Tahmasian Masoud, Jamalabadi Hamidreza, Abedini Mina, Ghadami Mohammad R, Sepehry Amir A, Knight David C, Khazaie Habibolah
Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran; Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; Department of Psychiatry, Division for Translational Psychiatry, University of Tübingen, Tübingen, Germany.
Neurosci Lett. 2017 May 22;650:174-179. doi: 10.1016/j.neulet.2017.04.042. Epub 2017 Apr 24.
Sleep disturbance is common in chronic post-traumatic stress disorder (PTSD). However, prior work has demonstrated that there are inconsistencies between subjective and objective assessments of sleep disturbance in PTSD. Therefore, we investigated whether subjective or objective sleep assessment has greater clinical utility to differentiate PTSD patients from healthy subjects. Further, we evaluated whether the combination of subjective and objective methods improves the accuracy of classification into patient versus healthy groups, which has important diagnostic implications. We recruited 32 chronic war-induced PTSD patients and 32 age- and gender-matched healthy subjects to participate in this study. Subjective (i.e. from three self-reported sleep questionnaires) and objective sleep-related data (i.e. from actigraphy scores) were collected from each participant. Subjective, objective, and combined (subjective and objective) sleep data were then analyzed using support vector machine classification. The classification accuracy, sensitivity, and specificity for subjective variables were 89.2%, 89.3%, and 89%, respectively. The classification accuracy, sensitivity, and specificity for objective variables were 65%, 62.3%, and 67.8%, respectively. The classification accuracy, sensitivity, and specificity for the aggregate variables (combination of subjective and objective variables) were 91.6%, 93.0%, and 90.3%, respectively. Our findings indicate that classification accuracy using subjective measurements is superior to objective measurements and the combination of both assessments appears to improve the classification accuracy for differentiating PTSD patients from healthy individuals.
睡眠障碍在慢性创伤后应激障碍（PTSD）中很常见。然而，先前的研究表明，PTSD患者睡眠障碍的主观评估和客观评估之间存在不一致。因此，我们调查了主观或客观睡眠评估在区分PTSD患者与健康受试者方面是否具有更大的临床效用。此外，我们评估了主观和客观方法的结合是否能提高将患者与健康组分类的准确性，这具有重要的诊断意义。我们招募了32名慢性战争诱发的PTSD患者和32名年龄及性别匹配的健康受试者参与本研究。从每位参与者收集主观（即来自三份自我报告的睡眠问卷）和客观睡眠相关数据（即来自活动记录仪得分）。然后使用支持向量机分类分析主观、客观和综合（主观和客观）睡眠数据。主观变量的分类准确率、敏感性和特异性分别为89.2%、89.3%和89%。客观变量的分类准确率、敏感性和特异性分别为65%、62.3%和67.8%。总体变量（主观和客观变量的组合）的分类准确率、敏感性和特异性分别为91.6%、93.0%和90.3%。我们的研究结果表明，使用主观测量的分类准确率优于客观测量，并且两种评估方法的结合似乎提高了区分PTSD患者与健康个体的分类准确率。
