Risk of psychiatric disorders in patients with chronic insomnia and sedative-hypnotic prescription: A nationwide population-based follow-up study

Kuo Hsuan Chung, Chung Yi Li, Shu Yu Kuo, Trevor Sithole, Wen Wei Liu, Min Huey Chung

Research output: Contribution to journalArticle

26 Citations (Scopus)

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 sedativehypnotic 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% confi dence 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 signifi cantly 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.

Original languageEnglish
Pages (from-to)543-551
Number of pages9
JournalJournal of Clinical Sleep Medicine
Volume11
Issue number5
DOIs
Publication statusPublished - 2015

Fingerprint

Sleep Initiation and Maintenance Disorders
Hypnotics and Sedatives
Prescriptions
Psychiatry
Population
Substance-Related Disorders
Anxiety
National Health Programs
Depressive Disorder
Anxiety Disorders
Benzodiazepines
Taiwan
Bipolar Disorder
Epidemiologic Studies
Schizophrenia
Sleep
Cohort Studies
Databases

Keywords

  • Anxiety disorder
  • Bipolar disorder
  • Depressive disorder
  • Insomnia
  • Schizophrenia
  • Sedative-hypnotics
  • Somatoform disorder
  • Substance-related disorder

ASJC Scopus subject areas

  • Clinical Neurology
  • Pulmonary and Respiratory Medicine
  • Neurology

Cite this

@article{d61e0a4ba2e0421ca01ae32b06a44526,
title = "Risk of psychiatric disorders in patients with chronic insomnia and sedative-hypnotic prescription: A nationwide population-based follow-up study",
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 sedativehypnotic 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{\%} confi dence 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 signifi cantly 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.",
keywords = "Anxiety disorder, Bipolar disorder, Depressive disorder, Insomnia, Schizophrenia, Sedative-hypnotics, Somatoform disorder, Substance-related disorder",
author = "Chung, {Kuo Hsuan} and Li, {Chung Yi} and Kuo, {Shu Yu} and Trevor Sithole and Liu, {Wen Wei} and Chung, {Min Huey}",
year = "2015",
doi = "10.5664/jcsm.4700",
language = "English",
volume = "11",
pages = "543--551",
journal = "Journal of Clinical Sleep Medicine",
issn = "1550-9389",
publisher = "American Academy of Sleep Medicine",
number = "5",

}

TY - JOUR

T1 - Risk of psychiatric disorders in patients with chronic insomnia and sedative-hypnotic prescription

T2 - A nationwide population-based follow-up study

AU - Chung, Kuo Hsuan

AU - Li, Chung Yi

AU - Kuo, Shu Yu

AU - Sithole, Trevor

AU - Liu, Wen Wei

AU - Chung, Min Huey

PY - 2015

Y1 - 2015

N2 - 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 sedativehypnotic 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% confi dence 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 signifi cantly 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.

AB - 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 sedativehypnotic 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% confi dence 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 signifi cantly 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.

KW - Anxiety disorder

KW - Bipolar disorder

KW - Depressive disorder

KW - Insomnia

KW - Schizophrenia

KW - Sedative-hypnotics

KW - Somatoform disorder

KW - Substance-related disorder

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