender differences in the quality of depressive symptoms were found in community studies (Wittchen et al., 1999; Kivelä and Pahkala, 1988; Rajala et al., 1994; Wilhelm et al., 1998; Dryman and Eaton, 1991) as well a…”
BackgroundPredictors of mortality in patients diagnosed with probable Alzheimer's disease
Bowen, J. D., Malter, A. D., Sheppard, L. A., Kukull, W. A., McCormick, W. C., Teri, L. L., & Larson, E. B. (1996) · Neurology · doi:10.1212/wnl.47.2.433 · Cited by 115
Chronic Insomnia: Clinical and Research Challenges - An Agenda
Riemann, D. W., Spiegelhalder, K., Espie, C. A., Pollmächer, T., Léger, D., Bassetti, C. L., & Someren, E. J. W. V. (2010) · Pharmacopsychiatry · doi:10.1055/s-0030-1267978 · Cited by 114
Smith, M. T., Perlis, M. L., Chengazi, V., Pennington, J., Soeffing, J. P., Ryan, J. M., & Giles, D. E. (2002) · SLEEP · doi:10.1093/sleep/25.3.325 · Cited by 101
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“Self-reports of anhedonia predict the onset of major depression 1 year later (Dryman & Eaton, 1991), and undergraduate students and individuals with histories of depression report individual differences in hedonic capacity that are stable across long periods of time (Clark, Fawcett, Salazar-Grueso,…”
BackgroundInsomnia in relation to depression and anxiety: Epidemiologic considerations
Soldatos, C. R. (1994) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(94)90130-9 · Cited by 91
Jansson‐Fröjmark, M., & Linton, S. J. (2006) · Psychology and Health · doi:10.1080/14768320500129015 · Cited by 90
Are Sleep Difficulties Associated With Migraine Attributable to Anxiety and Depression?
Vgontzas, A., Cui, L., & Merikangas, K. R. (2008) · Headache The Journal of Head and Face Pain · doi:10.1111/j.1526-4610.2008.01175.x · Cited by 90
“For example, sleep problems were found to herald the onset of depression in a prospective study of a large population-based cohort by Dryman et al.47 Confirmation of these findings in other samples generated systematic intervention studies of sleep problems to reduce the incidence of episodes of major depression.48 Ho…”
ResultTaylor, D. J., Peterson, A. L., Pruiksma, K. E., Young‐McCaughan, S., Nicholson, K. L., & Mintz, J. (2017) · SLEEP · doi:10.1093/sleep/zsx075 · Cited by 88
Prodromal stage of major depression
Fava, G. A., & Tossani, E. (2007) · Early Intervention in Psychiatry · doi:10.1111/j.1751-7893.2007.00005.x · Cited by 85
Sleep and Its Disorders in Seniors
Stepnowsky, C. J., & Ancoli‐Israel, S. (2008) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2008.01.011 · Cited by 80
Wilcox, H. C., & Anthony, J. C. (2004) · Journal of Affective Disorders · doi:10.1016/j.jad.2003.10.007 · Cited by 78
“These results are also consistent with the literature on MDD clinical features as predictors of onset among adults (Dryman and Eaton, 1991; Horwath et al., 1992).”
BackgroundResultThe role of disturbed sleep in the early recognition of bipolar disorder: a systematic review
Ritter, P. S., Marx, C., Bauer, M., Lepold, K., & Pfennig, A. (2011) · Bipolar Disorders · doi:10.1111/j.1399-5618.2011.00917.x · Cited by 75
“A study by Dryman and Eaton (45) similarly investigated new onset depression in a large cohort and found that sleep disturbances (as defined by sleep questions in the Diagnostic Interview Schedule for DSM-III), in otherwise well adults, predicted depression only in females (OR = 9.4) but not in males (OR = 1.3).”
BackgroundInfluentialLiu, W., Roiser, J. P., Wang, L.-Z., Zhu, Y.-H., Huang, J., Neumann, D. L., Shum, D., Cheung, E. F. C., & Chan, R. C. K. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.10.050 · Cited by 84
“Anhedonia is often prodromal to major depression (Dryman and Eaton, 1991), can be relatively stable across episodes (Oquendo et al.”
