Vollrath M, Wicki W, Angst J
Psychiatric University Hospital, Zurich, Research Department, Switzerland.
Eur Arch Psychiatry Neurol Sci. 1989;239(2):113-24. doi: 10.1007/BF01759584.
The association of three subtypes of insomnia with psychic and functional syndromes, and the course of insomnia over 7 years were examined in a Swiss cohort of young adults interviewed three times. Specific associations were found between repeated brief insomnia (RBI) and recurrent brief depression (RBD). Continued insomnia (CI) was associated with major depression. All three subtypes of insomnia were associated with anxiety disorders; 52% of insomniacs were free of concurrent anxiety and depression. Insomnia--especially RBI and CI--was also associated with a number of functional complaints, but not with the consumption of alcohol, medicine, or illegal drugs. Insomniacs with RBI and occasional insomnia (OI) experienced more life events and interpersonal conflicts than controls. These findings support the subdivision of insomnia into different subtypes. The longitudinal analysis showed that insomnia tends to reoccur. For subjects with insomnia either at age 21 or 23 years, there was a higher risk of further insomnia at follow-ups. The specific subtype of insomnia at the first occurrence was not predictive for the outcome: all subtypes of insomnia enhance the risk of relapses in a similar way. Insomnia at age 21 is no precursor of the first onset of a depressive or anxiety disorder within a 2-year follow-up. With respect to the course of insomnia over 7 years, the subtypes did not differentiate.
在一个瑞士年轻成年人队列中，对三种失眠亚型与精神和功能综合征的关联以及失眠7年的病程进行了研究，该队列接受了三次访谈。发现反复短暂失眠（RBI）与复发性短暂抑郁（RBD）之间存在特定关联。持续性失眠（CI）与重度抑郁相关。所有三种失眠亚型均与焦虑症相关；52%的失眠症患者没有并发焦虑和抑郁。失眠——尤其是RBI和CI——也与一些功能主诉相关，但与酒精、药物或非法药物的使用无关。患有RBI和偶尔失眠（OI）的失眠症患者比对照组经历了更多的生活事件和人际冲突。这些发现支持将失眠细分为不同亚型。纵向分析表明，失眠容易复发。对于在21岁或23岁时患有失眠的受试者，随访时进一步失眠的风险更高。首次出现时失眠的具体亚型对结果没有预测作用：所有失眠亚型以相似的方式增加复发风险。21岁时的失眠不是2年随访内抑郁或焦虑症首次发作的先兆。关于失眠7年的病程，各亚型没有差异。
