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失眠障碍对成人注意缺陷多动障碍严重程度的影响:一项为期六个月的随访研究。

The impact of insomnia disorder on adult attention-deficit/hyperactivity disorder severity: A six-month follow-up study.

机构信息

Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.

Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.

出版信息

Psychiatry Res. 2022 Feb;308:114349. doi: 10.1016/j.psychres.2021.114349. Epub 2021 Dec 20.

Abstract

BACKGROUND AND OBJECTIVES

The longitudinal relationship between insomnia disorder and adult attention-deficit/hyperactivity disorder (ADHD) has been scarcely investigated. This study aimed to evaluate the relationship between the remission of insomnia disorder and adult ADHD clinical severity, psychiatric and medical comorbidities, and the health-related quality of life (HRQoL) in a 6-month follow-up.

METHODS

Ninety-two adult patients with ADHD and insomnia disorder (52.2% males; mean age 39.5 ± 11.0 years) were comprehensively assessed at baseline, 3 months, and 6 months of a follow-up period. The evaluation included semi-structured interviews (for ADHD and comorbidity assessment), the Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Epworth Sleepiness Scale. The diagnosis of ADHD and insomnia disorder was performed according to DSM-5 criteria. At baseline and follow-up, psychoeducation/sleep hygiene and, if necessary, pharmacological were prescribed for insomnia.

RESULTS

Eighty-seven patients completed the 6-month follow-up. Insomnia disorder remission was reported in 72.4% of cases and was related to a greater improvement in ADHD symptoms and severity throughout the follow-up period. Additionally, an improvement in psychiatric comorbidities and better HRQoL were associated with insomnia disorder remission.

CONCLUSION

The current study highlights that the treatment of insomnia disorder in ADHD adult patients may have an important role in the outcome of ADHD therapeutic approaches by reducing their severity.

摘要

背景和目的

失眠障碍与成人注意缺陷多动障碍(ADHD)之间的纵向关系尚未得到充分研究。本研究旨在评估失眠障碍缓解与成人 ADHD 临床严重程度、精神和医学共病以及健康相关生活质量(HRQoL)之间的关系,随访时间为 6 个月。

方法

92 名患有 ADHD 和失眠障碍的成年患者(52.2%为男性;平均年龄 39.5±11.0 岁)在基线、3 个月和 6 个月的随访期间进行了全面评估。评估包括半结构化访谈(用于 ADHD 和共病评估)、匹兹堡睡眠质量指数、失眠严重程度指数和 Epworth 嗜睡量表。ADHD 和失眠障碍的诊断符合 DSM-5 标准。在基线和随访时,为失眠症提供了心理教育/睡眠卫生,如果必要,还提供了药物治疗。

结果

87 名患者完成了 6 个月的随访。72.4%的患者报告失眠症缓解,并且在整个随访期间,ADHD 症状和严重程度都有更大的改善。此外,精神共病的改善和更好的 HRQoL 与失眠症缓解相关。

结论

本研究强调,治疗 ADHD 成年患者的失眠症可能通过降低其严重程度,在 ADHD 治疗方法的结果中发挥重要作用。

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