BackgroundSleep as a Therapeutic Target in the Aging Brain
Bah, T. M., Goodman, J. R., & Iliff, J. J. (2019) · Neurotherapeutics · doi:10.1007/s13311-019-00769-6 · Cited by 76
Cuijpers, P. J., Smit, F., & Willemse, G. (2004) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2004.00416.x · Cited by 73
Quality of sleep during economic recession in Finland: A longitudinal cohort study
Hyyppä, M. T., Kronholm, E., & Alanen, E. (1997) · Social Science & Medicine · doi:10.1016/s0277-9536(96)00407-8 · Cited by 73
Fetveit, A. (2009) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/j.1447-0594.2009.00537.x · Cited by 68
Fatigue and psychiatric disorder: different or the same?
der Linden, G. V., Chalder, T., Hickie, I. B., Koschera, A., Sham, P. C., & Wessely, S. C. (1999) · Psychological Medicine · doi:10.1017/s0033291799008697 · Cited by 68
“In contrast, Dryman & Eaton (1991) using the ECA dataset, found that fatigue predicted the onset of depression over the following year.”
MethodDiagnosis, prevalence, pathways, consequences & treatment of insomnia.
Pigeon, W. R. (2010) · PubMed · Cited by 65
Depression and Sleep Disorders: Clinical Relevance, Economic Burden and Pharmacological Treatment
Brunello, N., Armitage, R., Feinberg, I., Holsboer‐Trachsler, E., Léger, D., Linkowski, P., Mendelson, W. B., Racagni, G., Saletu, B., Sharpley, A. L., et al. (2000) · Neuropsychobiology · doi:10.1159/000026680 · Cited by 68
Anhedonia and major depression: The role of agomelatine
Giannantonio, M. D., & Martinotti, G. (2012) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2012.07.004 · Cited by 62
“Different studies have found that anhedonia can precede the onset of a depressive episode (Dryman and Eaton, 1991), influence its severity, predicts poor outcome 12 months later (Spijker et al.”
BackgroundDoes Effective Management of Sleep Disorders Reduce Depressive Symptoms and the Risk of Depression?
Riemann, D. W. (2009) · Drugs · doi:10.2165/11531130-000000000-00000 · Cited by 62
“Dryman and Eaton 1991([8]) ‡18 9295 5.”
MethodInfluentialArnaldo, I., Corcoran, A. W., Friston, K. J., & Ramstead, M. J. D. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104590 · Cited by 56
“These plastic changes would explain anhedonic symptomatology that often precedes depressive episodes and characterizes melancholic depression (Dryman and Eaton, 1991).”
Propagation of major depressive disorder: Relationship between first episode symptoms and recurrence
Pettit, J. W., Lewinsohn, P. M., & Joiner, T. E. (2006) · Psychiatry Research · doi:10.1016/j.psychres.2005.07.022 · Cited by 56
“Other studies have investigated the predictive ability of subsyndromal depressive symptoms forMDDonset, reporting that up to seven of the nine DSM MDD criteria are subsyndromal risk factors for MDD onset (Dryman and Eaton, 1991; Eaton et al., 1995; Hadjiyannakis et al., 2005).”
Multimodal Investigations of Reward Circuitry and Anhedonia in Adolescent Depression
Ely, B. A., Nguyen, T. N. B., Tobe, R. H., Walker, A., & Gabbay, V. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.678709 · Cited by 57
“In adolescents, anhedonia often presents as a prodromal symptom prior to the onset of well-defined psychopathology (40, 41) and is associated with less favorable treatment responses (42–44), including persistence of depression symptoms into adulthood (8).”
BackgroundBechdolf, A., Schultze-Lutter, F., & Klosterkötter, J. (2002) · European psychiatry · doi:10.1016/s0924-9338(02)00698-3 · Cited by 53
Matteson-Rusby, S. E., Pigeon, W. R., Gehrman, P., & Perlis, M. L. (2010) · The Primary Care Companion to The Journal of Clinical Psychiatry · doi:10.4088/pcc.08r00743bro · Cited by 52
Cope, H., MANN, A. H., Pelosi, A. J., & David, A. S. (1996) · Psychological Medicine · doi:10.1017/s0033291700035923 · Cited by 52
Gosling, J. A., Glozier, N., Griffiths, K. M., Ritterband, L. M., Thorndike, F. P., Mackinnon, A. J., Hehir, K. K., Bennett, A., Bennett, K., & Christensen, H. M. (2014) · Trials · doi:10.1186/1745-6215-15-56 · Cited by 45
“All major longitudinal North American psychiatric epidemiological studies confirm this finding: the Epidemiological Catchment Area study [11], the National Comorbidity Study [12], Johns Hopkins Precursor study [13], the Stirling County Study 9 [14] and those from Europe [15] and elsewhere [16].”
