Lopes Maria Cecilia, Boarati Miguel Angelo, Fu-I Lee
Child and Adolescent Affective Disorder Program (PRATA), Department and Institute of Psychiatry at University of Sao Paulo Medical School, Sao Paulo, Brazil.
Front Psychiatry. 2020 Jan 23;10:1021. doi: 10.3389/fpsyt.2019.01021. eCollection 2019.
Depressive and manic episodes of bipolar disorder can interact with sleep complaints, followed by a worsened psychiatric condition. The aim of this study was to examine the interaction of sleep disorders with bipolar disorder in youths during depressive and manic episodes.
The target population was children and adolescents drawn from the Children and Adolescents Affective Disorder Program. Clinical assessment for current psychiatric diagnosis was done by direct clinical interview, Diagnostic Interview for Children and Adolescents (DSM-IV), and best-estimated clinical consensus. We applied sleep questionnaires from which we obtained sleep and daytime complaints during manic and depressive episodes. All statistical tests of significance were done using 2-tailed tests with α = 0.05.
Participants in this study comprised 29 children (age = 10 ± 3 years, boys = 23) and 43 adolescents (age = 15 ± 2.4 years, boys = 30). Sleep complaints were observed in 66.4% of participants during manic episodes and 52.3% during depressive episodes. 37.9% of patients had sleep complaints in both episodes. Time in bed was longer during depressive episodes than manic episodes (p = 0.01). We found a high prevalence of nocturnal enuresis in depressive episodes in children and adolescents, which was statistically significant compared with manic episodes (p < 0.05). Unrested sleep was higher in adolescents in both episodes, and it was statistically significant during manic episodes (p < 0.05).
According to our analyses, the minority of patients had sleep complaints in both episodes. Our data showed that nocturnal enuresis occurred more frequently during depressive than manic episodes. Further research is necessary to understand the implications of these data.
双相情感障碍的抑郁和躁狂发作可能与睡眠问题相互作用，进而导致精神状况恶化。本研究的目的是探讨青少年在抑郁和躁狂发作期间睡眠障碍与双相情感障碍的相互作用。
目标人群为来自儿童和青少年情感障碍项目的儿童和青少年。通过直接临床访谈、儿童和青少年诊断访谈（DSM-IV）以及最佳估计的临床共识对当前精神疾病诊断进行临床评估。我们应用了睡眠问卷，从中获取了躁狂和抑郁发作期间的睡眠及日间问题。所有显著性统计检验均采用双侧检验，α = 0.05。
本研究的参与者包括29名儿童（年龄 = 10 ± 3岁，男孩 = 23名）和43名青少年（年龄 = 15 ± 2.4岁，男孩 = 30名）。66.4%的参与者在躁狂发作期间有睡眠问题，52.3%在抑郁发作期间有睡眠问题。37.9%的患者在两个发作期均有睡眠问题。抑郁发作期间的卧床时间比躁狂发作期间长（p = 0.01）。我们发现儿童和青少年在抑郁发作期间夜尿症的患病率较高，与躁狂发作相比具有统计学意义（p < 0.05）。两个发作期青少年的睡眠未恢复情况均较高，在躁狂发作期间具有统计学意义（p < 0.05）。
根据我们的分析，少数患者在两个发作期均有睡眠问题。我们的数据显示，抑郁发作期间夜尿症的发生频率高于躁狂发作期间。有必要进行进一步研究以了解这些数据的意义。
