De la Fuente J M, Bobes J, Vizuete C, Mendlewicz J
Department of Psychiatry, Erasme Hospital, Free University of Brussels, 808 route de Lennik, B-1070, Brussels, Belgium.
Psychiatry Res. 2001 Dec 15;105(1-2):87-95. doi: 10.1016/s0165-1781(01)00330-4.
The link between borderline personality disorder (BPD) and the affective disorders remains controversial. The aim of this study was to examine the relationships between BPD and major depression (MD) from the perspective of sleep parameters and to contribute to the characterisation of the sleep-EEG in BPD. We compared 20 off-medication BPD in-patients without co-existing MD with 20 sex- and age-matched MD patients without BPD and 20 sex- and age-matched control subjects. BPD patients had a greater prevalence of drug or alcohol abuse and suicide attempts than MD patients. MD patients had higher scores on the Hamilton Depression Rating Scale (HDRS). Both BPD and MD patients had less total sleep time, more prolonged sleep onset latency, and a greater percentage of wakefulness than control subjects. BPD patients and control subjects had more stage 2 sleep than MD patients. BPD patients had a longer duration of rapid eye movement (REM) sleep, and less stage 3, stage 4 and slow wave sleep than MD patients and control subjects. REM latency did not differentiate the three groups. BPD and MD patients shared sleep-continuity characteristics, but sleep architecture differentiated the two groups. BPD patients with a past history of MD had more wakefulness and less slow wave sleep than BPD patients without a history of MD; other sleep parameters, age, sex and HDRS scores were not statistically different in the two BPD subgroups. Although BPD and MD may coexist, the present study offers more arguments favouring the concept that they are not biologically linked and that BPD patients with depressive symptoms often experience an affective syndrome different from that in MD patients without BPD, in terms of quality and duration of symptoms and of the biological substrate.
边缘性人格障碍（BPD）与情感障碍之间的联系仍存在争议。本研究的目的是从睡眠参数的角度检查BPD与重度抑郁症（MD）之间的关系，并有助于描述BPD患者的睡眠脑电图特征。我们将20名未服用药物且无共病MD的BPD住院患者与20名年龄和性别匹配的无BPD的MD患者以及20名年龄和性别匹配的对照受试者进行了比较。BPD患者药物或酒精滥用以及自杀未遂的患病率高于MD患者。MD患者在汉密尔顿抑郁量表（HDRS）上得分更高。BPD患者和MD患者的总睡眠时间均少于对照受试者，睡眠开始潜伏期更长，清醒时间百分比更高。BPD患者和对照受试者的2期睡眠时间比MD患者更多。BPD患者的快速眼动（REM）睡眠时间更长，3期、4期和慢波睡眠时间比MD患者和对照受试者更少。REM潜伏期无法区分这三组。BPD患者和MD患者具有共同的睡眠连续性特征，但睡眠结构区分了这两组。有MD病史的BPD患者比无MD病史的BPD患者清醒时间更多，慢波睡眠时间更少；两个BPD亚组的其他睡眠参数、年龄、性别和HDRS得分在统计学上无差异。尽管BPD和MD可能共存，但本研究提供了更多证据支持以下观点：它们在生物学上没有联系，并且有抑郁症状的BPD患者在症状的质量和持续时间以及生物学基础方面，通常经历与无BPD的MD患者不同的情感综合征。
