Freeman Daniel, Pugh Katherine, Vorontsova Natasha, Southgate Laura
Department of Psychology, Institute of Psychiatry, King's College London, United Kingdom.
Schizophr Res. 2009 Mar;108(1-3):280-4. doi: 10.1016/j.schres.2008.12.001. Epub 2008 Dec 20.
Insomnia is a potential cause of anxiety, depression, and anomalies of experience; separate research has shown that anxiety, depression and anomalies of experience are predictors of paranoia. Thus insomnia may contribute to the formation and maintenance of persecutory ideation. The aim was to examine for the first time the association of insomnia symptoms and paranoia in the general population and the extent of insomnia in individuals with persecutory delusions attending psychiatric services. Assessments of insomnia, persecutory ideation, anxiety, and depression were completed by 300 individuals from the general population and 30 individuals with persecutory delusions and a diagnosis of non-affective psychosis. Insomnia symptoms were clearly associated with higher levels of persecutory ideation. Consistent with the theoretical understanding of paranoia, the association was partly explained by the presence of anxiety and depression. Moderate or severe insomnia was present in more than 50% of the delusions group. The study provides the first direct evidence that insomnia is common in individuals with high levels of paranoia. It is plausible that sleep difficulties contribute to the development of persecutory ideation. The intriguing implication is that insomnia interventions for this group could have the added benefit of lessening paranoia.
失眠是焦虑、抑郁及体验异常的一个潜在原因；另外的研究表明，焦虑、抑郁及体验异常是偏执狂的预测因素。因此，失眠可能促使被害妄想的形成与维持。其目的是首次在普通人群中检验失眠症状与偏执狂之间的关联，以及在接受精神科服务的有被害妄想的个体中失眠的程度。来自普通人群的300人以及30名有被害妄想且被诊断为非情感性精神病的个体完成了对失眠、被害妄想、焦虑及抑郁的评估。失眠症状与更高水平的被害妄想明显相关。与对偏执狂的理论理解一致，这种关联部分可由焦虑和抑郁的存在来解释。超过50%的妄想症组个体存在中度或重度失眠。该研究提供了首个直接证据，证明失眠在偏执狂程度高的个体中很常见。睡眠困难促使被害妄想的发展这一说法似乎合理。有趣的是，对该群体进行失眠干预可能会有减轻偏执狂的额外益处。
