Is restless legs syndrome related with depression/anxiety disorders or medications used in these disorders? A cross-sectional, clinic-based study

Figures & data

Table 1. The distribution of some descriptive and clinical features according to the presence of restless legs syndrome.

	RLS presence		p^b
	No (n = 350)	Yes (n = 64)
	n (%)	n (%)
Age (years), mean ± SD (min–max)	41.95 ± 14.82 (18–83)	43.09 ± 13.09 (19–66)	0.491^c
Gender
Female	232 (66.3)	48 (75.0)	0.171
Male	118 (33.7)	16 (25.0)
Marital status^a
Married	216 (61.7)	44 (68.8)	0.284
Single	134 (38.3)	20 (31.2)
Education status
Illiterate/elementary	116 (33.1)	19 (29.7)	0.064
Secondary/high School	93 (26.6)	26 (40.6)
University	141 (40.3)	19 (29.7)
Smoking status	70 (20.0)	23 (35.9)	0.005
Comorbid diseases	64 (18.3)	9 (14.1)	0.415
Drug therapy
Monotherapy	252 (72.0)	24 (37.5)	<0.001
Combined drug therapy	98 (28.0)	40 (62.5)
Disorder
Anxiety disorder	203 (58.0)	41 (64.1)	0.365^b
Depression disorder	147 (42.0)	23 (35.9)

Note: Mean: average; SD: standard deviation; n: number of patients; %: column percentage.

^aThose who were divorced or widowed combined with the column single la.

^bChi-square test.

^cMann–Whitney U test.

Table 2. The prevalence of RLS and the IRLSSG scale score and the severity of RLS according to the diagnosis of the patients.

	Total	Anxiety disorder	Depression disorder	p
RLS (n = 414), n (%)
No	350 (84.5)	203 (83.2)	147 (86.5)	0.365^a
Yes	64 (15.5)	41 (16.8)	23 (13.5)
RLS severity (n = 64), n (%)
Light	5 (7.8)	4 (9.8)	1 (4.3)	0.692^a
Medium	34 (53.1)	22 (53.7)	12 (52.2)
Severe	25 (39.1)	15 (36.6)	10 (43.5)
IRLSSG (n = 64), mean ± SD (min–max)	18.95 ± 5.11 (7–29)	19.12 ± 5.03 (8–29)	18.65 ± 5.35 (7–29)	0.822^b

Note: Mean: average; SD: standard deviation; n: number of patients; %: column percentage; RLS: restless leg syndrome; IRLSSG: International Restless Legs Syndrome Working Group Scale.

^aChi-square test.

^bMann–Whitney U test.

Table 3. Distribution of RLS absence, severity and IRLSSG score according to severity of anxiety and depression.

	HADS anxiety		P	HADS depression		p
	≤10	>10		≤7	>7
RLS (n = 414), n (%)
No	213 (91.8)	137 (75.3)	<0.001^a	225 (88.2)	125 (78.6)	0.008^a
Yes	19 (8.2)	45 (24.7)		30 (11.8)	34 (21.4)
RLS Severity (n = 64), n (%)
Light/medium	11 (57.9)	28 (62.2)	0.746^a	19 (63.3)	20 (58.8)	0.712^a
Severe	8 (42.1)	17 (37.8)		11 (36.7)	14 (41.2)
IRLSSG (n = 64), av ± SD	19.00 ± 5.35	18.93 ± 5.06	0.962^b	18.67 ± 4.72	19.21 ± 5.48	0.677^b

Note: av: average; SD: standard deviation; n: number of patients; %: column percentage; RLS: restless leg syndrome; IRLSSG: International Restless Leg Syndrome Study Group Scale.

^aChi-square test.

^bStudent’s T test.

Table 4. The distribution of severity of restless leg syndrome according to the drugs used by the patients.

Drugs used	Mild/Moderate RLS (n = 61)	Severe RLS (n = 36)	p^a
SSRI	24 (57.1)	18 (42.9)	0.390
Escitalopram	6 (60.0)	4 (40.0)	1.000^b
Fluoxetine	4 (66.7)	2 (33.3)	1.000^b
Paroxetine	5 (41.7)	7 (58.3)	0.190^b
Sertraline	8 (80.0)	2 (20.0)	0.292^b
Citalopram	1 (25.0)	3 (75.0)	0.291^b
TCA	0	1 (100)	0.391^b
Clomipramin	0	1 (100)	0.391^b
SNRI	14 (70.0)	6 (30.0)	0.316
Duloxetine	8 (61.5)	5 (38.5)	0.960
Venlafaxine	6 (85.7)	1 (14.3)	0.231^b
OTHERS	1 (100)	0	1.000^b
Agomelatine	1 (100)	0	1.000^b

Note: n: number of patients; %: per cent; RLS: restless leg syndrome; SSRI: selective serotonin reuptake inhibitor; TCA: tricyclic antidepressant; SNRI: serotonin and noradrenaline reuptake inhibitor.

^aChi-square test.

^bFisher’s final test.

Table 5. Distribution of RLS presence according to combination types of SSRI and SNRI combination groups.

	Patients without RLS (n = 295)	Patients with RLS (n = 51)	p
	n (%)	n (%)
SSRI combination type
SSRI + quetiapine	17 (60.7)	11 (39.3)	<0.001
SSRI + mirtazapine	8 (66.7)	4 (33.3)
SSRI + trazodone	12 (66.7)	6 (33.3)
Only SSRI	189 (93.1)	14 (6.9)
SNRI combination type
SNRI + quetiapine	12 (92.3)	1 (7.7)	0.012
SNRI + mirtazapine	9 (81.8)	2 (18.2)
SNRI + trazodone	5 (45.5)	6 (54.5)
Only SNRI	43 (86.0)	7 (14.0)

Note: n: number of patients; %: per cent of line; SSRI: selective serotonin reuptake inhibitor; SNRI: serotonin and noradrenaline reuptake inhibitor.

Table 6. Independent effects of some possible predators in predicting restless leg syndrome (multivariate logistic regression analysis).

	B	SE	Wald χ^2	sd	OR	%95-CI	p
HADS anxiety score
≤10	Reference
>10	1.155	0.319	13.142	1	3.174	1.700–5.927	<0.001
HADS depression score
≤7	Reference
>7	0.189	0.312	0.369	1	1.208	0.656–2.226	0.543
Gender
Male	Reference
Female	0.674	0.368	3.356	1	1.962	0.954–4.034	0.067
Smoking status	0.965	0.338	8.130	1	2.624	1.352–5.092	0.004
Using alcohol	−0.688	0.496	1.920	1	0.503	0.190–1.330	0.166
Combined treatment	1.409	0.314	20.142	1	4.091	2.211–7.569	<0.001
Using SSRI	0.209	0.804	0.068	1	1.233	0.255–5.958	0.794
Using SNRI	0.345	0.841	0.168	1	1.412	0.272–7.342	0.682

Note: regression factor; SE: standard error; OR: odds ratio; GA: confidence interval. Cox and Snell R2: 0.13; Nagelkerke R2: 0.23; Hosmer and Lemeshow, 2: 8.43, p = 0.393.