The Menninger Clinic, 12301 S. Main St., Houston TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston TX 77030, USA.
The Menninger Clinic, 12301 S. Main St., Houston TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston TX 77030, USA; The University of Houston Downtown, 1 Main St., Houston TX 77002, USA.
J Psychiatr Res. 2021 Jan;133:174-180. doi: 10.1016/j.jpsychires.2020.12.039. Epub 2020 Dec 11.
A common reason for admission to inpatient psychiatric units is suicidal ideation. Growing evidence of the link between sleep disturbance and suicidal ideation brings an interest in greater clarity of the pathways; this paper focused on post-traumatic stress disorder (PTSD), which carries increased risk for both sleep disturbance and suicidal ideation, as well as sex differences in those pathways. Patients were 2822 inpatients studied at admission to an inpatient psychiatric hospital and mediation analyses were used to examine pathways of interest. There was an indirect effect of PTSD on suicidal ideation through sleep disturbances for the entire sample and for men and women separately. The effect for men was larger than that for women, suggesting a stronger effect for sleep disturbance in the relationship for men. For women only, the direct effect between PTSD and suicidal ideation remained significant after mediation. Sleep disturbance plays an important role in the relationship between PTSD and suicidal ideation. Early identification of sleep disturbance in inpatients and targeted focus of sleep in conjunction with resolving trauma-related symptoms may help reduce suicidal ideation. This may be especially true of men; the indirect effect was smaller for women, suggesting that sleep disturbance should be addressed in conjunction with other PTSD symptoms likely leading to suicidal ideation.
住院精神科病房收治的常见原因是自杀意念。越来越多的证据表明睡眠障碍与自杀意念之间存在关联，这引起了人们对这些途径的更清晰认识；本文重点研究了创伤后应激障碍（PTSD），因为它既增加了睡眠障碍的风险，也增加了自杀意念的风险，以及这些途径中的性别差异。在一家住院精神病院入院时，对 2822 名住院患者进行了研究，并采用中介分析来检验相关途径。在整个样本中以及男性和女性中，PTSD 通过睡眠障碍对自杀意念有间接影响。对于男性，这种影响大于女性，这表明睡眠障碍在男性关系中的影响更大。仅对于女性，在中介作用后，PTSD 和自杀意念之间的直接影响仍然显著。睡眠障碍在 PTSD 和自杀意念之间的关系中起着重要作用。在住院患者中早期识别睡眠障碍，并针对性地关注睡眠，同时解决与创伤相关的症状，可能有助于减少自杀意念。对于男性来说尤其如此；对于女性，间接影响较小，这表明睡眠障碍应与可能导致自杀意念的其他 PTSD 症状一起解决。
