Perfectionism mediates the relationship between insomnia and depressive symptoms

Empirical evidence indicates that persistent insomnia is a risk factor for developing depression. A personal variable shown to be related to both insomnia and depressive symptoms is perfectionism. However, results of previous studies do not allow to understand how perfectionism influences the relationship between these two clinical conditions. The aim of the present study is to evaluate, through a prospective design, whether perfectionism mediates the relationship between insomnia and depressive symptoms. A community sample of 819 participants filled the Achenbach depression scale, the Pittsburgh Sleep Quality Index and the Frost's Perfectionism scale (F-MPS) and 720 were interviewed again after three months. Analyses of Structural Equation Modeling evidence that insomnia symptoms influence depressive symptoms both directly and indirectly, through the mediation of the negative aspects of perfectionism Concerns over Mistakes and Doubts about Actions. This pattern of relationship is present in both the cross-sectional and prospective models. Results imply that clinical interventions could benefit from targeting perfectionism and insomnia in the treatment of depression.