Department of Clinical Psychology and Psychotherapy.
Department of Psychiatry and Psychotherapy.
J Abnorm Psychol. 2021 Jan;130(1):78-88. doi: 10.1037/abn0000645. Epub 2020 Nov 19.
Sleep-related problems are prevalent in patients with psychotic disorders, yet their contribution to fluctuations in delusional experiences is less clear. This study combined actigraphy and experience-sampling methodology (ESM) to capture the relation between sleep and next-day persecutory symptoms in patients with psychosis and prevailing delusions. Individuals with current persecutory delusions (PD; = 67) and healthy controls (HC; = 39) were assessed over 6 consecutive days. Objective sleep and circadian rhythm measures were assessed using actigraphy. Every morning upon awakening, subjective sleep quality was measured using ESM. Momentary assessments of affect and persecutory symptoms were gathered at 10 random time points each day using ESM. Robust linear mixed modeling was performed to assess the predictive value of sleep measures on affect and daytime persecutory symptoms. PD showed significantly lower scores for subjective quality of sleep but significantly higher actigraphic-measured sleep duration and efficiency compared with HC. Circadian rhythm disruption was associated with more pronounced severity of persecutory symptoms in HC. Low actigraphy-derived sleep efficiency was predictive of next-day persecutory symptoms in the combined sample. Negative affect was partly associated with sleep measures and persecutory symptoms. Our results imply an immediate relationship between disrupted sleep and persecutory symptoms in day-to-day life. They also emphasize the relevance of circadian rhythm disruption for persecutory symptoms. Therapeutic interventions that aim to reduce persecutory symptoms could benefit from including modules aimed at improving sleep efficacy, stabilizing sleep-wake patterns, and reducing negative affect. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
睡眠相关问题在精神病患者中很常见，但它们对妄想体验波动的贡献尚不清楚。本研究结合了活动记录仪和经验采样方法（ESM），以捕捉睡眠与精神病患者和普遍存在的妄想者次日被害妄想症状之间的关系。当前存在被害妄想（PD；n=67）和健康对照者（HC；n=39）在连续 6 天内接受评估。使用活动记录仪评估客观睡眠和昼夜节律指标。每天早上醒来时，使用 ESM 评估主观睡眠质量。使用 ESM 每天随机 10 个时间点收集即时的情绪和被害妄想症状评估。采用稳健线性混合模型评估睡眠指标对情绪和日间被害妄想症状的预测价值。PD 的主观睡眠质量评分明显较低，但客观测量的睡眠时间和效率明显较高，与 HC 相比。昼夜节律紊乱与 HC 中更明显的被害妄想症状严重程度相关。低活动记录仪衍生的睡眠效率可预测综合样本中次日的被害妄想症状。负性情绪部分与睡眠指标和被害妄想症状相关。我们的结果表明，在日常生活中，睡眠中断与被害妄想症状之间存在直接关系。它们还强调了昼夜节律紊乱对被害妄想症状的相关性。旨在减少被害妄想症状的治疗干预可能受益于包括旨在提高睡眠效率、稳定睡眠-觉醒模式和减少负性情绪的模块。
