Lee Hyeong Gon, Choi Jae Won, Lee Yu Jin, Jeong Do-Un
Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea.
Psychiatry Investig. 2016 Mar;13(2):227-31. doi: 10.4306/pi.2016.13.2.227. Epub 2016 Mar 23.
REM sleep behavior disorder (RBD) is associated with psychiatric symptoms, such as anxiety and alexithymia. However, only a few studies on the relationship between depression and RBD have been published. In this study, we investigated the occurrence of depression and associated factors in patients with RBD.
In total 94 patients (mean age: 61.9±12.7 years, male: 70.2%) diagnosed as RBD were examined using detailed clinical histories, the Beck Depression Inventory (BDI), the Epworth Sleepiness Scale (ESS), and nocturnal polysomnography (PSG).
The mean BDI score of all patients was 12.4±10.3 and 44.7% of RBD patients showed depressed mood (BDI >11 points). Depressed RBD patients were less able to recall enacted dreams than were non-depressed patients (61.9% vs. 86.5%, p=0.008). Logistic regression analysis showed that failure to recall enacted dreams was significantly associated with depression, after controlling for confounding variables including the respiratory disturbance index and a history of psychiatric disorders (odds ratio=0.323, p=0.041).
In this study, 44.7% of RBD patients were found to suffer from depressed mood. And, depression was found to be associated with reduced ability to recall enacted dreams. We suggest that routine evaluation of depression be performed in RBD patients, particularly when failure to recall enacted dreams is evident. We speculate that such failure may be associated with emotional dysregulation or neurodegeneration.
快速眼动睡眠行为障碍(RBD)与焦虑和述情障碍等精神症状相关。然而,关于抑郁症与RBD之间关系的研究仅有少数发表。在本研究中,我们调查了RBD患者中抑郁症的发生率及相关因素。
对总共94例被诊断为RBD的患者(平均年龄:61.9±12.7岁,男性:70.2%)进行详细的临床病史检查、贝克抑郁量表(BDI)、爱泼沃斯思睡量表(ESS)以及夜间多导睡眠图(PSG)检查。
所有患者的BDI平均得分为12.4±10.3,44.7%的RBD患者表现出抑郁情绪(BDI>11分)。与非抑郁患者相比,抑郁的RBD患者回忆梦境情节的能力较差(61.9%对86.5%,p=0.008)。逻辑回归分析表明,在控制包括呼吸紊乱指数和精神疾病史等混杂变量后,无法回忆梦境情节与抑郁症显著相关(比值比=0.323,p=0.041)。
在本研究中,发现44.7%的RBD患者患有抑郁情绪。并且,发现抑郁症与回忆梦境情节的能力下降有关。我们建议对RBD患者进行抑郁症的常规评估,尤其是当明显无法回忆梦境情节时。我们推测这种情况可能与情绪调节障碍或神经退行性变有关。