Academic journal article Indian Journal of Psychiatry

Prevalence of Restless Leg Syndrome in Subjects with Depressive Disorder

Academic journal article Indian Journal of Psychiatry

Prevalence of Restless Leg Syndrome in Subjects with Depressive Disorder

Article excerpt

Byline: Ravi. Gupta, Vivekananda. Lahan, Deepak. Goel

Background: Restless legs syndrome (RLS) is known to be associated with depression. We hypothesized that RLS in depression is linked to the severity, duration, and frequency of depressive episodes. Materials and Methods: Subjects fulfilling DSM-IV-TR criteria of depressive disorders were included in this study after seeking informed consent. Using structured interview of MINI-Plus their demographic data and history were recorded. Severity of depression was assessed with the help of HAM-D. Insomnia was diagnosed following ICSD-2 criteria. RLS was diagnosed according to IRLSSG criteria. Descriptive statistics, Chi-square test, independent sample t test and MANOVA were computed with the help of SPSS v 17.0. Results: RLS was reported by 31.48% of sample. There was no gender difference in prevalence of RLS ( X [sup]2=0.46; P=0.33). There was no difference in the age , total duration of depressive illness and number of depressive episodes between RLS and non-RLS groups (F=0.44; P=0.77; Wilk's Lambda=0.96). The HAM-D score was higher in the non-RLS group ( P=0.03). Onset of RLS symptoms was not related to onset of depressive symptoms. Conclusion: RLS is prevalent in depressive disorder. However, onset of RLS is unrelated to age and number or duration of depressive disorders.

Introduction

Restless legs syndrome (RLS) is a sensori-motor disorder that interferes with the sleep of the sufferers. This syndrome is characterized by four major symptoms including urge to move legs which is more in the evening and night, this urge is usually relieved by movement and increased by rest. [sup][1] Disruption in dopamine transmission in brain is hypothesized for this problem as it frequently responds to dopaminergic therapy. [sup][2]

RLS has been found to be associated with depression in clinical sample as well as epidemiological studies. [sup][3],[4] Dopamine is implicated in the causation of depression and treatment of RLS is thought to improve depressive symptoms in RLS patients. [sup][2] Together, these facts suggest that there may be some overlap between these two disorders. Earlier studies have analyzed the presence of depression in RLS patients, but to the best of our knowledge no study has assessed the prevalence of RLS in depressed patients except one. [sup][5] This kind of study can throw more light on the patho-physiological underpinnings of both the disorders. Hence, the present study was planned.

Materials and Methods

The present study was conducted in a tertiary care teaching institution after seeking approval from the institutional ethics committee. All subjects presenting to psychiatry OPD with complaints of depressive illness were included in this study. Depressive illness included three categories - major depressive disorder (MDD) or dysthymia or recurrent depressive disorders fulfilling the DSM-IV-TR criteria were included in this study. [sup][6] Mini International Neuropsychiatric Interview Plus (MINI-Plus) was used for structured clinical interview. [sup][7] However, subjects suffering from any medical or neurological disorder that predisposes them to develop RLS, those ever suffered from any kind of psychotic disorder or currently taking antipsychotic drug; presently meeting criteria of substance abuse or dependence or withdrawal; consuming any medicine which can induce depression or RLS or disturbed sleep; those unwilling to participate; suffering from any other sleep disorder, e.g., sleep apnea, parasomnia were not included in this study. Similarly, pregnant females, those within post partum period (12 months since last childbirth) or those suffering from postmenopausal syndrome were also excluded from the study.

Subjects were explained the rationale of study before taking their informed written consent. Their demographic data were recorded and clinical history, drug history, and family history of psychiatric disorder, RLS, and sleep disorder were sought. …

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