Chiara Baglioni on Insomnia as a Predictor of Depression

April 2013
Chiara Baglioni, Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Freiburg, Germany

A recent analysis of InCites: Essential Science Indicators (a subset of the Web of Knowledge from Thomson Reuters) demonstrated that a 2011 report, “Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiologic studies,” (C. Baglioni, et al., Journal of Affective Disorders, 135(1-3): 10-9, December 2011) is a New Hot Paper in the field of Psychiatry/Psychology. To qualify as a Hot Paper, a report must be indexed by Thomson Reuters within the last two years and must be cited at a level notably above reports of comparable type and age published in the same journal. To date, this paper by Baglioni et al. has been cited 34 times in Web of Knowledge.

Corresponding author Chiara Baglioni is affiliated with the Department of Psychiatry and Psychotherapy at the University of Freiburg Medical Center, Germany. Along with colleagues at Freiburg, she is joined on this paper by co-authors from Sapienza University, Rome, Italy, and the Schön Klinik Roseneck, Prien Am Chiemsee, Germany.

Below, Baglioni answers a few questions about this New Hot Paper in Psychiatry/Psychology.


SW: Why do you think your paper is highly cited?

The present paper describes a meta-analysis of longitudinal epidemiological studies which evaluates whether insomnia is a clinical predictor of major depression. The topic is of relevance because both insomnia and depression are highly prevalent psychiatric conditions which have been found to be undertreated and underdiagnosed. In addition, is it necessary to deepen our knowledge on the course of depression and treat it with timely and efficacious methods. That is, major depression is a heterogeneous disorder with a variable course which is associated with high levels of disability, impairment in quality of life, and increased mortality rates. It adversely affects physical health, cognitive performance, and social relationships. Depression is the leading cause of disability in both women and men in the United States and worldwide, and is one of the 10 leading disorders for global disease burden. In order to narrow the gap between prevalence and primary care assistance, the recognition of clinical early predictors of depression seems of utmost relevance.

SW: Does it describe a new discovery or new synthesis of knowledge?

The aim of the present study was to provide a new synthesis of knowledge about the relationship between insomnia and depression and especially to assess whether individuals with insomnia and no depression have an increased probability of presenting with depression after one year or more as compared with healthy individuals.

SW: Would you summarize the significance of your paper in layman's terms?

The results of the present study indicate that individuals with insomnia and no depression have an increased probability of manifesting depression after one year or more as compared to healthy individuals. This result is important because it suggests that the early treatment of insomnia could, at least partially, contribute to the prevention of depression.

SW: How did you become involved in this research, and how would you describe the particular challenges, setbacks, and successes that you've encountered along the way?

The Centre of Sleep Research and Sleep Medicine at the University of Freiburg in Germany, directed by Prof. Dieter Riemann, has a leading expertise in the field of insomnia and psychiatric sleep research. Moreover, my main research interests since my PhD work focus on insomnia and its relationship with psychopathology.

The results of the present study are challenging for insomnia research because they show that basic and clinical research about insomnia could have a key role in the understanding of depression and psychopathology in general. Nevertheless, it is important to note that more longitudinal studies are needed in order to evaluate the causal relationship between insomnia and depression rigorously independently from all other related variables, such as alcohol or drug abuse, other somatic and psychiatric diseases, and medication status.

SW: Where do you see your research leading in the future?

The results of this study suggest the need for more research in two possible directions. First, there is a need to understand the psychobiological mechanisms explaining the close link between depression and insomnia and their causal relationship. Second, there is a need for more clinical research evaluating the possible effectiveness of the early treatment of insomnia in preventing the onset of a depressive episode.

SW: Do you foresee any social or political implications for your research?

The disorder of insomnia is underdiagnosed and undertreated. The results of the present study suggest that treating insomnia at an early stage could not only ameliorate the quality of sleep and reduce the daytime distress associated with this condition, but could also prevent the development of depressive symptoms. As a consequence, we need more clinicians who have expertise in insomnia and sleep problems and who can address them correctly and at an early stage.


Chiara Baglioni
Department of Psychiatry and Psychotherapy
University of Freiburg Medical Center
Freiburg, Germany

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