Van Veen M M, Rutters F, Spreen M, Lancel M
GGZ Drenthe Mental Health Institute, Department of Forensic Psychiatry, Assen, the Netherlands; GGZ Drenthe Mental Health Institute, Sleep Centre for Psychiatry, Assen, the Netherlands.
Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Location VUMC, Amsterdam, the Netherlands.
Sleep Med. 2020 Mar;67:1-6. doi: 10.1016/j.sleep.2019.11.1183. Epub 2019 Nov 14.
In forensic psychiatric patients, sleep problems as well as impulsivity and aggression are highly prevalent, yet studies on their association over time are lacking. This study investigates the association between sleep quality and changes in impulsivity and aggression in forensic psychiatric patients over one year.
Data were drawn from an ongoing prospective observational study in adult forensic psychiatric patients admitted to a forensic treatment facility between October 2006 and January 2018. Validated self-reports and observational instruments were used to assess sleep quality, impulsivity and aggression upon admission to the hospital and after one year. Linear regression analyses were performed to examine the association between sleep quality, impulsivity and aggression. All models were adjusted for baseline values of outcome measures, demographic features and general psychopathology.
Data from 83 men (age 37.7 ± 11.7 years) with completed consecutive measurements were analyzed. Poor sleep quality was associated with increased self-reported aggression (β = 1.08; 95% CI, 0.38-1.78). This association was positively confounded by general psychopathology, indicating that sleep quality is specifically related to self-reported aggression instead of being part of general psychopathology (adjusted β = 1.18; 95% CI, 0.39-1.97). Poor sleep quality was not associated with changes in self-reported impulsivity, clinician-rated impulsivity or clinician-rated hostility in this population.
Poor sleep quality was associated with an increase in self-reported aggression over one year in male forensic psychiatric patients. Early evaluation and treatment of sleep problems in (forensic) psychiatric patients may play an important role in reducing the risk of aggressive behavior.
在法医精神病患者中，睡眠问题以及冲动性和攻击性非常普遍，但缺乏关于它们随时间关联的研究。本研究调查了法医精神病患者睡眠质量与冲动性和攻击性在一年时间内变化之间的关联。
数据来自于一项正在进行的前瞻性观察性研究，研究对象为2006年10月至2018年1月入住法医治疗机构的成年法医精神病患者。使用经过验证的自我报告和观察工具，在入院时和一年后评估睡眠质量、冲动性和攻击性。进行线性回归分析以检验睡眠质量、冲动性和攻击性之间的关联。所有模型均针对结局指标的基线值、人口统计学特征和一般精神病理学进行了调整。
对83名完成连续测量的男性（年龄37.7±11.7岁）的数据进行了分析。睡眠质量差与自我报告的攻击性增加相关（β = 1.08；95%CI，0.38 - 1.78）。这种关联被一般精神病理学正向混淆，表明睡眠质量与自我报告的攻击性具体相关，而非一般精神病理学的一部分（调整后β = 1.18；95%CI，0.39 - 1.97）。在该人群中，睡眠质量差与自我报告的冲动性、临床医生评定的冲动性或临床医生评定的敌意的变化无关。
在男性法医精神病患者中，睡眠质量差与一年中自我报告的攻击性增加相关。对（法医）精神病患者睡眠问题的早期评估和治疗可能在降低攻击行为风险方面发挥重要作用。
