McGlinchey Eleanor L, Reyes-Portillo Jazmin A, Turner J Blake, Mufson Laura
Columbia University Medical Center, New York State Psychiatric Institute, Child and Adolescent Psychiatry, 1051 Riverside Drive Box 78, New York, NY, USA.
Child Adolesc Ment Health. 2017 May;22(2):96-99. doi: 10.1111/camh.12176. Epub 2016 Jun 30.
Sleep disturbance is frequently comorbid with depression and sleep complaints are the most common residual symptoms after treatment among adolescents with depression. The present analyses investigated the effect of sleep disturbance in depressed adolescents treated with Interpersonal Psychotherapy for Adolescents (IPT-A) versus Treatment as Usual (TAU) in school-based mental health clinics.
63 adolescents participated in a randomized clinical trial of IPT-A versus TAU for adolescent depression. Participants were diagnosed with a DSM-IV depressive disorder and assessed for symptoms of depression, interpersonal functioning and sleep disturbance. Measures were assessed at baseline, session 4 and 8 of treatment, and session 12 for post-acute treatment follow-up. Hierarchical linear modeling (HLM) was used to model change in depression, interpersonal functioning and sleep disturbance.
Ongoing sleep disturbance was significantly associated with worse depression scores as rated by clinician (γ = 1.04, = 0.22, < .001) and self-report (γ = 1.63, = 0.29, < .001), as well as worse interpersonal functioning across the course of treatment (γ = 0.09, = 0.02, < .001). Treatment condition did not predict change in sleep disturbance (γ = -0.13, = 0.14, = ).
For all patients in the study, sleep disturbance was a predictor of depression and interpersonal functioning for depressed adolescents. Sleep disturbance predicted more depression and interpersonal stress across treatments and led to a slower improvement in depression and interpersonal functioning. This data suggests that sleep disturbance should be a target for future treatment development research among depressed adolescents.
睡眠障碍常与抑郁症并发，睡眠问题是抑郁症青少年治疗后最常见的残留症状。本分析研究了在学校心理健康诊所中，接受青少年人际心理治疗（IPT - A）与常规治疗（TAU）的抑郁症青少年中，睡眠障碍的影响。
63名青少年参与了IPT - A与TAU治疗青少年抑郁症的随机临床试验。参与者被诊断为DSM - IV抑郁障碍，并评估其抑郁症状、人际功能和睡眠障碍。在基线、治疗的第4和8次会话以及急性治疗后随访的第12次会话时进行测量。使用分层线性模型（HLM）对抑郁、人际功能和睡眠障碍的变化进行建模。
持续的睡眠障碍与临床医生评定的更差抑郁评分（γ = 1.04， = 0.22， <.001）和自我报告评分（γ = 1.63， = 0.29， <.001）显著相关，并且在整个治疗过程中人际功能更差（γ = 0.09， = 0.02， <.001）。治疗条件不能预测睡眠障碍的变化（γ = -0.13， = 0.14， = ）。
对于研究中的所有患者，睡眠障碍是抑郁症青少年抑郁和人际功能的预测指标。睡眠障碍在各种治疗中预示着更多的抑郁和人际压力，并导致抑郁和人际功能改善较慢。这些数据表明，睡眠障碍应成为未来抑郁症青少年治疗发展研究的目标。
