Insônia e depressão: confluências neurobiológicas e tratamento

Autores

  • Márcio Andrei Zanini Preceptor da Residência Médica em Psiquiatria, IAMSPE; Hospital do Servidor Público Estadual, São Paulo, SP, Brasil https://orcid.org/0000-0002-1551-7091
  • Camilla Moreira de Sousa Pinna Preceptora da Residência Médica em Psiquiatria do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0001-9841-1227
  • Rafael Brandes Lourenço Doutorando em Ciências Médicas, Universidade Estadual de Campinas, UNICAMP, Campinas, SP, Brasil https://orcid.org/0000-0003-0268-5827
  • Flavia Zuccolotto dos Reis Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, São Paulo, SP, Brasil https://orcid.org/0009-0004-5744-2907
  • Daniel Guilherme Suzuki Borges Médico Assistente ASONO – IPq, Hospital das Clínicas, HC, Faculdade de Medicina da Universidade de São Paulo, FMUSP, São Paulo, SP, Brasil https://orcid.org/0009-0008-7886-6687
  • Glícia Prates Santana Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, Vitória da Conquista, BA, Brasil https://orcid.org/0009-0005-7256-0917
  • Regina Margis Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, São Paulo, SP, Brasil
  • Almir Ribeiro Tavares Júnior Professor de Neurociências e Psiquiatria, Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brasil https://orcid.org/0000-0001-9517-8546

DOI:

https://doi.org/10.25118/2763-9037.2025.v15.1332

Palavras-chave:

Transtorno depressivo, transtorno do sono, Insônia, distúrbios do início e da manutenção do sono

Resumo

Introdução:  A relação bidirecional entre sono e depressão é amplamente conhecida e descrita na literatura, bem como observada na prática clínica. A insônia, além de fazer parte dos critérios diagnósticos da depressão, se apresenta como um fator de risco para episódio depressivo, prediz menor resposta ao tratamento, aumento do risco de recidivas e associa-se a uma maior gravidade do quadro em pacientes com transtorno depressivo. Para um tratamento adequado se faz fundamental o entendimento dessas entidades e os aspectos envolvidos neste cenário.  Método: Trata-se de uma revisão narrativa acerca da relação entre insônia e depressão, englobando fatores neuroquímicos, moleculares, cronobiológicos e epidemiológicos, articulando-se com a terapêutica disponível atualmente. Resultados:  Insônia e depressão compartilham anomalias em alguns sistemas neurotransmissores e vias cerebrais. A hiperatividade do sistema ativador reticular ascendente (SARA) é comum a ambas as condições. Alterações no ritmo circadiano e em parâmetros polissonográficos também são encontradas em indivíduos com quadro depressivo. Ainda, estudos epidemiológicos demonstram que a depressão é um importante preditor de insônia de forma recíproca. Conclusões: Com base nas diversas confluências fisiológicas, moleculares, genéticas e psicológicas, insônia e depressão se influenciam mutuamente. O uso das ferramentas farmacológicas e não farmacológicas com foco no manejo eficaz destas duas condições se faz mandatório para redução da gravidade e cronificação global do quadro, objetivando legítimo êxito no tratamento.

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Biografia do Autor

Márcio Andrei Zanini, Preceptor da Residência Médica em Psiquiatria, IAMSPE; Hospital do Servidor Público Estadual, São Paulo, SP, Brasil

http://lattes.cnpq.br/8069050480622437

Camilla Moreira de Sousa Pinna, Preceptora da Residência Médica em Psiquiatria do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil

http://lattes.cnpq.br/3191029579908434

Rafael Brandes Lourenço, Doutorando em Ciências Médicas, Universidade Estadual de Campinas, UNICAMP, Campinas, SP, Brasil

http://lattes.cnpq.br/6654584691382531

Flavia Zuccolotto dos Reis, Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, São Paulo, SP, Brasil

http://lattes.cnpq.br/3710777352705280

Daniel Guilherme Suzuki Borges, Médico Assistente ASONO – IPq, Hospital das Clínicas, HC, Faculdade de Medicina da Universidade de São Paulo, FMUSP, São Paulo, SP, Brasil

http://lattes.cnpq.br/9430695171810857

Glícia Prates Santana, Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, Vitória da Conquista, BA, Brasil

http://lattes.cnpq.br/6193825830756887

Regina Margis, Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, São Paulo, SP, Brasil

http://lattes.cnpq.br/4126517391759813

https://orcid.org/0009-0004-3133-2507

 

