Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia.
Psychiatry Department "E", Razi Hospital, Mannouba, Tunisia.
J Clin Psychol. 2019 Sep;75(9):1643-1657. doi: 10.1002/jclp.22793. Epub 2019 Apr 17.
We aimed to evaluate the links between different sleep parameters and suicidal ideation and behavior in remitted bipolar I patients.
One hundred eight remitted bipolar I patients were recruited from the psychiatry department of Razi Hospital. The third item of the "Hamilton Depression Rating Scale" was used to evaluate current suicidal behaviors. Circadian typology, daytime sleepiness and sleep quality were evaluated using the "Horne and Ostberg Morningness-Eveningness Questionnaire," the "Epworth Sleepiness Scale," and the "Pittsburgh Sleep Quality Index," respectively.
Current suicidal ideation and behavior were significantly associated with circadian typology, daytime sleepiness, and sleep quality. After controlling for demographic variables (age and gender) and psychosocial factors (depression and substance use), suicidal ideation significantly contributed to sleep quality. Depression was a significant predictor within the second step when entered with other psychosocial variables; however, once suicide variables were included, depression was no longer a significant predictor.
An evaluation of sleep's quality should be included in the suicide risk assessment of bipolar I patients.
评估缓解期单相双相 I 型患者不同睡眠参数与自杀意念和行为之间的关联。
从拉齐医院精神科招募了 108 名缓解期单相双相 I 型患者。使用“汉密尔顿抑郁评定量表”的第 3 项评估当前的自杀行为。使用“Horne 和 Ostberg 晨型-晚型问卷”、“Epworth 嗜睡量表”和“匹兹堡睡眠质量指数”评估昼夜节律类型、日间嗜睡和睡眠质量。
当前的自杀意念和行为与昼夜节律类型、日间嗜睡和睡眠质量显著相关。在控制人口统计学变量（年龄和性别）和社会心理因素（抑郁和物质使用）后，自杀意念显著影响睡眠质量。在进入其他社会心理变量后，抑郁在第二步中是一个显著的预测因素；然而，一旦包括自杀变量，抑郁就不再是一个显著的预测因素。
应该将睡眠质量评估纳入单相双相 I 型患者的自杀风险评估中。
