Ferentinos Panayotis, Kontaxakis Vassilis, Havaki-Kontaxaki Beata, Paparrigopoulos Thomas, Dikeos Dimitris, Ktonas Periklis, Soldatos Constantin
Department of Psychiatry, Eginition Hospital, University of Athens, Athens, Greece.
J Psychosom Res. 2009 Jan;66(1):37-42. doi: 10.1016/j.jpsychores.2008.07.009. Epub 2008 Nov 22.
This study aimed to investigate the independent correlations of subjective sleep disturbances (insomnia and daytime sleepiness) with the severity of fatigue in patients with major depression.
Eighty-one currently depressed patients (70 females and 11 males), aged between 23 and 65 years, with a DSM-IV diagnosis of major depressive disorder were studied. Patients with physical diseases or other conditions associated with prominent fatigue were excluded. The 17-item Hamilton Depression Rating Scale (HDRS), the Athens Insomnia Scale (AIS), and the Epworth Sleepiness Scale (ESS) were used for the cross-sectional assessment of the severity of depression, insomnia, and sleepiness, respectively. Severity of fatigue was measured with the Fatigue Severity Scale (FSS). Pearson's and Spearman's coefficients were used in bivariate correlations between FSS score and the independent variables (age, gender, inpatient/outpatient status, HDRS score, AIS total score, AIS individual item scores, and ESS score). A stepwise multiple regression analysis was then performed, with FSS score as the dependent variable.
The severity of fatigue was significantly correlated with female sex, HDRS score, AIS total score, awakenings during the night (AIS item 2), compromised sleep quality (AIS item 5), and ESS score. Sleep quality (AIS item 5) and daytime sleepiness (ESS) were the only significant predictors of the severity of fatigue in the multiple regression analysis.
Both sleep quality and daytime sleepiness correlate independently with fatigue severity, as measured with the FSS, in patients with major depression. The FSS does not appear to be a 'pure' measure of fatigue in depressed patients, a finding with potential implications for the choice of appropriate fatigue measures in this population.
本研究旨在调查主观睡眠障碍（失眠和日间嗜睡）与重度抑郁症患者疲劳严重程度之间的独立相关性。
对81名目前患有抑郁症的患者（70名女性和11名男性）进行了研究，年龄在23至65岁之间，根据《精神疾病诊断与统计手册》第四版（DSM-IV）诊断为重度抑郁症。排除患有躯体疾病或其他与明显疲劳相关疾病的患者。分别使用17项汉密尔顿抑郁量表（HDRS）、雅典失眠量表（AIS）和爱泼华嗜睡量表（ESS）对抑郁、失眠和嗜睡的严重程度进行横断面评估。采用疲劳严重程度量表（FSS）测量疲劳严重程度。FSS评分与自变量（年龄、性别、住院/门诊状态、HDRS评分、AIS总分、AIS单项评分和ESS评分）之间的双变量相关性采用Pearson系数和Spearman系数。然后以FSS评分为因变量进行逐步多元回归分析。
疲劳严重程度与女性、HDRS评分、AIS总分、夜间觉醒（AIS第2项）、睡眠质量受损（AIS第5项）和ESS评分显著相关。在多元回归分析中，睡眠质量（AIS第5项）和日间嗜睡（ESS）是疲劳严重程度的唯一显著预测因素。
在重度抑郁症患者中，睡眠质量和日间嗜睡均与通过FSS测量的疲劳严重程度独立相关。FSS似乎并不是抑郁症患者疲劳的“纯粹”测量指标，这一发现可能对该人群中适当疲劳测量指标的选择具有潜在影响。
