Kupfer D J
Biol Psychiatry. 1976 Apr;11(2):159-74.
Previous investigations have indicated that one of the most consistent EEG sleep findings in depressive patients has been a shortened REM latency. On the basis of these studies, we have concluded that with the exception of drug withdrawal states (such as CNS depressant or amphetamine withdrawal and narcolepsy) shortened REM latency points to a strong affective component in the patient's illness. Short REM latency has also been observed in patients suffering from schizo-affective illness as well as in certain schizophrenic patients who require tricyclic antidepressants in their management. Furthermore, this psychobiologic marker is a persistent, rather than a transient phenomenon, and can be observed over a period of several weeks unless a patient's condition becomes more favorable through clinical intervention. This present report indicates that short REM latency is found in virtually all primary depressive illness and is absent in secondary depression. Thus, REM latency appears to be a dependable, measurable marker for diagnosing primary depression, and we argue that the phenomenon is independent of age, drug effect and changes in other sleep parameters. It is expected that EEG sleep and motor measurements can yield further significant data and improve differential diagnosis in psychiatry, in much the same way that laboratory data support other medical specialities.
先前的研究表明,抑郁症患者脑电图睡眠研究中最一致的发现之一是快速眼动(REM)睡眠潜伏期缩短。基于这些研究,我们得出结论,除了药物戒断状态(如中枢神经系统抑制剂或苯丙胺戒断以及发作性睡病)外,REM潜伏期缩短表明患者病情中存在强烈的情感成分。在患有分裂情感性疾病的患者以及某些需要三环类抗抑郁药治疗的精神分裂症患者中也观察到了REM潜伏期缩短。此外,这种心理生物学标志物是一种持续存在而非短暂的现象,并且在几周时间内都可观察到,除非通过临床干预患者的病情有所改善。本报告表明,几乎所有原发性抑郁症患者都存在REM潜伏期缩短的情况,而继发性抑郁症患者则不存在。因此,REM潜伏期似乎是诊断原发性抑郁症的一个可靠、可测量的标志物,并且我们认为该现象与年龄、药物作用以及其他睡眠参数的变化无关。预计脑电图睡眠和运动测量能够产生更多重要数据,并改善精神病学中的鉴别诊断,就如同实验室数据支持其他医学专科一样。