Brownlow Janeese A, Klingaman Elizabeth A, Boland Elaine M, Brewster Glenna S, Gehrman Philip R
Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.
Veterans Affairs Maryland Health Care System, Baltimore, MD, USA.
J Affect Disord. 2017 Oct 15;221:25-30. doi: 10.1016/j.jad.2017.06.023. Epub 2017 Jun 13.
There has been a great deal of research on the comorbidity of insomnia and psychiatric disorders, but much of the existing data is based on small samples and does not assess the full diagnostic criteria for each disorder. Further, the exact nature of the relationship between these conditions and their impact on cognitive problems are under-researched in military samples.
Data were collected from the All Army Study of the Army Study to Assess Risk and Resilience in Service members (unweighted N = 21, 449; weighted N = 674,335; 18-61 years; 13.5% female). Participants completed the Brief Insomnia Questionnaire to assess for insomnia disorder and a self-administered version of the Composite International Diagnostic Interview Screening Scales to assess for psychiatric disorders and cognitive problems.
Military soldiers with current major depressive episode (MDE) had the highest prevalence of insomnia disorder (INS; 85.0%), followed by current generalized anxiety disorder (GAD; 82.6%) and current posttraumatic stress disorder (PTSD; 69.7%), respectively. Significant interactions were found between insomnia and psychiatric disorders; specifically, MDE, PTSD, and GAD status influenced the relationship between insomnia and memory/concentration problems.
Cross-sectional nature of the assessment and the absence of a comprehensive neurocognitive battery.
Psychiatric disorders moderated the relationship between insomnia and memory/concentration problems, suggesting that psychiatric disorders contribute unique variance to cognitive problems even though they are associated with insomnia disorder. Results highlight the importance of considering both insomnia and psychiatric disorders in the diagnosis and treatment of cognitive deficits in military soldiers.
关于失眠与精神障碍共病的研究颇多，但现有数据大多基于小样本，且未对每种障碍的完整诊断标准进行评估。此外，在军事样本中，这些病症之间关系的确切性质及其对认知问题的影响尚未得到充分研究。
数据收集自全军军人风险与恢复力评估研究（未加权N = 21449；加权N = 674335；年龄18 - 61岁；女性占13.5%）。参与者完成简短失眠问卷以评估失眠症，并完成一份自行填写的综合国际诊断访谈筛查量表，以评估精神障碍和认知问题。
目前患有重度抑郁发作（MDE）的军人失眠症（INS）患病率最高（85.0%），其次分别是目前患有广泛性焦虑症（GAD；82.6%）和创伤后应激障碍（PTSD；69.7%）。在失眠与精神障碍之间发现了显著的交互作用；具体而言，MDE、PTSD和GAD状态影响了失眠与记忆/注意力问题之间的关系。
评估的横断面性质以及缺乏全面的神经认知测试组。
精神障碍调节了失眠与记忆/注意力问题之间的关系，这表明尽管精神障碍与失眠症相关，但它们对认知问题有独特的影响。研究结果凸显了在诊断和治疗军人心智缺陷时同时考虑失眠和精神障碍的重要性。
