Goldman-Mellor Sidra, Gregory Alice M, Caspi Avshalom, Harrington HonaLee, Parsons Michael, Poulton Richie, Moffitt Terrie E
Center for Developmental Science, University of North Carolina at Chapel Hill, Chapel Hill, NC ; Department of Psychology & Neuroscience, Duke University, Durham, NC ; Institute for Genome Sciences & Policy, Duke University, Durham, NC ; Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC.
Department of Psychology, Goldsmiths, University of London, London, UK.
Sleep. 2014 Nov 1;37(11):1767-75. doi: 10.5665/sleep.4168.
Insomnia is a highly prevalent condition that constitutes a major public health and economic burden. However, little is known about the developmental etiology of adulthood insomnia.
We examined whether indicators of psychological vulnerability across multiple developmental periods (psychiatric diagnoses in young adulthood and adolescence, childhood behavioral problems, and familial psychiatric history) predicted subsequent insomnia in adulthood.
We used data from the ongoing Dunedin Multidisciplinary Health and Development Study, a population-representative birth cohort study of 1,037 children in New Zealand who were followed prospectively from birth (1972-1973) through their fourth decade of life with a 95% retention rate.
Insomnia was diagnosed at age 38 according to DSM-IV criteria. Psychiatric diagnoses, behavioral problems, and family psychiatric histories were assessed between ages 5 and 38.
In cross-sectional analyses, insomnia was highly comorbid with multiple psychiatric disorders. After controlling for this concurrent comorbidity, our results showed that individuals who have family histories of depression or anxiety, and who manifest lifelong depression and anxiety beginning in childhood, are at uniquely high risk for age-38 insomnia. Other disorders did not predict adulthood insomnia.
The link between lifelong depression and anxiety symptoms and adulthood insomnia calls for further studies to clarify the neurophysiological systems or behavioral conditioning processes that may underlie this association.
失眠是一种高度普遍的病症，构成了重大的公共卫生和经济负担。然而，关于成年期失眠的发展病因知之甚少。
我们研究了多个发育阶段的心理易感性指标（青年期和青春期的精神疾病诊断、儿童期行为问题以及家族精神病史）是否能预测成年期后续的失眠情况。
我们使用了正在进行的达尼丁多学科健康与发展研究的数据，这是一项具有人群代表性的出生队列研究，对新西兰的1037名儿童进行了前瞻性跟踪，从出生（1972 - 1973年）一直到他们生命的第四个十年，保留率为95%。
根据《精神疾病诊断与统计手册》第四版标准，在38岁时诊断失眠。在5岁至38岁之间评估精神疾病诊断、行为问题和家族精神病史。
在横断面分析中，失眠与多种精神疾病高度共病。在控制了这种并发共病情况后，我们的结果表明，有抑郁症或焦虑症家族史且从儿童期就表现出终身抑郁和焦虑的个体，患38岁失眠症的风险特别高。其他疾病并不能预测成年期失眠。
终身抑郁和焦虑症状与成年期失眠之间的联系需要进一步研究，以阐明可能是这种关联基础的神经生理系统或行为条件作用过程。