Almir Ribeiro Tavares Júnior, Professor de Neurociências e Psiquiatria, Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brasil

https://lattes.cnpq.br/5215895509002939

 

 

Referências

.1. Carskadon MA, Dement WC. Chapter 2 - Normal human sleep: an overview. In: Kryger MH, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 5th ed. New York: Elsevier; 2011. p. 16-26. https://doi.org/10.1016/B978-1-4160-6645-3.00002-5 DOI: https://doi.org/10.1016/B978-1-4160-6645-3.00002-5

.2. Siegel JM. Sleep function: an evolutionary perspective. Lancet Neurol. 2022;21(10):937-46. https://doi.org/10.1016/s1474-4422(22)00210-1 PMID:36115365 - PMCID:PMC9670796 DOI: https://doi.org/10.1016/S1474-4422(22)00210-1

.3. Girardeau G, Lopes-Dos-Santos V. Brain neural patterns and the memory function of sleep. Science. 2021;374(6567):560-4. https://doi.org/10.1126/science.abi8370 PMID:34709916 PMCID:PMC7611961 DOI: https://doi.org/10.1126/science.abi8370

.4. Edge LC. The role of emotional brain processing during sleep in depression. J Psychiatr Ment Health Nurs. 2010;17(10):857-61. https://doi.org/10.1111/j.1365-2850.2010.01598.x PMID:21078000 DOI: https://doi.org/10.1111/j.1365-2850.2010.01598.x

.5. Tomaso CC, Johnson AB, Nelson TD. The effect of sleep deprivation and restriction on mood, emotion, and emotion regulation: three meta-analyses in one. Sleep. 2021;44(6):zsaa289. https://doi.org/10.1093/sleep/zsaa289 PMID:33367799 - PMCID:PMC8193556 DOI: https://doi.org/10.1093/sleep/zsaa289

.6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington: American Psychiatric Association; 2022. Major depressive disorder. https://doi.org/10.1176/appi.books.9780890425787 DOI: https://doi.org/10.1176/appi.books.9780890425787

.7. Vargas I, Perlis ML. Insomnia and depression: clinical associations and possible mechanistic links. Curr Opin Psychol. 2020;34:95-9. https://doi.org/10.1016/j.copsyc.2019.11.004 PMID:31846870 DOI: https://doi.org/10.1016/j.copsyc.2019.11.004

.8. Steiger A, Pawlowski M. Depression and sleep. Int J Mol Sci. 2019;20(3):607. https://doi.org/10.3390/ijms20030607 PMID:30708948 - PMCID:PMC6386825 DOI: https://doi.org/10.3390/ijms20030607

.9. Riemann D, Krone LB, Wulff K, Nissen C. Sleep, insomnia, and depression. Neuropsychopharmacology. 2020;45(1):74-89. https://doi.org/10.1038/s41386-019-0411-y PMID:31071719 PMCID:PMC6879516 DOI: https://doi.org/10.1038/s41386-019-0411-y

.10. Summers-Bremner E. Insomnia: a cultural history. London: Reaktion Books; 2010.

.11. Casiraghi LP, Plano SA, Fernández-Duque E, Valeggia C, Golombek DA, de la Iglesia HO. Access to electric light is associated with delays of the dim-light melatonin onset in a traditionally hunter-gatherer Toba/Qom community. J Pineal Res. 2020;69(4):e12689. https://doi.org/10.1111/jpi.12689 PMID:32761922 DOI: https://doi.org/10.1111/jpi.12689

