757 Associations Between Sleep Complaints, Suicidal Ideation and Depression Among Adolescents and Young Adults in Greece

Abstract

Abstract Introduction Suicide risk begins to increase among adolescents and young adults representing the leading cause of death in this age group. The aim of this study was to assess associations between sleep complaints, suicidal ideation and depression in a large, representative sample of adolescents and young adults of the general population in Greece. Methods A structured telephone questionnaire was conducted in a representative sample of 2.741 young Greeks aged 15–24 years, including sociodemographic variables, life-style habits, and substance use. symptoms were assessed using the PhQ-9. Suicidal ideation and sleep complaints, i.e. insomnia/ hypersomnia symptoms, were assessed based on the relevant questions of the PhQ-9 questionnaire. We conducted a direct and indirect effect analysis between the modified PhQ-7 scale, sleep complaints and suicidality controlling for gender, family income, education and substance use. Results In our sample prevalence of suicidal ideation was 7.8%, while 47.9% reported sleep complaints. The mean PhQ-7 score was 6.15±4.11. The direct paths from depression to sleep, as well as from sleep to ideation were both statistically significant with p-values <0.001. Indirect mediation analysis revealed a significant indirect effect of depression on ideation mediated by sleep complaints as indicated by the sobel test (z=3.59, p=0.0003). This is a partial mediation given that the direct effect of depression on ideation controlling for sleep (the mediator) remains significant (p<.001). The percentage of the effect of depression on ideation accounted for by the indirect effect through sleep is estimated at 16.5%. The mediation remains significant (p<.001) after controlling for income, gender, education, and substance use. Conclusion Our study supports that among youth there is direct associations between depression, sleep complaints and suicidal ideation. Furthermore, we found an indirect effect of depression on suicidal ideation mediated by sleep complaints. Our findings highlight the presence of complex interactions between subjective psychiatric symptoms and perceived sleep problems to account for suicidal ideation Therefore, treatment of sleep among youth with depression may significantly independently further reduce suicidal risk. Support (if any) EEA/Norwegian Financial Mechanism 2009–2014, under Project Contract n° EEA Grants/ GR07- 3757