Sleep Disturbance Scale for Children Subdomains and Depressive Severity in Youth With Major Depressive Disorder
Maria Angélica Rios, Isabela Gontijo Lopes, Carolina Luisa Silva Nascimento, Letícia Santos e Pereira, Maria Vitória Lucena Zanetti, Luiz Alexandre Viana MagnoBackground
Most studies linking sleep disturbances to depressive symptoms in youth have relied on aggregate sleep scores rather than subdomain‐specific measures, leaving the role of specific sleep disturbance subdomains in clinical populations poorly understood.
Objective
To examine whether specific subdomains of the Sleep Disturbance Scale for Children (SDSC) are differentially associated with depressive symptom severity in a clinical sample.
Methods
Cross‐sectional study of 52 children and adolescents (mean [SD] age, 15.05 [1.27] years; 86.5% female) diagnosed with major depressive disorder (MDD) at a public, referral‐based outpatient mental health clinic in Brazil. Associations between SDSC subdomains and CDI scores were examined using age‐ and sex‐adjusted logistic (CDI ≥ 17) and continuous CDI regression. Discrimination was explored using ROC analysis.
Results
Disorders of initiating and maintaining sleep (DIMS) showed the largest standardized difference between participants above and below the CDI threshold (Cohen ′ s d = 1.09, 95% CI 0.45–1.72). In a multivariable model including DIMS and sleep hyperhidrosis, only DIMS remained associated with CDI ≥ 17 (OR = 1.21, 95% CI 1.05–1.40). This pattern was consistent with CDI as a continuous outcome and after excluding the CDI sleep item. DIMS had the highest apparent AUC among individual sleep measures (0.828).
Conclusions
In this predominantly female sample of children and adolescents with MDD treated in a tertiary service, DIMS was the SDSC subdomain most consistently associated with depressive symptom severity.