.12. Pilz LK, Levandovski R, Oliveira MAB, Hidalgo MP, Roenneberg T. Sleep and light exposure across different levels of urbanisation in Brazilian communities. Sci Rep. 2018;8:11389. https://doi.org/10.1038/s41598-018-29494-4 PMID:30061685 PMCID:PMC6065379 DOI: https://doi.org/10.1038/s41598-018-29494-4

.13. Moreno CR, Vasconcelos S, Marqueze EC, Lowden A, Middleton B, Fischer FM, Louzada FM, Skene DJ. Sleep patterns in Amazon rubber tappers with and without electric light at home. Sci Rep. 2015;5:14074. https://doi.org/10.1038/srep14074 PMID:26361226 - PMCID:PMC4566125 DOI: https://doi.org/10.1038/srep14074

.14. Fang H, Tu S, Sheng J, Shao A. Depression in sleep disturbance: a review on a bidirectional relationship, mechanisms and treatment. J Cell Mol Med. 2019;23(4):2324-32. https://doi.org/10.1111/jcmm.14170 PMID:30734486 PMCID:PMC6433686 DOI: https://doi.org/10.1111/jcmm.14170

.15. Spielman AJ, Caruso LS, Glovinsky PB. A behavioral perspective on insomnia treatment. Psychiatr Clin North Am. 1987;10(4):541-53. PMID:3332317 DOI: https://doi.org/10.1016/S0193-953X(18)30532-X

.16. Baglioni C, Battagliese G, Feige B, Spiegelhalder K, Nissen C, Voderholzer U, Lombardo C, Riemann D. Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. J Affect Disord. 2011;135(1-3):10-9. https://doi.org/10.1016/j.jad.2011.01.011 PMID:21300408 DOI: https://doi.org/10.1016/j.jad.2011.01.011

.17. Li L, Wu C, Gan Y, Qu X, Lu Z. Insomnia and the risk of depression: a meta-analysis of prospective cohort studies. BMC Psychiatry. 2016;16:375. https://doi.org/10.1186/s12888-016-1075-3 PMID:27816065 - PMCID:PMC5097837 DOI: https://doi.org/10.1186/s12888-016-1075-3

.18. Paunio T, Korhonen T, Hublin C, Partinen M, Koskenvuo K, Koskenvuo M, Kaprio J. Poor sleep predicts symptoms of depression and disability retirement due to depression. J Affect Disord. 2015;172:381-9. https://doi.org/10.1016/j.jad.2014.10.002 PMID:25451441 DOI: https://doi.org/10.1016/j.jad.2014.10.002

.19. Stahl SM. Psicofarmacologia: bases neurocientíficas e aplicações práticas. 5. ed. São Paulo: Guanabara Koogan; 2022.

.20. Buysse DJ, Germain A, Hall M, Monk TH, Nofzinger EA. A neurobiological model of insomnia. Drug Discov Today Dis Models. 2011;8(4):129-37. https://doi.org/10.1016/j.ddmod.2011.07.002 PMID:22081772 - PMCID:PMC3212043 DOI: https://doi.org/10.1016/j.ddmod.2011.07.002

.21. Pigeon WR, Perlis ML. Insomnia and depression: birds of a feather? Int J Sleep Disord. 2007;1(3):82-91. https://www.med.upenn.edu/cbti/assets/user-content/documents/BirdsofaFeather-reprint.pdf

.22. Lamont EW, Legault-Coutu D, Cermakian N, Boivin DB. The role of circadian clock genes in mental disorders. Dialogues Clin Neurosci. 2007;9(3):333-42. https://doi.org/10.31887/dcns.2007.9.3/elamont PMID:17969870 PMCID:PMC3202489 DOI: https://doi.org/10.31887/DCNS.2007.9.3/elamont

.23. Zaki NFW, Spence DW, BaHammam AS, Pandi-Perumal SR, Cardinali DP, Brown GM. Chronobiological theories of mood disorder. Eur Arch Psychiatry Clin Neurosci. 2018;268(2):107-18. https://doi.org/10.1007/s00406-017-0835-5 PMID:28894915 DOI: https://doi.org/10.1007/s00406-017-0835-5

