A longitudinal study of restless legs symptoms among patients with depression

Abstract

Background

The aim of this study was to analyse the relationship between depressive symptoms and clinical depression and restless legs symptoms in a longitudinal primary care setting.

Methods

The prevalence of restless legs symptoms at baseline and after a six-year follow-up was studied in 474 patients with depressive symptoms and 333 population-based control subjects without depressive symptoms. Depressive symptoms at the baseline and after the six-year follow-up were evaluated with the Beck Depression Inventory (BDI) Second Edition. A psychiatric diagnosis was confirmed with a diagnostic interview (M.I.N.I.). Statistical comparisons between groups were made using analysis of variance (ANOVA) for continuous variables and a chi‐square test or logistic models for categorical variables. Repeated measures were analysed using generalizing estimating equations (GEE) models.

Results

At baseline the prevalence of restless legs symptoms was 24.3% in control subjects, 43.8% in the patients with depressive symptoms without a depression diagnosis, and 49.3% in clinically depressed patients. During the follow-up up the prevalence of restless legs symptoms declined significantly (p = 0.003). In addition to baseline restless legs symptoms, the prognostic factors for restless legs symptoms among patients with clinical depression were age and BDI score. In the control subjects, moderate and high leisure time physical activity was inversely associated with restless legs symptoms at the follow-up.

Conclusions

A higher level of baseline depressive symptoms was a risk factor for restless legs symptoms in patients with clinical depression. In the prevention and treatment of restless legs symptoms among the patients with depression, the priority is the effective treatment of depression.

Keywords:

• Restless legs syndrome
• depressive disorder
• depression
• primary health care

Acknowledgements

The authors thank the following nurse case managers who took part in the practical implementation of the FDMSA: Mari Alanko, Harri Back, Timo Hannula, Anu Holopainen, Ritva Häkkinen, Katja Johansson, Eija Kinnunen, Kaija Luoma, Hannele Niemi, Hillevi Peura, Inga Pöntiö, Kirsi Rouvinen, Tiina Silvennoinen and Marianne Vihtamäki, as well as FDMSA study nurses Anne Kirmanen, Reetta Oksanen and Olli Niemi, and Pia Jauhiainen, the scientific secretary of the study.

Ethical approval

The study protocol was approved on the 17th of April 2007 by the Ethics Committee of Central Finland Central Hospital

Disclosure statement

The authors declare that they have no competing interests

Additional information

Funding

This study was supported by the Central Finland Hospital District and the Northern Savo Hospital District and University of Eastern Finland.

Notes on contributors

Piritta Auvinen

Piritta Auvinen Ph.D. has studied restless legs symptoms and depression in the Institute of Public Health and Clinical Nutrition in the University of Eastern Finland. The dissertation ‘Restless legs symptoms in primary health care patients with depression.’ was completed in 2021.

Hannu Koponen

Hannu Koponen Ph.D. is a researcher and a professor in the Department of Psychiatry in the University of Helsinki.

Hannu Kautiainen

Hannu Kautiainen is a professional statistical analyst in several research groups.

Katariina Korniloff

Katariina Korniloff Ph.D. is a researcher in the Institute of Rehabilitation in the JAMK University of Applied Sciences in Jyväskylä.

Tiina Ahonen

Tiina Ahonen Ph.D. is a researcher in the Primary Health Care Unit in the Central Finland Central Hospital in Jyväskylä.

Mauno Vanhala

Mauno Vanhala Ph.D. is a researcher and a former professor in the Institute of Public Health and Clinical Nutrition in the University of Eastern Finland.

Pekka Mäntyselkä

Pekka Mäntyselkä Ph.D. is a researcher and a professor in the Institute of Public Health and Clinical Nutrition in the University of Eastern Finland.