McDonald Keltie C, Saunders Kate Ea, Geddes John R
1 Department of Psychiatry, University of Oxford, Oxford, UK.
2 Oxford Health NHS Foundation Trust, Oxford, UK.
Aust N Z J Psychiatry. 2017 Aug;51(8):822-828. doi: 10.1177/0004867416687398. Epub 2017 Jan 17.
Mood instability is common in the general population. Mood instability is a precursor to mental illness and associated with a range of negative health outcomes. Sleep disturbance appears to be closely linked with mood instability. This study assesses the association between mood instability and sleep disturbance and the link with suicidal ideation and behaviour in a general population sample in England.
The Adult Psychiatric Morbidity Survey, 2007 collected detailed information about mental health symptoms and correlates in a representative sample of adult household residents living in England ( n = 7303). Mood instability was assessed using the Structured Clinical Interview for DSM-IV Axis-II. Sleep problems were defined as sleeping more than usual or less than usual during the past month. Other dependent variables included medication use and suicidal ideation and behaviour (response rate 57%). Generalized linear modelling was used to estimate the prevalence of mood instability and sleep problems. Logistic regression was used to estimate odds ratios. All estimates were weighted.
The prevalence of mood instability was 14.7% (95% confidence interval [13.6%, 15.7%]). Sleep problems occurred in 69.8% (95% confidence interval: [66.6%, 73.1%]) of those with mood instability versus 37.6% (95% confidence interval: [36.2%, 39.1%]) of those without mood instability. The use of sedating and non-sedating medications did not influence the association. Sleep problems were significantly associated with suicidal ideation and behaviour even after adjusting for mood instability.
Sleep problems are highly prevalent in the general population, particularly among those with mood instability. Sleep problems are strongly associated with suicidal ideation and behaviour. Treatments that target risk and maintenance factors that transcend diagnostic boundaries, such as therapies that target sleep disturbance, may be particularly valuable for preventing and addressing complications related to mood instability such as suicide.
情绪不稳定在普通人群中很常见。情绪不稳定是精神疾病的先兆，并与一系列负面健康结果相关。睡眠障碍似乎与情绪不稳定密切相关。本研究评估了英国普通人群样本中情绪不稳定与睡眠障碍之间的关联以及与自杀意念和行为的联系。
2007年成人精神病发病率调查收集了居住在英国的成年家庭居民代表性样本（n = 7303）中有关心理健康症状及其相关因素的详细信息。使用《精神疾病诊断与统计手册》第四版轴II障碍的结构化临床访谈来评估情绪不稳定。睡眠问题定义为过去一个月内睡眠时间比平常多或比平常少。其他因变量包括药物使用以及自杀意念和行为（应答率57%）。使用广义线性模型估计情绪不稳定和睡眠问题的患病率。使用逻辑回归估计比值比。所有估计值均进行了加权。
情绪不稳定的患病率为14.7%（95%置信区间[13.6%，15.7%]）。情绪不稳定者中有69.8%（95%置信区间：[66.6%，73.1%]）出现睡眠问题，而无情绪不稳定者中这一比例为37.6%（95%置信区间：[36.2%，39.1%]）。使用镇静和非镇静药物并不影响这种关联。即使在调整了情绪不稳定因素后，睡眠问题仍与自杀意念和行为显著相关。
睡眠问题在普通人群中非常普遍，尤其是在情绪不稳定者中。睡眠问题与自杀意念和行为密切相关。针对跨越诊断界限的风险和维持因素的治疗方法，如针对睡眠障碍的疗法，对于预防和处理与情绪不稳定相关的并发症（如自杀）可能特别有价值。