.24. Bunney BG, Li JZ, Walsh DM, Stein R, Vawter MP, Cartagena P, Barchas JD, Schatzberg AF, Myers RM, Watson SJ, Akil H, Bunney WE. Circadian dysregulation of clock genes: clues to rapid treatments in major depressive disorder. Mol Psychiatry. 2015;20(1):48-55. https://doi.org/10.1038/mp.2014.138 PMID:25349171 - PMCID:PMC4765913 DOI: https://doi.org/10.1038/mp.2014.138

.25. Fishbein AB, Knutson KL, Zee PC. Circadian disruption and human health. J Clin Invest. 2021;131(19):e148286. https://doi.org/10.1172/jci148286 PMID:34596053 PMCID:PMC8483747 DOI: https://doi.org/10.1172/JCI148286

.26. Emens JS, Berman AM, Thosar SS, Butler MP, Roberts SA, Clemons NA, Herzig MX, McHill AW, Morimoto M, Bowles NP, Shea SA. Circadian rhythm in negative affect: implications for mood disorders. Psychiatry Res. 2020;293:113337. https://doi.org/10.1016/j.psychres.2020.113337 PMID:32777620 PMCID:PMC8053038. DOI: https://doi.org/10.1016/j.psychres.2020.113337

.27. Wang X, Cheng S, Xu H. Systematic review and meta-analysis of the relationship between sleep disorders and suicidal behaviour in patients with depression. BMC Psychiatry. 2019;19:303. https://doi.org/10.1186/s12888-019-2302-5 PMID:31623600 PMCID:PMC6798511 DOI: https://doi.org/10.1186/s12888-019-2302-5

.28. Liu RT, Steele SJ, Hamilton JL, Do QBP, Furbish K, Burke TA, Martinez AP, Gerlus N. Sleep and suicide: a systematic review and meta-analysis of longitudinal studies. Clin Psychol Rev. 2020;81:101895. https://doi.org/10.1016/j.cpr.2020.101895 PMID:32801085 - PMCID:PMC7731893 DOI: https://doi.org/10.1016/j.cpr.2020.101895

.29. Dolsen EA, Prather AA, Lamers F, Penninx BWJH. Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation. Psychol Med. 2021;51(12):2094-103. https://doi.org/10.1017/s0033291720000860 PMID:32321599 DOI: https://doi.org/10.1017/S0033291720000860

.30. Hedström AK, Hössjer O, Bellocco R, Ye W, Trolle LY, Åkerstedt T. Insomnia in the context of short sleep increases suicide risk. Sleep. 2021;44(4):zsaa245. https://doi.org/10.1093/sleep/zsaa245 PMID:33216134 - PMCID:PMC8033451 DOI: https://doi.org/10.1093/sleep/zsaa245

.31. Gebara MA, Siripong N, DiNapoli EA, Maree RD, Germain A, Reynolds CF, Kasckow JW, Weiss PM, Karp JF. Effect of insomnia treatments on depression: a systematic review and meta-analysis. Depress Anxiety. 2018;35(8):717-31. https://doi.org/10.1002/da.22776 PMID:29782076 DOI: https://doi.org/10.1002/da.22776

.32. Staner L. Comorbidity of insomnia and depression. Sleep Med Rev. 2010;14(1):35-46. https://doi.org/10.1016/j.smrv.2009.09.003 PMID:19939713 DOI: https://doi.org/10.1016/j.smrv.2009.09.003

.33. Pentagna A, Bacelar A, Claudino LS, Assis M. Tratamento farmacológico do transtorno da insônia. In: Bacelar A, Pinto Junior LR, editores. Insônia: do diagnóstico ao tratamento. São Caetano do Sul: Difusão Editora; 2019. https://absono.com.br/wp-content/uploads/2021/03/consenso_insonia_sono_diagnostico_tratamento.pdf

