González-Rodríguez Alexandre, Labad Javier, Seeman Mary V
Department of Mental Health, Parc Tauli University Hospital, Autonomous University of Barcelona (UAB), I3PT, Sabadell, 08280 Barcelona, Spain.
Department of Psychiatry, Hospital of Mataró, Consorci Sanitari del Maresme, Institut d'Investigació i Innovació Parc Tauli (I3PT), CIBERSAM, Mataró, 08304 Barcelona, Spain.
Clocks Sleep. 2020 Oct 16;2(4):399-415. doi: 10.3390/clockssleep2040030.
Sleep disturbances accompany almost all mental illnesses, either because sound sleep and mental well-being share similar requisites, or because mental problems lead to sleep problems, or vice versa. The aim of this narrative review was to examine sleep in patients with delusions, particularly in those diagnosed with delusional disorder. We did this in sequence, first for psychiatric illness in general, then for psychotic illnesses where delusions are prevalent symptoms, and then for delusional disorder. The review also looked at the effect on sleep parameters of individual symptoms commonly seen in delusional disorder (paranoia, cognitive distortions, suicidal thoughts) and searched the evidence base for indications of antipsychotic drug effects on sleep. It subsequently evaluated the influence of sleep therapies on psychotic symptoms, particularly delusions. The review's findings are clinically important. Delusional symptoms and sleep quality influence one another reciprocally. Effective treatment of sleep problems is of potential benefit to patients with persistent delusions, but may be difficult to implement in the absence of an established therapeutic relationship and an appropriate pharmacologic regimen. As one symptom can aggravate another, comorbidities in patients with serious mental illness all need to be treated, a task that requires close liaison among medical specialties.
睡眠障碍几乎伴随所有精神疾病出现,这要么是因为良好的睡眠和心理健康有着相似的必要条件,要么是因为心理问题导致睡眠问题,反之亦然。本叙述性综述的目的是研究妄想症患者的睡眠情况,尤其是那些被诊断为妄想性障碍的患者。我们按顺序进行了此项研究,首先针对一般精神疾病,然后针对以妄想为常见症状的精神病性疾病,最后针对妄想性障碍。该综述还研究了妄想性障碍中常见的个体症状(偏执、认知扭曲、自杀念头)对睡眠参数的影响,并在证据库中搜索抗精神病药物对睡眠影响的迹象。随后,它评估了睡眠疗法对精神病性症状,尤其是妄想的影响。该综述的发现具有临床重要性。妄想症状和睡眠质量相互影响。有效治疗睡眠问题可能对持续性妄想患者有益,但在缺乏既定治疗关系和适当药物治疗方案的情况下可能难以实施。由于一种症状可能会加重另一种症状,严重精神疾病患者的合并症都需要治疗,而这一任务需要各医学专科之间密切协作。