Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU, Montpellier, France.
National Reference Network for Narcolepsy, CHU Gui de Chauliac, Montpellier, France.
Mov Disord. 2022 Apr;37(4):812-825. doi: 10.1002/mds.28903. Epub 2022 Jan 5.
Whether depression and suicide thoughts relate to restless legs syndrome (RLS) or comorbidities associated with RLS remain unclear.
To determine frequency of depressive symptoms and suicidal thoughts in patients with RLS and their change after RLS treatment, associated clinical and polysomnographic factors, and current major depressive episode (MDE) frequency and suicide risk in RLS.
Overall, 549 untreated patients with RLS and 549 age-, sex-, and education level-matched controls completed a standardized evaluation, including the Beck Depression Inventory-II that has one item on suicide thoughts. Patients underwent a polysomnographic recording and completed the Urgency, Premeditation, Perseverance, Sensation Seeking Impulsive Behavior scale. In a subgroup of 153 patients, current MDE and suicide risk were assessed with the face-to-face Mini-International Neuropsychiatric Interview (MINI). A subgroup of 152 patients were evaluated in untreated and treated conditions.
The frequency of depressive symptoms (32.5%) and suicidal thoughts (28%) was 10-fold and 3-fold higher, respectively, in patients with RLS than controls. Current MDE (10.5%) and suicidal risk (19.9%) (MINI) were also high. Moderate-to-severe depressive symptoms were associated with young age, female sex, insomnia symptoms, and urgency dimension. The suicide risk was associated with depression, impulsiveness, and RLS severity. RLS treatment improved depressive symptoms but not suicidal thoughts.
The rate of depressive symptoms, depression, and suicidal thoughts/risk was higher in patients with RLS, with key associations with insomnia symptoms, urgency dimension, and RLS severity. These results emphasize the importance of detecting these symptoms in current practice and of evaluating their change after treatment, especially in young women, to improve RLS management. © 2022 International Parkinson and Movement Disorder Society.
抑郁和自杀念头与不宁腿综合征（RLS）有关，还是与 RLS 相关的合并症有关，目前仍不清楚。
确定 RLS 患者中抑郁症状和自杀念头的频率，以及 RLS 治疗后这些症状的变化，相关的临床和多导睡眠图因素，以及 RLS 中当前的重性抑郁发作（MDE）频率和自杀风险。
共有 549 名未经治疗的 RLS 患者和 549 名年龄、性别和教育程度匹配的对照者完成了标准化评估，包括贝克抑郁量表第二版，该量表有一个关于自杀念头的项目。患者接受了多导睡眠图记录，并完成了紧迫性、预谋、坚持、感觉寻求冲动行为量表。在 153 名患者的亚组中，使用面对面的迷你国际神经精神访谈（MINI）评估当前的 MDE 和自杀风险。152 名患者的亚组接受了未治疗和治疗条件下的评估。
RLS 患者的抑郁症状（32.5%）和自杀念头（28%）的频率分别是对照组的 10 倍和 3 倍。当前的 MDE（10.5%）和自杀风险（19.9%）（MINI）也很高。中重度抑郁症状与年龄较小、女性、失眠症状和紧迫性维度有关。自杀风险与抑郁、冲动和 RLS 严重程度有关。RLS 治疗改善了抑郁症状，但没有改善自杀念头。
RLS 患者的抑郁症状、抑郁症和自杀念头/风险发生率较高，与失眠症状、紧迫性维度和 RLS 严重程度有重要关联。这些结果强调了在当前实践中检测这些症状的重要性，以及评估治疗后这些症状变化的重要性，尤其是在年轻女性中，以改善 RLS 的管理。
