Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University & Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China.
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University & Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China; School of Psychology, Northeast Normal University, Changchun, China.
J Affect Disord. 2022 Jan 1;296:363-369. doi: 10.1016/j.jad.2021.09.072. Epub 2021 Sep 28.
Frequent nightmares are related to depressive symptoms in adolescents. Little is known about pathways from frequent nightmares to depressive symptoms. This study aimed to examine the mediation effect of nightmare distress in the association between frequent nightmares and depressive symptoms in a large sample of Chinese adolescents.
A total of 11,831 adolescents who participated in the baseline survey of Shandong Adolescent Behavior and Health Cohort were included in the analysis. A self-administered questionnaire was used to measure nightmare frequency, nightmare distress, depressive symptoms, sleep duration, insomnia, and demographic characteristics. Linear regressions and mediation analyses were performed to examine the associations between frequent nightmares, nightmare distress and depressive symptoms.
Of 11,831 participates, 50.9% were males and the mean age was 14.97 ± 1.45. Adolescents with frequent nightmares scored significantly higher on nightmare distress (t = 29.87, P < 0.001) and depressive symptoms (t = 20.05, P < 0.001) than those adolescents without frequent nightmares. Frequent nightmares (β = 1.04, 95% CI: 0.48-1.60) and nightmare distress (β = 0.30, 95% CI: 0.28-0.32) were associated with depressive symptoms. Mediation analyses showed that nightmare distress accounted for 63.76% of the total effects in the entire sample, 51.17% in males and 80.00% in females, respectively.
No causality could be made from the cross-sectional data and possible information bias due to self-report.
The association between frequent nightmares and depressive symptoms appears to be substantially mediated by nightmare distress. Assessing and intervening distress associated with frequent nightmares may have important clinical implications for reducing the risk of depression in adolescents.
频繁的噩梦与青少年的抑郁症状有关。但对于频繁的噩梦如何导致抑郁症状的机制，目前知之甚少。本研究旨在检验在一个较大的中国青少年样本中，频繁噩梦与抑郁症状之间的关联中，噩梦困扰的中介作用。
共有 11831 名参加山东青少年行为与健康队列基线调查的青少年被纳入分析。采用自填式问卷来测量噩梦频率、噩梦困扰、抑郁症状、睡眠时间、失眠和人口统计学特征。线性回归和中介分析用于检验频繁噩梦、噩梦困扰和抑郁症状之间的关联。
在 11831 名参与者中，50.9%为男性，平均年龄为 14.97±1.45 岁。与没有频繁噩梦的青少年相比，有频繁噩梦的青少年在噩梦困扰（t=29.87，P<0.001）和抑郁症状（t=20.05，P<0.001）方面得分显著更高。频繁噩梦（β=1.04，95%置信区间：0.48-1.60）和噩梦困扰（β=0.30，95%置信区间：0.28-0.32）与抑郁症状相关。中介分析表明，在整个样本中，噩梦困扰占总效应的 63.76%，在男性中占 51.17%，在女性中占 80.00%。
由于横断面数据，以及可能的自我报告导致的信息偏倚，不能得出因果关系。
频繁的噩梦与抑郁症状之间的关联似乎主要是由噩梦困扰介导的。评估和干预与频繁的噩梦相关的困扰可能对降低青少年抑郁风险具有重要的临床意义。
