Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium.
Erasme Hospital, Department of Psychiatry and Sleep Laboratory, Université libre de Bruxelles, ULB, Brussels, Belgium.
J Psychiatr Res. 2022 Jun;150:338-345. doi: 10.1016/j.jpsychires.2021.11.034. Epub 2021 Nov 22.
Individuals with insomnia are a subpopulation at high-risk of suicide. However, despite the elements in favour of an implication of anhedonia in the occurrence of current suicidal ideations (SI), no study has investigated the role played by this affective symptom in the occurrence of current SI in individuals with insomnia. The aim of this study was to investigate the risk of current SI associated with lifelong anhedonia and recent change of anhedonia in individuals with insomnia.
Demographic and polysomnographic data from 493 individuals with insomnia selected retrospectively from the clinical database of the Erasme Hospital Sleep Laboratory were analysed. Current SI were considered present if the score in item 9 of the Beck Depression Inventory (BDI-II) was ≥1 and/or if they were highlighted during the systematic psychiatric assessment conducted on admission to the Sleep Laboratory. Logistic regression analyses were used to determine the risk of current SI associated with anhedonia in individuals with insomnia.
The prevalence of current SI was 21.5% in our sample of individuals with insomnia. After adjusting for major confounding factors, multivariate logistic regression analyses demonstrated that unlike lifelong anhedonia, only recent change of anhedonia was a risk factor for current SI in individuals with insomnia.
In this study, we demonstrated that in individuals with insomnia, recent change of anhedonia is a risk factor for current SI, which seems to justify more systematic research and adequate therapeutic management of this condition to allow better prevention in this particular subpopulation at high-risk of suicide.
失眠个体是自杀高危亚群。尽管快感缺失在当前自杀意念(suicidal ideation,SI)的发生中存在一些影响因素,但尚无研究调查这种情感症状在失眠个体中当前 SI 发生中的作用。本研究旨在调查与终生快感缺失和近期快感缺失变化相关的失眠个体当前 SI 的风险。
从 Erasme 医院睡眠实验室的临床数据库中回顾性选择了 493 名失眠患者的人口统计学和多导睡眠图数据。如果贝克抑郁量表(Beck Depression Inventory,BDI-II)第 9 项的得分≥1 并且/或者在入院睡眠实验室进行的系统精神评估中突出显示,则认为存在当前 SI。使用逻辑回归分析来确定与失眠个体快感缺失相关的当前 SI 的风险。
在我们的失眠个体样本中,当前 SI 的患病率为 21.5%。在调整了主要混杂因素后,多变量逻辑回归分析表明,与终生快感缺失不同,近期快感缺失的变化是失眠个体当前 SI 的一个风险因素。
在这项研究中,我们证明了在失眠个体中,近期快感缺失的变化是当前 SI 的一个风险因素,这似乎证明了更系统的研究和适当的治疗管理这种情况的合理性,以便在这个自杀高危亚群中更好地预防。