Mahnke Amanda R, Linkovski Omer, Timpano Kiara, van Roessel Peter, Sanchez Catherine, Varias Andrea D, Mukunda Pavithra, Filippou-Frye Maria, Lombardi Anthony, Raila Hannah, Anderson Kelley, Sandhu Thasveen, Wright Brianna, McCarthy Elizabeth A, Garcia Geronimo E, Asgari Sepehr, Qiu Tori, Bernert Rebecca, Rodriguez Carolyn I
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA; Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.
J Psychiatr Res. 2021 May;137:597-602. doi: 10.1016/j.jpsychires.2020.10.044. Epub 2020 Nov 3.
Hoarding disorder (HD), characterized by difficulty parting with possessions and functionally impairing clutter, affects 2-6% of the population. Originally considered part of Obsessive-Compulsive Disorder (OCD), HD became a distinct diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. While sleep impacts OCD, little is known about sleep in HD. As HD patients often report poor sleep in clinical settings, understanding global subjective sleep quality and disturbances may lead to novel therapeutic targets. To address this gap, the authors used a sample of convenience: an existing data set designed to screen research study eligibility and explore the psychopathology and phenomenology of OCD and HD. The data set included information collected from individuals with HD (n = 38), OCD (n = 26), and healthy participants (n = 22) about insomnia, sleep quality, and mood using interviews and structured instruments including the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Depression Anxiety Stress Scales (DASS). In this data set, HD and OCD groups reported significantly greater insomnia symptoms and poorer sleep quality compared with healthy controls while controlling for depression, age, and gender. A sizable minority of HD and OCD individuals met criteria for comorbid sleep disorders. OCD and HD groups differed in delayed sleep phase prevalence. To our knowledge, this is the first study examining subjective sleep quality and insomnia in HD as compared to healthy individuals and those with OCD, while controlling for relevant clinical characteristics. Given that there are evidence-based treatments for insomnia and other sleep disorders, our study raises the possibility that treatment interventions targeting sleep may improve HD outcomes.
囤积障碍（HD）的特征是难以舍弃物品以及功能性的杂乱无章，影响着2%至6%的人口。HD最初被认为是强迫症（OCD）的一部分，2013年在《精神疾病诊断与统计手册》（DSM - 5）中成为一个独立的诊断实体。虽然睡眠会影响强迫症，但关于囤积障碍中的睡眠情况却知之甚少。由于囤积障碍患者在临床环境中常报告睡眠不佳，了解整体主观睡眠质量和干扰因素可能会带来新的治疗靶点。为了填补这一空白，作者使用了一个便利样本：一个现有的数据集，旨在筛选研究资格并探索强迫症和囤积障碍的精神病理学及现象学。该数据集包含从患有囤积障碍（n = 38）、强迫症（n = 26）的个体以及健康参与者（n = 22）那里收集到的关于失眠、睡眠质量和情绪的信息，使用了包括失眠严重程度指数（ISI）、匹兹堡睡眠质量指数（PSQI）和抑郁焦虑压力量表（DASS）在内的访谈和结构化工具。在这个数据集中，在控制了抑郁、年龄和性别后，与健康对照组相比，囤积障碍组和强迫症组报告的失眠症状明显更多，睡眠质量更差。相当一部分患有囤积障碍和强迫症的个体符合共病睡眠障碍的标准。强迫症组和囤积障碍组在睡眠相位延迟患病率方面存在差异。据我们所知，这是第一项在控制相关临床特征的同时，将囤积障碍患者与健康个体及强迫症患者的主观睡眠质量和失眠情况进行比较的研究。鉴于有基于证据的治疗失眠和其他睡眠障碍的方法，我们的研究提出了针对睡眠的治疗干预可能改善囤积障碍治疗效果的可能性。
