Quality of life impacts associated with comorbid insomnia and depression in adult population.

IF 3.3 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES Quality of Life Research Pub Date : 2024-12-01 Epub Date: 2024-09-26 DOI:10.1007/s11136-024-03793-y

Phuong Hong Le, Long Khanh-Dao Le, Shantha M W Rajaratnam, Cathrine Mihalopoulos

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Abstract

Purpose: Health-related quality of life (HRQoL) impacts of insomnia and depression (as separated entities) have been well investigated in previous studies. However, little is known about the effect of comorbid insomnia and depression on HRQoL. This study aimed to assess the impacts of insomnia and depression, in combination or alone, on HRQoL in Australian adults.

Methods: Data used in this study were obtained from the large-scale longitudinal Household, Income and Labour Dynamics in Australia (HILDA) survey. Insomnia was defined using key insomnia criteria of DSM-V. Depression was based on validated cut-off points of the Mental Health Inventory-5 (MHI-5) (scores ≤ 62) in the base case analysis. HRQoL expressed as utility scores (ranging from 0 to 1) were measured using the Short-Form 6-Dimension (SF-6D) converted from the SF-36 and valued using an Australian scoring algorithm. Multi-level modelling was applied to assess the effect of insomnia and/or depression on utility scores.

Results: The study analysed 30,972 observations from 10,324 individuals (age [mean ± SD]: 45.7 ± 16.5, female: 54.6%). The proportion of individuals with insomnia only, depression only, and comorbid insomnia and depression was 11.3%, 11.6%, and 8.2%, respectively. The interaction effect suggested the combined impact of insomnia and depression on health-related quality of life beyond the sum of their individual effects. Marginal mean difference in utility scores for insomnia only, depression only, and the comorbidity relative to no insomnia or depression was -0.058 (SE: 0.003, Cohen's d: 0.420, small effect), -0.210 (SE: 0.003, Cohen's d: 1.530, large effect), and -0.291 (SE: 0.004, Cohen's d: 2.120, large effect), respectively.

Conclusion: Comorbid depression and insomnia appear to have very large quality-of-life impacts. Furthermore, this is the first study that has estimated the magnitude of the impact of comorbid insomnia and depression on utility scores which can be utilised in future clinical or economic studies.

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成人群体中失眠和抑郁并发症对生活质量的影响。

目的：以往的研究已对失眠和抑郁（作为独立个体）对健康相关生活质量（HRQoL）的影响进行了深入研究。然而，人们对失眠和抑郁并存对 HRQoL 的影响知之甚少。本研究旨在评估失眠和抑郁（合并或单独）对澳大利亚成年人 HRQoL 的影响：本研究使用的数据来自大规模的澳大利亚家庭、收入和劳动力动态纵向调查（HILDA）。失眠的定义采用 DSM-V 的主要失眠标准。在基础病例分析中，抑郁症是根据心理健康量表-5（MHI-5）的有效临界点（得分≤62）来定义的。以效用分数（0 至 1 分）表示的 HRQoL 采用从 SF-36 转换而来的短表 6 维（SF-6D）进行测量，并采用澳大利亚的评分算法进行估值。采用多层次模型评估失眠和/或抑郁对效用评分的影响：研究分析了来自 10,324 名患者的 30,972 个观察结果（年龄[平均值±标清值]：45.7 ± 16.5，女性：54.6%）。仅患有失眠症、仅患有抑郁症、合并失眠症和抑郁症的患者比例分别为 11.3%、11.6% 和 8.2%。交互效应表明，失眠和抑郁对健康相关生活质量的综合影响超出了其单独影响的总和。仅失眠、仅抑郁以及合并症相对于无失眠或抑郁的效用得分边际平均差异分别为-0.058（SE：0.003，Cohen's d：0.420，小效应）、-0.210（SE：0.003，Cohen's d：1.530，大效应）和-0.291（SE：0.004，Cohen's d：2.120，大效应）：结论：合并抑郁和失眠似乎对生活质量有很大影响。此外，这是第一项估算合并失眠和抑郁对效用评分影响程度的研究，可用于未来的临床或经济学研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Quality of Life Research 医学-公共卫生、环境卫生与职业卫生

CiteScore

6.50

自引率

8.60%

发文量

224

审稿时长

3-8 weeks

期刊介绍： Quality of Life Research is an international, multidisciplinary journal devoted to the rapid communication of original research, theoretical articles and methodological reports related to the field of quality of life, in all the health sciences. The journal also offers editorials, literature, book and software reviews, correspondence and abstracts of conferences. Quality of life has become a prominent issue in biometry, philosophy, social science, clinical medicine, health services and outcomes research. The journal''s scope reflects the wide application of quality of life assessment and research in the biological and social sciences. All original work is subject to peer review for originality, scientific quality and relevance to a broad readership. This is an official journal of the International Society of Quality of Life Research.