Department of Psychiatry, Konkuk University Medical Center, Seoul, Korea.
Department of Psychiatry, Konkuk University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2021 Mar 8;36(9):e30. doi: 10.3346/jkms.2021.36.e30.
This study aimed to determine if sleep disturbances may mediate the relationship between panic symptoms and depression in patients with panic disorder (PD).
Electronic medical records were retrospectively reviewed for 110 consecutive patients with diagnosed PD in an outpatient clinic between October 2018 and December 2019. Measurements include the PD Severity Scale, Beck Depression Inventory-II (BDI-II) and Insomnia Severity Index (ISI). Statistical analyses were performed to assess any potential relationship between PD, insomnia and depression.
Of the PD patients, 88 (80%) and 89 (80.9%) had comorbid depression (BDI-II ≥ 14) and insomnia (Korean version of the ISI ≥ 8), respectively. In a mediation model using insomnia as the mediating variable, the total effect of panic symptom severity on depression was significant ( = 7.23, < 0.001). There were significant effects of panic symptoms on insomnia ( = 4.62, < 0.001) and of insomnia on depression ( = 6.69, < 0.001). The main effect of panic symptom severity on depression was also significant, after controlling for the effect of insomnia ( = 5.10, < 0.001), suggesting partial mediation.
Both depressive symptoms and insomnia are common in patients with PD and depression was partially mediated by insomnia in these patients. These results suggest that an intervention for insomnia in patients with PD might help prevent the development of depression.
本研究旨在确定睡眠障碍是否可以在惊恐障碍（PD）患者的惊恐症状和抑郁之间起中介作用。
回顾性分析了 2018 年 10 月至 2019 年 12 月在门诊就诊的 110 例连续 PD 患者的电子病历。测量包括 PD 严重程度量表、贝克抑郁量表第二版（BDI-II）和失眠严重程度指数（ISI）。进行了统计分析，以评估 PD、失眠和抑郁之间的任何潜在关系。
在 PD 患者中，分别有 88 例（80%）和 89 例（80.9%）患有共病性抑郁（BDI-II≥14）和失眠（韩国版 ISI≥8）。在使用失眠作为中介变量的中介模型中，惊恐症状严重程度对抑郁的总效应显著（ = 7.23，<0.001）。惊恐症状对失眠有显著影响（ = 4.62，<0.001），失眠对抑郁有显著影响（ = 6.69，<0.001）。在控制了失眠的影响后，惊恐症状严重程度对抑郁的主要效应仍然显著（ = 5.10，<0.001），表明存在部分中介作用。
抑郁症状和失眠在 PD 患者中很常见，在这些患者中，抑郁部分通过失眠来介导。这些结果表明，对 PD 患者的失眠进行干预可能有助于预防抑郁的发生。