.34. Drager LF, Assis M, Bacelar AFR, Poyares DLR, Conway SG, Pires GN, Azevedo AP, Carissimi A, Eckeli AL, Pentagna A, Almeida CMO, Franco CMR, Sobreira EST, Stelzer FG, Mendes GM, Minhoto GR, Linares IMP, Sousa KMM, Gitaí LLG, Sukys-Claudino L, Sobreira-Neto MA, Zanini MA, Margis R, Martinez SCG. 2023 Guidelines on the diagnosis and treatment of insomnia in adults - Brazilian Sleep Association. Sleep Sci. 2023;16(Suppl 2):507-49. https://doi.org/10.1055/s-0043-1776281 PMID:38370879 PMCID:PMC10869237 DOI: https://doi.org/10.1055/s-0043-1776281

.35. Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American academy of sleep medicine clinical practice guideline. J Clin Sleep Med. 2017;13(2):307-49. https://doi.org/10.5664/jcsm.6470 PMID:27998379 PMCID:PMC5263087 DOI: https://doi.org/10.5664/jcsm.6470

.36. Morin CM, Inoue Y, Kushida C, Poyares D, Winkelman J; Guidelines Committee Members; Governing Council of the World Sleep Society. Endorsement of European guideline for the diagnosis and treatment of insomnia by the World Sleep Society. Sleep Med. 2021;81:124-6. https://doi.org/10.1016/j.sleep.2021.01.023 PMID:33667998 DOI: https://doi.org/10.1016/j.sleep.2021.01.023

.37. Atkin T, Comai S, Gobbi G. Drugs for insomnia beyond benzodiazepines: pharmacology, clinical applications, and discovery. Pharmacol Rev. 2018;70(2):197-245. https://doi.org/10.1124/pr.117.014381 PMID:29487083 DOI: https://doi.org/10.1124/pr.117.014381

.38. Rumble ME, White KH, Benca RM. Sleep disturbances in mood disorders. Psychiatr Clin North Am. 2015;38(4):743-59. https://doi.org/10.1016/j.psc.2015.07.006 PMID:26600106 DOI: https://doi.org/10.1016/j.psc.2015.07.006

.39. Hutka P, Krivosova M, Muchova Z, Tonhajzerova I, Hamrakova A, Mlyncekova Z, Mokry J, Ondrejka I. Association of Sleep Architecture and Physiology with Depressive Disorder and Antidepressants Treatment. Int J Mol Sci. 2021;22(3):1333. https://doi.org/10.3390/ijms22031333 PMID:33572767 PMCID:PMC7866255 DOI: https://doi.org/10.3390/ijms22031333

.40. Schweitzer PK, Randazzo AC. Chapter 45 - Drugs that disturb sleep and wakefulness. In: Kryger MH, Roth T, Dement WC, editors. Principles and practice of sleep medicine. 6th ed. New York: Elsevier; 2017. p. 480-98.e8. https://doi.org/10.1016/B978-0-323-24288-2.00045-3 DOI: https://doi.org/10.1016/B978-0-323-24288-2.00045-3

.41. DeMartinis NA, Winokur A. Effects of psychiatric medications on sleep and sleep disorders. CNS Neurol Disord Drug Targets. 2007;6(1):17-29. https://doi.org/10.2174/187152707779940835 PMID:17305551 DOI: https://doi.org/10.2174/187152707779940835

.42. Alberti S, Chiesa A, Andrisano C, Serretti A. Insomnia and somnolence associated with second-generation antidepressants during the treatment of major depression: a meta-analysis. J Clin Psychopharmacol. 2015;35(3):296-303. https://doi.org/10.1097/jcp.0000000000000329 PMID:25874915 DOI: https://doi.org/10.1097/JCP.0000000000000329

.43. Zhou S, Li P, Lv X, Lai X, Liu Z, Zhou J, Liu F, Tao Y, Zhang M, Yu X, Tian J, Sun F. Adverse effects of 21 antidepressants on sleep during acute-phase treatment in major depressive disorder: a systemic review and dose-effect network meta-analysis. Sleep. 2023;46(10):zsad177. https://doi.org/10.1093/sleep/zsad177 PMID:37422714 - PMCID:PMC10566234 DOI: https://doi.org/10.1093/sleep/zsad177

