Differential co-occurring patterns between depressive symptomatology and sleep-wake-related disturbances in mood disorders

Sze Yu Chen, Chun Hao Chen, Chen Lo, Mong Liang Lu, Cheng Dien Hsu, Yi Hang Chiu, Chun Hao Chen, Shih Ku Lin, Ming Chyi Huang, Hsi Chung Chen, Po Hsiu Kuo

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Purpose: This study aimed to elucidate the various co-occurring patterns of depressive symptomatology and sleep-wake-related disturbances (SWRDs) in patients with mood disorders. Patients and Methods: Individuals in non-acute states of major depressive disorder or bipolar disorder were recruited. The Beck Depression Inventory II (BDI-II) was utilized to evaluate depressive symptoms. BDI-II items were classified into three domains: Cognitive, affective, and somatic. Between-domain differences with various SWRDs were examined. Latent class analysis was used to empirically classify participants using BDI-II items as indicator variables. Co-occurring patterns between domains of BDI-II items and SWRDs were re-examined in each subgroup to elucidate inter-individual differences. Results: In total, 657 participants were enrolled. Of participants, 66.8% were female, and 52.4% were diagnosed with major depressive disorder. Each BDI-II domain exhibited different co-occurring patterns. The somatic domain was most likely to co-occur with various SWRDs. Three subgroups were derived from latent class analysis and were designated as poor sleep quality and high insomnia (n=150), poor sleep quality and moderate insomnia (n=248), and poor sleep quality and low insomnia (n=159). The group with more severe insomnia presented with more severe depressive and anxiety symptoms. The three subgroups further differed in co-occurring patterns. From the low insomnia to high insomnia group, the associations with various SWRDs appeared in the sequence of somatic, affective, and cognitive domains. Conclusion: Co-occurring patterns between domains of depressive symptomatology with various SWRDs differ and may vary among individuals.

Original languageEnglish
Pages (from-to)503-514
Number of pages12
JournalNature and Science of Sleep
Publication statusPublished - 2021


  • Co-occurring
  • Depression
  • Latent class analysis
  • Mood disorders
  • Sleep-wake-related disturbance

ASJC Scopus subject areas

  • Applied Psychology
  • Behavioral Neuroscience


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