Hornyak Magdolna, Kopasz Marta, Berger Mathias, Riemann Dieter, Voderholzer Ulrich
Department of Psychiatry and Psychotherapy, University Hospital, Freiburg, Germany.
J Clin Psychiatry. 2005 Sep;66(9):1139-45. doi: 10.4088/jcp.v66n0909.
Restless legs syndrome (RLS) is a distressing sensorimotor disorder with a 5% to 10% prevalence in the United States and Western Europe. The nocturnal occurrence of symptoms often leads to severe sleep disturbances. RLS has been reported to be associated with depression and anxiety. The aim of the present study was to investigate the relationship between RLS symptom severity, sleep disturbances, and depressive symptoms.
Questionnaire data from 100 consecutive patients with idiopathic RLS who had been investigated in our Sleep Disorders Unit from April 1999 to December 2004 were evaluated. Patients were untreated regarding RLS, depression, or sleep disturbances. Severity of RLS was assessed with the International RLS Study Group rating scale (IRLS). Depressive symptoms and subjective sleep quality were determined using the Beck Depression Inventory (BDI) and the Pittsburgh Sleep Quality Index (PSQI), respectively.
IRLS scores indicated moderate-to-severe RLS symptoms in the population studied (mean +/- SD IRLS score = 23.6 +/- 6.7). The mean +/- SD BDI score was 9.3 +/- 5.6, with highest values on the "reduced sleep," "loss of energy," and "work difficulties" items, indicating predominating somatic symptoms of depression. Fourteen patients had a BDI score of 15 to 20 ("mild depression"), and 3 patients had a BDI score of 20 to 30 ("mild to moderate depression"). Overall, patients estimated their sleep quality as moderately impaired (mean +/- SD PSQI score = 10.9 +/- 3.7). Severity of RLS correlated with the impairment of subjective sleep quality (r = 0.281, p = .007) but not with self-rated depressive symptoms (r = 0.119, p = .237).
RLS patients scored high on the somatic items of the BDI, particularly on those related to sleep disturbance, but not on the other items that mostly address cognitive symptoms. Our results indicate that RLS might be associated with some features of depression but not with the full spectrum of a depressive disorder. The relationship between the 2 disorders should be investigated in further studies.
不宁腿综合征（RLS）是一种令人苦恼的感觉运动障碍，在美国和西欧的患病率为5%至10%。症状在夜间出现常常导致严重的睡眠障碍。据报道，RLS与抑郁和焦虑有关。本研究的目的是调查RLS症状严重程度、睡眠障碍和抑郁症状之间的关系。
对1999年4月至2004年12月在我们睡眠障碍科接受调查的100例连续性特发性RLS患者的问卷数据进行评估。患者未接受过针对RLS、抑郁或睡眠障碍的治疗。使用国际RLS研究组评分量表（IRLS）评估RLS的严重程度。分别使用贝克抑郁量表（BDI）和匹兹堡睡眠质量指数（PSQI）确定抑郁症状和主观睡眠质量。
IRLS评分表明，在所研究的人群中存在中度至重度RLS症状（平均±标准差IRLS评分为23.6±6.7）。平均±标准差BDI评分为9.3±5.6，在“睡眠减少”“精力丧失”和“工作困难”项目上得分最高，表明抑郁的躯体症状占主导。14例患者的BDI评分为15至20（“轻度抑郁”），3例患者的BDI评分为20至30（“轻度至中度抑郁”）。总体而言，患者估计其睡眠质量受到中度损害（平均±标准差PSQI评分为10.9±3.7）。RLS的严重程度与主观睡眠质量的损害相关（r = 0.281，p = 0.007），但与自评抑郁症状无关（r = 0.119，p = 0.237）。
RLS患者在BDI的躯体项目上得分较高，特别是与睡眠障碍相关的项目，但在主要涉及认知症状的其他项目上得分不高。我们的结果表明，RLS可能与抑郁的某些特征有关，但与抑郁症的整个范围无关。这两种疾病之间的关系应在进一步研究中进行调查。
