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注意缺陷多动障碍伴环性心境成人的睡眠时相延迟障碍、情绪调节障碍与情感气质之间的关系。

Relationships Among Delayed Sleep Phase Disorder, Emotional Dysregulation, and Affective Temperaments in Adults With Attention Deficit Hyperactivity Disorder and Cyclothymia.

机构信息

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

出版信息

J Nerv Ment Dis. 2020 Nov;208(11):857-862. doi: 10.1097/NMD.0000000000001209.

Abstract

This study aims to explore the relationships between delayed sleep phase disorder (DSPD) and emotional dysregulation in 240 patients (134 with cyclothymia, 81 with attention deficit hyperactivity disorder [ADHD] and 25 with both conditions). DSPD was assessed using the Morningness-Eveningness Questionnaire, followed by a clinical evaluation. Affective temperaments and emotional dysregulation were also investigated through the brief version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego and the Reactivity, Intensity, Polarity, Stability questionnaires, respectively. Clinical variables were compared in patients with and without DSPD, and a logistic regression model was used to identify the predictive value of the clinical characteristics on the presence of DSPD. DSPD patients (19% of the total sample) were significantly younger than patients without DSPD, showed an about 4 times higher lifetime history of comorbid ADHD and cyclothymia, and reported higher scores in the irritable and cyclothymic temperamental subscales and in the affective instability and impulsivity dimensions. In the multiple logistic regression, we found a negative predictive value of increasing age on the presence of DSPD, whereas comorbid cyclothymia and ADHD and cyclothymic temperament seem to represent risk factors for DSPD.

摘要

本研究旨在探讨 240 名患者(134 名双相情感障碍患者、81 名注意缺陷多动障碍患者和 25 名同时患有两种疾病的患者)中睡眠时相延迟障碍(DSPD)与情绪失调之间的关系。采用晨型-晚型问卷评估 DSPD,随后进行临床评估。通过 Memphis、Pisa、Paris 和 San Diego 简短版气质评估问卷和 Reactivity、Intensity、Polarity、Stability 问卷分别调查情感气质和情绪失调。比较有和无 DSPD 的患者的临床变量,并使用逻辑回归模型确定临床特征对 DSPD 存在的预测价值。DSPD 患者(占总样本的 19%)明显比无 DSPD 患者年轻,一生中合并 ADHD 和双相情感障碍的发生率高约 4 倍,在易激惹和双相情感障碍气质子量表以及情感不稳定和冲动维度上的得分更高。在多元逻辑回归中,我们发现年龄增长对 DSPD 存在具有负预测价值,而合并的双相情感障碍和 ADHD 以及双相情感障碍气质似乎是 DSPD 的危险因素。

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