.44. Uca AU, Uğuz F, Kozak HH, Gümüş H, Aksoy F, Seyithanoğlu A, Kurt HG. Antidepressant-induced sleep bruxism: prevalence, incidence, and related factors. Clin Neuropharmacol. 2015;38(6):227-30. https://doi.org/10.1097/wnf.0000000000000108 PMID:26536018 DOI: https://doi.org/10.1097/WNF.0000000000000108

.45. Kolla BP, Mansukhani MP, Bostwick JM. The influence of antidepressants on restless legs syndrome and periodic limb movements: a systematic review. Sleep Med Rev. 2018;38:131-40. https://doi.org/10.1016/j.smrv.2017.06.002 PMID:28822709 DOI: https://doi.org/10.1016/j.smrv.2017.06.002

.46. Doghramji K, Jangro WC. Adverse effects of psychotropic medications on sleep. Psychiatr Clin North Am. 2016;39(3):487-502. https://doi.org/10.1016/j.psc.2016.04.009 PMID:27514301 DOI: https://doi.org/10.1016/j.psc.2016.04.009

.47. Wichniak A, Wierzbicka A, Walęcka M, Jernajczyk W. Effects of antidepressants on sleep. Curr Psychiatry Rep. 2017;19(9):63. https://doi.org/10.1007/s11920-017-0816-4 PMID:28791566 PMCID:PMC5548844 DOI: https://doi.org/10.1007/s11920-017-0816-4

.48. Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. New York: The Guilford Press; 1979. (Guilford clinical psychology and psychotherapy).

.49. Edinger JD, Arnedt JT, Bertisch SM, Carney CE, Harrington JJ, Lichstein KL, Sateia MJ, Troxel WM, Zhou ES, Kazmi U, Heald JL, Martin JL. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021;17(2):255-62. https://doi.org/10.5664/jcsm.8986 PMID:33164742 - PMCID:PMC7853203 DOI: https://doi.org/10.5664/jcsm.8986

.50. van Straten A, van der Zweerde T, Kleiboer A, Cuijpers P, Morin CM, Lancee J. Cognitive and behavioral therapies in the treatment of insomnia: a meta-analysis. Sleep Med Rev. 2018;38:3-16. https://doi.org/10.1016/j.smrv.2017.02.001 PMID:28392168 DOI: https://doi.org/10.1016/j.smrv.2017.02.001

.51. Gao Y, Ge L, Liu M, Niu M, Chen Y, Sun Y, Chen J, Yao L, Wang Q, Li Z, Xu J, Li M, Hou L, Shi J, Yang K, Cai Y, Li L, Zhang J, Tian J. Comparative efficacy and acceptability of cognitive behavioral therapy delivery formats for insomnia in adults: a systematic review and network meta-analysis. Sleep Med Rev. 2022;64:101648. https://doi.org/10.1016/j.smrv.2022.101648 PMID:35759820 DOI: https://doi.org/10.1016/j.smrv.2022.101648

.52. Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Ann Intern Med. 2015;163(3):191-204. https://doi.org/10.7326/m14-2841 PMID:26054060 DOI: https://doi.org/10.7326/M14-2841

.53. Perlis M, Aloia M, Kuhn B. Behavioral treatments for sleep disorders: a comprehensive primer of behavioral sleep medicine intervention. London: Academic Press; 2010.

.54. American Psychiatric Association. Manual diagnóstico e estatístico de transtornos mentais: DSM-5. 5. ed. Porto Alegre: Artmed; 2014.

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2025-01-17

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Zanini MA, Pinna CM de S, Lourenço RB, Reis FZ dos, Borges DGS, Santana GP, et al. Insônia e depressão: confluências neurobiológicas e tratamento. Debates em Psiquiatria [Internet]. 17º de janeiro de 2025 [citado 13º de fevereiro de 2025];15:1-28. Disponível em: https://revistardp.org.br/revista/article/view/1332

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Copyright (c) 2025 Márcio Andrei Zanini, Camilla Moreira de Sousa Pinna, Rafael Brandes Lourenço, Flavia Zuccolotto dos Reis, Daniel Guilherme Suzuki Borges, Glícia Prates Santana, Regina Margis, Almir Ribeiro Tavares Júnior

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