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发作性睡病与抑郁症的共病情况:一项基于台湾全国人口的研究。

Comorbidity of narcolepsy and depressive disorders: a nationwide population-based study in Taiwan.

作者信息

Lee Min-Jing, Lee Sheng-Yu, Yuan Shin-Sheng, Yang Chun-Ju, Yang Kang-Chung, Lee Tung-Liang, Sun Chi-Chin, Shyu Yu-Chiau, Wang Liang-Jen

机构信息

Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Sleep Med. 2017 Nov;39:95-100. doi: 10.1016/j.sleep.2017.07.022. Epub 2017 Sep 5.

Abstract

OBJECTIVE

Narcolepsy is a chronic sleep disorder that is likely to have neuropsychiatric comorbidities. Depression is a serious mood disorder that affects individuals' daily activities and functions. The current study aimed to investigate the relationship between narcolepsy and depressive disorders.

METHODS

The study consisted of patients diagnosed with narcolepsy between January 2002, and December 2011 (n = 258), and age-matched and gender-matched controls (n = 2580) from Taiwan's National Health Insurance database. Both the patients and the controls were monitored through December 31, 2011, to identify the occurrence of a depressive disorder. A multivariate logistic regression model was used to assess the narcolepsy's potential influence on the comorbidity of a depressive disorder.

RESULTS

During the study period, 32.7%, 24.8%, and 10.9% of the narcoleptic patients were comorbid with any depressive disorder, dysthymic disorder, and major depressive disorder, respectively. When compared to the control subjects, the patients with narcolepsy were at greater risks of having any depressive disorder (aOR 6.77; 95% CI 4.90-9.37), dysthymic disorder (aOR 6.62; 95% CI 4.61-9.57), and major depressive disorder (aOR 6.83; 95% CI 4.06-11.48). Of the narcoleptic patients that were comorbid with depression, >50% had been diagnosed with depression prior to being diagnosed with narcolepsy.

CONCLUSIONS

This nationwide data study revealed that narcolepsy and depression commonly co-occurred. Since some symptoms of narcolepsy overlapped with those of depressive disorders, the findings serve as a reminder that clinicians must pay attention to the comorbidity of narcolepsy and depression.

摘要

目的

发作性睡病是一种慢性睡眠障碍,可能伴有神经精神共病。抑郁症是一种严重的情绪障碍,会影响个体的日常活动和功能。本研究旨在调查发作性睡病与抑郁症之间的关系。

方法

该研究纳入了2002年1月至2011年12月期间被诊断为发作性睡病的患者(n = 258),以及来自台湾国民健康保险数据库的年龄和性别匹配的对照组(n = 2580)。对患者和对照组进行监测,直至2011年12月31日,以确定抑郁症的发生情况。采用多因素逻辑回归模型评估发作性睡病对抑郁症共病的潜在影响。

结果

在研究期间,分别有32.7%、24.8%和10.9%的发作性睡病患者合并有任何抑郁症、心境恶劣障碍和重度抑郁症。与对照组相比,发作性睡病患者患任何抑郁症(调整后比值比[aOR] 6.77;95%置信区间[CI] 4.90 - 9.37)、心境恶劣障碍(aOR 6.62;95% CI 4.61 - 9.57)和重度抑郁症(aOR 6.83;95% CI 4.06 - 11.48)的风险更高。在合并抑郁症的发作性睡病患者中,超过50%在被诊断为发作性睡病之前就已被诊断出患有抑郁症。

结论

这项全国性数据研究表明,发作性睡病和抑郁症常同时发生。由于发作性睡病的一些症状与抑郁症的症状重叠,这些发现提醒临床医生必须关注发作性睡病和抑郁症的共病情况。

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