LWL University Hospital Hamm of the Ruhr University Bochum, Hospital for Child and Adolescent Psychiatry, Heithofer Allee 64, 59071 Hamm, Germany.
J Neural Transm (Vienna). 2012 Sep;119(9):989-98. doi: 10.1007/s00702-012-0837-4. Epub 2012 Jun 9.
In many mentally ill children, a new phenotype of affective and behavioural dysregulation can be observed. Not much is known about development and maintenance of this phenotype. A possible risk factor that has been suggested is disturbed sleep. The co-occurrence of sleep disturbances and psychiatric symptoms is significant and it has been postulated that there are specific patterns of sleep disturbances for different psychiatric symptoms. The aim of this study, therefore, is to investigate the specific relation of sleep disturbances and affective dysregulation in school children and whether a specific pattern of sleep disturbances is associated with or of predictive value for affective dysfunctions. 4,774 school children took part in the Cologne Sleep Study and emotional disturbances and sleep abnormalities were assessed by parent reports. Of the sample, 206 children were identified as showing signs of severe affective and behavioural dysregulation (DP), 276 children were reported as showing a subclinical form (SUB-DP). Both groups reported significantly more sleep disturbances than healthy controls with moderate to large effect sizes. Differences between SUB-DP and DP exist, however, were not of clinical relevance (d < 0.03). Particularly, emotional problems were associated with sleep disturbances with small to moderate correlation coefficients. The regression analysis revealed a small, but significant influence of impaired daytime behaviour on affective dysregulation with 16.1 % of variance being explained. No specific patterns of sleep disturbances could be identified. However, impaired sleep and daytime behaviour in both the SUB-DP and DP group are indicated. Consequently, practitioners should address sleep problems in children with affective dysregulation.
在许多患有精神疾病的儿童中,可以观察到一种新的情感和行为失调表型。对于这种表型的发展和维持,我们知之甚少。有人提出,睡眠障碍可能是一个风险因素。睡眠障碍与精神症状的同时发生具有重要意义,有人推测不同的精神症状存在特定的睡眠障碍模式。因此,本研究旨在调查儿童睡眠障碍与情感失调之间的特定关系,以及睡眠障碍的特定模式是否与情感功能障碍相关或具有预测价值。4774 名学童参加了科隆睡眠研究,通过家长报告评估情绪障碍和睡眠异常。在样本中,有 206 名儿童表现出严重的情感和行为失调(DP)迹象,276 名儿童表现出亚临床形式(SUB-DP)。两组报告的睡眠障碍明显多于健康对照组,具有中等至较大的效应大小。然而,SUB-DP 和 DP 之间的差异没有临床意义(d < 0.03)。特别是,情绪问题与睡眠障碍相关,具有小到中等的相关系数。回归分析显示,日间行为受损对情感失调有较小但显著的影响,可解释 16.1%的方差。没有发现特定的睡眠障碍模式。然而,SUB-DP 和 DP 组都存在睡眠和日间行为受损的情况。因此,临床医生应该关注有情感失调的儿童的睡眠问题。