Kuo-Hsuan Chung1,2,3, Chung-Yi Li4,5, Shu-Yu Kuo6, Trevor Sithole7,8, Wen-Wei Liu9, Min-Huey Chung. 1. Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan. 2. Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan. 3. Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 4. Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 5. Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan. 6. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan. 7. Maternity Department, Emkhuzweni Health Center, Swaziland. 8. Customer Care Officer, Emkhuzweni Health Center, Swaziland. 9. Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Abstract
STUDY OBJECTIVES: Previous epidemiological studies have established insomnia as a major risk factor for mood, anxiety, and substance use disorders. However, the associations between insomnia with sedative-hypnotic prescriptions and various psychiatric disorders have not been thoroughly examined. The current study involved evaluating the risk of psychiatric disorders, namely schizophrenia, mood, anxiety, somatoform, and substance-related disorders, over a 6-y follow-up period in three groups: patients with insomnia and sedative-hypnotic prescriptions (Inso-Hyp), those with insomnia and without sedative-hypnotic prescriptions (Inso-NonHyp), and those with neither insomnia nor sedative-hypnotic prescriptions (NonInso-NonHyp). METHODS: We used a historical cohort study design to compare the risk of psychiatric disorders among the three groups. Data regarding these patients were derived from reimbursement claims recorded in Taiwan's National Health Insurance Research Database. Cox proportional hazards regression was used to compare the 6-y risk of subsequent psychiatric disorders among the Inso-Hyp, Inso-NonHyp, and NonInso-NonHyp groups. RESULTS: Compared with the Inso-NonHyp and NonInso-NonHyp group patients, the Inso-Hyp group patients exhibited a higher risk of psychiatric disorders, particularly bipolar disorders (adjusted hazard ratio [AHR]: 7.60; 95% confidence interval [CI]: 5.31-10.89 and AHR: 14.69; 95% CI: 11.11-19.43, respectively). Moreover, among the Inso-Hyp patient group, insomnia prescribed with benzodiazepine, a longer duration of sedative-hypnotic action, and higher doses of sedativehypnotics were significantly associated with a higher risk of depressive and anxiety disorders. CONCLUSION: The Inso-Hyp group exhibited a higher risk of developing psychiatric disorders than did the Inso-NonHyp and NonInso-NonHyp groups. The results regarding patients with insomnia and sedative-hypnotic prescriptions associated with the risk of psychiatric disorders can serve as a reference for care providers when managing sleep disturbances.
STUDY OBJECTIVES: Previous epidemiological studies have established insomnia as a major risk factor for mood, anxiety, and substance use disorders. However, the associations between insomnia with sedative-hypnotic prescriptions and various psychiatric disorders have not been thoroughly examined. The current study involved evaluating the risk of psychiatric disorders, namely schizophrenia, mood, anxiety, somatoform, and substance-related disorders, over a 6-y follow-up period in three groups: patients with insomnia and sedative-hypnotic prescriptions (Inso-Hyp), those with insomnia and without sedative-hypnotic prescriptions (Inso-NonHyp), and those with neither insomnia nor sedative-hypnotic prescriptions (NonInso-NonHyp). METHODS: We used a historical cohort study design to compare the risk of psychiatric disorders among the three groups. Data regarding these patients were derived from reimbursement claims recorded in Taiwan's National Health Insurance Research Database. Cox proportional hazards regression was used to compare the 6-y risk of subsequent psychiatric disorders among the Inso-Hyp, Inso-NonHyp, and NonInso-NonHyp groups. RESULTS: Compared with the Inso-NonHyp and NonInso-NonHyp group patients, the Inso-Hyp group patients exhibited a higher risk of psychiatric disorders, particularly bipolar disorders (adjusted hazard ratio [AHR]: 7.60; 95% confidence interval [CI]: 5.31-10.89 and AHR: 14.69; 95% CI: 11.11-19.43, respectively). Moreover, among the Inso-Hyp patient group, insomnia prescribed with benzodiazepine, a longer duration of sedative-hypnotic action, and higher doses of sedativehypnotics were significantly associated with a higher risk of depressive and anxiety disorders. CONCLUSION: The Inso-Hyp group exhibited a higher risk of developing psychiatric disorders than did the Inso-NonHyp and NonInso-NonHyp groups. The results regarding patients with insomnia and sedative-hypnotic prescriptions associated with the risk of psychiatric disorders can serve as a reference for care providers when managing sleep disturbances.
Authors: Kevin Pottie; Wade Thompson; Simon Davies; Jean Grenier; Cheryl A Sadowski; Vivian Welch; Anne Holbrook; Cynthia Boyd; Robert Swenson; Andy Ma; Barbara Farrell Journal: Can Fam Physician Date: 2018-05 Impact factor: 3.275
Authors: Kevin Pottie; Wade Thompson; Simon Davies; Jean Grenier; Cheryl A Sadowski; Vivian Welch; Anne Holbrook; Cynthia Boyd; Robert Swenson; Andy Ma; Barbara Farrell Journal: Can Fam Physician Date: 2018-05 Impact factor: 3.275
Authors: Ayal Schaffer; Lauren M Weinstock; Mark Sinyor; Catherine Reis; Benjamin I Goldstein; Lakshmi N Yatham; Anthony J Levitt Journal: Int J Bipolar Disord Date: 2017-05-11