INSOMNIA IN YOUNG MEN AND SUBSEQUENT DEPRESSION - THE HOPKINS,JOHNS PRECURSORS STUDY

The Johns Hopkins Precursors Study, a long-term prospective study, was used to study the relation between self-reported sleep disturbances a nd subsequent clinical depression and psychiatric distress. A total of 1,053 men provided information on sleep habits during medical school at The Johns Hopkins University (classes of 1948-1964) and have been f ollowed since graduation. During a median follow-up period of 34 years (range 1-45), 101 men developed clinical depression (cumulative incid ence at 40 years, 12.2%), including 13 suicides. In Cox proportional h azards analysis adjusted for age at graduation, class year, parental h istory of clinical depression, coffee drinking, and measures of temper ament, the relative risk of clinical depression was greater in those w ho reported insomnia in medical school (relative risk (RR) 2.0, 95% co nfidence interval (CI) 1.2-3.3) compared with those who did not and gr eater in those with difficulty sleeping under stress in medical school (RR 1.8, 95% CI 1.2-2.7) compared with those who did not report diffi culty. There were weaker associations for those who reported poor qual ity of steep (RR 1.6, 95% CI 0.9-2.9) and sleep duration of 7 hours or less (RR 1.5, 95% CI 0.9-2.3) with development of clinical depression . Similar associations were observed between reports of sleep disturba nces in medical school and psychiatric distress assessed in 1988 by th e General Health Questionnaire. These findings suggest that insomnia i n young men is indicative of a greater risk for subsequent clinical de pression and psychiatric distress that persists for at least 30 years.