Mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression

ObjectiveTo explore the mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression. MethodsA total of 384 drug-naive patients diagnosed with depression were recruited from the Department of Psychological Medicine of Zhongshan Hospital, Fudan Uni...

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Main Authors: Xiaotong LI, Zexin ZHAO, Ye LIU, Haibin LI, Xiao HUANG
Format: Article
Language:English
Published: Shanghai Chinese Clinical Medicine Press Co., Ltd. 2025-06-01
Series:Zhongguo Linchuang Yixue
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Online Access:https://www.c-jcm.com/article/doi/10.12025/j.issn.1008-6358.2025.20250295
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author Xiaotong LI
Zexin ZHAO
Ye LIU
Haibin LI
Xiao HUANG
author_facet Xiaotong LI
Zexin ZHAO
Ye LIU
Haibin LI
Xiao HUANG
author_sort Xiaotong LI
collection DOAJ
description ObjectiveTo explore the mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression. MethodsA total of 384 drug-naive patients diagnosed with depression were recruited from the Department of Psychological Medicine of Zhongshan Hospital, Fudan University, during the period from February to August 2024. The severity of depression, somatic symptoms, and sleep quality were assessed using Patient Health Qusetionaire (PHQ)-9, PHQ-15, and Pittsburgh sleep quality index (PSQI), respectively. Based on the PHQ-15 scores, all participants were stratified into two groups: a mild somatic symptoms group(<10 points, n=136)and a moderate-to-severe somatic symptoms group(≥10 points, n=248). Comparisons of sleep quality between the two groups were conducted, and partial correlation analysis was performed to examine the correlation between sleep quality and somatic symptoms. Additionally, linear regression and mediation analyses were conducted to investigate the mediating effect of sleep quality between somatic symptoms and severity of depression. ResultsThe PSQI scores in moderate-to-severe somatic symptoms group were significantly higher than those in mild somatic symptoms group (P<0.001). Partial correlation analysis indicated that, after controlling for depression severity, the positive correlation between PSQI and PHQ-15 scores remained significant in both groups (P<0.01). Regression analysis identified both sleep quality and somatic symptoms as predictors of severity of depression (P<0.001). Additionally, mediation analysis demonstrated that sleep quality partially mediated the relationship between somatic symptoms and severity of depression, accounting for 26.63% (0.090/0.338) of the total effect. ConclusionsIn patients with depression, sleep quality is associated with somatic symptoms, and both contribute to an increased risk of the severity of depression. Moreover, sleep quality plays a partial mediating effect between somatic symptoms and severity of depression, highlighting the importance of addressing sleep-related issues in the management of depression.
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spelling doaj-art-bf9f13c641cc4c76bcce70a01f9daeea2025-07-10T05:43:05ZengShanghai Chinese Clinical Medicine Press Co., Ltd.Zhongguo Linchuang Yixue1008-63582025-06-0132346547110.12025/j.issn.1008-6358.2025.2025029520250295Mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depressionXiaotong LI0Zexin ZHAO1Ye LIU2Haibin LI3Xiao HUANG4Department of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaDepartment of Psychological Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaObjectiveTo explore the mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression. MethodsA total of 384 drug-naive patients diagnosed with depression were recruited from the Department of Psychological Medicine of Zhongshan Hospital, Fudan University, during the period from February to August 2024. The severity of depression, somatic symptoms, and sleep quality were assessed using Patient Health Qusetionaire (PHQ)-9, PHQ-15, and Pittsburgh sleep quality index (PSQI), respectively. Based on the PHQ-15 scores, all participants were stratified into two groups: a mild somatic symptoms group(<10 points, n=136)and a moderate-to-severe somatic symptoms group(≥10 points, n=248). Comparisons of sleep quality between the two groups were conducted, and partial correlation analysis was performed to examine the correlation between sleep quality and somatic symptoms. Additionally, linear regression and mediation analyses were conducted to investigate the mediating effect of sleep quality between somatic symptoms and severity of depression. ResultsThe PSQI scores in moderate-to-severe somatic symptoms group were significantly higher than those in mild somatic symptoms group (P<0.001). Partial correlation analysis indicated that, after controlling for depression severity, the positive correlation between PSQI and PHQ-15 scores remained significant in both groups (P<0.01). Regression analysis identified both sleep quality and somatic symptoms as predictors of severity of depression (P<0.001). Additionally, mediation analysis demonstrated that sleep quality partially mediated the relationship between somatic symptoms and severity of depression, accounting for 26.63% (0.090/0.338) of the total effect. ConclusionsIn patients with depression, sleep quality is associated with somatic symptoms, and both contribute to an increased risk of the severity of depression. Moreover, sleep quality plays a partial mediating effect between somatic symptoms and severity of depression, highlighting the importance of addressing sleep-related issues in the management of depression.https://www.c-jcm.com/article/doi/10.12025/j.issn.1008-6358.2025.20250295depressionsleep qualitysomatic symptommediating effect
spellingShingle Xiaotong LI
Zexin ZHAO
Ye LIU
Haibin LI
Xiao HUANG
Mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression
Zhongguo Linchuang Yixue
depression
sleep quality
somatic symptom
mediating effect
title Mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression
title_full Mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression
title_fullStr Mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression
title_full_unstemmed Mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression
title_short Mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression
title_sort mediating effect of sleep quality between somatic symptoms and severity of depression in patients with depression
topic depression
sleep quality
somatic symptom
mediating effect
url https://www.c-jcm.com/article/doi/10.12025/j.issn.1008-6358.2025.20250295
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