PURPOSE: This study examined the associations of insomnia symptoms with subsequent psychotropic medication, reflecting mental health. METHODS: Postal baseline surveys among 40- to 60-year-old employees of the city of Helsinki, Finland, were collected in 2000-2002 (N = 6,227, response rate 67%, 78% women) and longitudinally linked with national register data on prescribed reimbursed medication. Insomnia symptoms at baseline comprised difficulties in initiating and maintaining sleep, and non-restorative sleep. All purchased psychotropic medication 5-7 years prior to and 5 years after baseline was included. Outcomes were any psychotropic medication; antidepressants; and anxiolytics, hypnotics, and sedatives. Covariates included socio-demographic and work-related factors, health behaviors, lifetime mental disorders, and prior psychotropic medication. Logistic regression analysis was used to calculate odds ratios (OR) and their 95% confidence intervals (CI). RESULTS: Insomnia symptoms were associated with higher frequency of subsequent psychotropic medication prescriptions. The associations were strongest for frequent insomnia symptoms (women OR 3.55, 95% CI 2.64-4.77; men OR 4.64, 95% CI 2.49-8.66, adjusted for age and prior medication), but also rare and occasional symptoms were associated with psychotropic medication. Further adjustments had negligible effects. CONCLUSIONS: Insomnia symptoms were associated with prescribed psychotropic medication during follow-up in a dose-response manner. Attention should be given to the prevention of insomnia symptoms to curb subsequent mental problems.
PURPOSE: This study examined the associations of insomnia symptoms with subsequent psychotropic medication, reflecting mental health. METHODS: Postal baseline surveys among 40- to 60-year-old employees of the city of Helsinki, Finland, were collected in 2000-2002 (N = 6,227, response rate 67%, 78% women) and longitudinally linked with national register data on prescribed reimbursed medication. Insomnia symptoms at baseline comprised difficulties in initiating and maintaining sleep, and non-restorative sleep. All purchased psychotropic medication 5-7 years prior to and 5 years after baseline was included. Outcomes were any psychotropic medication; antidepressants; and anxiolytics, hypnotics, and sedatives. Covariates included socio-demographic and work-related factors, health behaviors, lifetime mental disorders, and prior psychotropic medication. Logistic regression analysis was used to calculate odds ratios (OR) and their 95% confidence intervals (CI). RESULTS:Insomnia symptoms were associated with higher frequency of subsequent psychotropic medication prescriptions. The associations were strongest for frequent insomnia symptoms (women OR 3.55, 95% CI 2.64-4.77; men OR 4.64, 95% CI 2.49-8.66, adjusted for age and prior medication), but also rare and occasional symptoms were associated with psychotropic medication. Further adjustments had negligible effects. CONCLUSIONS:Insomnia symptoms were associated with prescribed psychotropic medication during follow-up in a dose-response manner. Attention should be given to the prevention of insomnia symptoms to curb subsequent mental problems.
Authors: Mari-Ann Wallander; Saga Johansson; Ana Ruigómez; Luis A García Rodríguez; Roger Jones Journal: Prim Care Companion J Clin Psychiatry Date: 2007