BackgroundMajor depression in the primary care setting
Boswell, E. B., & Stoudemire, A. (1996) · The American Journal of Medicine · doi:10.1016/s0002-9343(96)00392-0 · Cited by 44
Mayers, A., van Hooff, J. C., & Baldwin, D. S. (2002) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.438 · Cited by 43
Personalized medicine: Prediction of disease vulnerability in mood disorders
Prendes-Alvarez, S., & Nemeroff, C. B. (2016) · Neuroscience Letters · doi:10.1016/j.neulet.2016.09.049 · Cited by 42
Fatigue is not associated with vitamin D deficiency in inflammatory bowel disease patients
Frigstad, S. O., Høivik, M. L., Jahnsen, J., Cvancarova, M., Grimstad, T. B., Berset, I. P., Huppertz‐Hauss, G., Hovde, Ø., Bernklev, T., Moum, B. A., et al. (2018) · World Journal of Gastroenterology · doi:10.3748/wjg.v24.i29.3293 · Cited by 42
Ahnquist, J., Wamala, S. P., & Lindström, M. (2010) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzq024 · Cited by 41
“Previous research has shown mild psychiatric symptoms to be associated with increased risk for severe psychiatric problems at a later stage [4–7] and predictors of severe psychiatric disease [4, 5, 8, 9].”
BackgroundGallo, J. J., Rabins, P. V., & Iliffe, S. (1997) · The International Journal of Psychiatry in Medicine · doi:10.2190/jf9w-9q87-kv0f-ycy4 · Cited by 40
The Temporal Association of Depression and Anxiety in Young Men with Erectile Dysfunction
Manalo, T. A., Biermann, H., Patil, D. H., & Mehta, A. (2021) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2021.11.011 · Cited by 39
The relationship between mood and sleep in different female reproductive states
Toffol, E., Kalleinen, N., Urrila, A. S., Himanen, S., Porkka‐Heiskanen, T., Partonen, T., & Polo‐Kantola, P. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-177 · Cited by 38
Goracci, A., Rucci, P., Forgione, R. N., Campinoti, G., Valdagno, M., Casolaro, I., Carretta, E., Bolognesi, S., & Fagiolini, A. M. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.02.034 · Cited by 38
“In addition, the risk of developing major depression is significantly higher in patients who complain of insomnia (Breslau et al., 1996; Dryman and Eaton, 1991; Mallon et al., 2000; Weissman et al., 1997).”
BackgroundOn the comparability of pharmacotherapy and behavior therapy for chronic insomnia
Perlis, M. L., Smith, M. T., Cacialli, D. O., Nowakowski, S., & Orff, H. (2003) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00547-0 · Cited by 36
“There is a great deal of data which clearly shows that chronic insomnia is a highly prevalent problem, that it is associated with substantial medical and psychiatric morbidity, and that the costs to society are staggering [13–27].”
BackgroundSelf-disparagement as feature and forerunner of depression: Findings from the Stirling County Study
Murphy, J. M., Nierenberg, A. A., Monson, R. R., Laird, N. M., Sobol, A. M., & Leighton, A. H. (2002) · Comprehensive Psychiatry · doi:10.1053/comp.2002.29842 · Cited by 33
Bradley, K., Case, J. A. C., Freed, R. D., Stern, E. R., & Gabbay, V. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.11.042 · Cited by 33
“Anhedonia, a reduced capacity to experience pleasure, is a known prodromal symptom for various psychiatric illnesses, including depression (Dryman and Eaton, 1991) and schizophrenia (Gelber et al., 2004).”
Otago Women's Health Survey 30-Month Follow-Up
Romans, S. E., Walton, V. A., McNoe, B., Herbison, P., & Mullen, P. E. (1993) · The British Journal of Psychiatry · doi:10.1192/bjp.163.6.739 · Cited by 33
Metadata
- Authors
- Dryman, A., & Eaton, W. W.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Dryman, A.
- ORCID
- Eaton, W. W.
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 1991-07
- Volume
- 84
- Issue
- 1
- Pages
- 1-5
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W2018277040
- Cited by
- 169
- References
- 22
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 1 · 2019: 5 · 2018: 2 · 2017: 2 · 2016: 9 · 2015: 5 · 2014: 9 · 2013: 10 · 2012: 10
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (3u01mh033883-05s3)
- National Institute of Mental Health (U01 MH-33883, U01 MH34224, U01 MH 38870)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- major depressive disorder, depression onset, depressive symptoms, affective symptoms, sleep disorders, fatigue, sexual drive, guilt, worthlessness, concentration difficulties, sex differences, secondary prevention, community mental health
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Catchment Area, Health, Depressive Disorder, Fatigue, Female, Follow-Up Studies, Guilt, Humans, Longitudinal Studies, Male, Middle Aged, Psychiatric Status Rating Scales, Self Concept, Sexual Behavior, Sex Factors, Sleep Wake Disorders, United States
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