Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
Beijing Key Laboratory of Applied Experimental Psychology, Beijing Normal University, Beijing, China.
Sleep Med. 2022 Dec;100:150-156. doi: 10.1016/j.sleep.2022.08.010. Epub 2022 Aug 24.
A bidirectional relationship between insomnia and depression has been observed. However, few studies have used network analysis to explore the interaction patterns in that association at the symptom level. This study aimed to estimate network structures of insomnia and depressive symptoms among shift workers, as well as to compare the differences in network properties between individuals without and with insomnia symptoms and/or at risk of depression. A total of 1883 shift workers were included in our study. Insomnia symptoms were evaluated by three items based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, and depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale. Network analyses were used for the statistical analysis. "Difficulty initiating sleep", "Hard to get started", and "Depressed mood" with higher expected influence (EI) values were identified as the most central symptoms within the insomnia-depressive networks among shift workers. The significant differences between individuals without and with insomnia symptoms and/or at risk of depression were observed in symptoms of "Difficulty initiating sleep" and "Hard to get started". "Depressed mood", "Difficulty initiating sleep", or "Hard to get started" were the most key symptoms that trigger and sustain the structure of insomnia and depressive symptom among shift workers. Hence, timely intervention for the above three symptoms in future research or clinical practice (e.g., cognitive behavioral therapy for insomnia) may be crucial in alleviating insomnia and depressive symptoms among shift workers.
失眠和抑郁之间存在双向关系。然而，很少有研究使用网络分析来探索症状水平上的这种关联的相互作用模式。本研究旨在估计轮班工人中失眠和抑郁症状的网络结构，并比较无失眠症状和/或无抑郁风险个体与有失眠症状和/或有抑郁风险个体之间网络特征的差异。我们的研究共纳入了 1883 名轮班工人。失眠症状采用基于《精神障碍诊断与统计手册》标准的三个项目进行评估，抑郁症状采用《流行病学研究中心抑郁量表》进行评估。网络分析用于统计分析。“入睡困难”、“难以开始”和“情绪低落”这三个具有较高预期影响（EI）值的症状被确定为轮班工人失眠-抑郁网络中的核心症状。无失眠症状和/或无抑郁风险个体与有失眠症状和/或有抑郁风险个体之间在“入睡困难”和“难以开始”这两个症状上存在显著差异。“入睡困难”、“难以开始”或“情绪低落”是引发和维持轮班工人失眠和抑郁症状结构的关键症状。因此，在未来的研究或临床实践中，及时干预上述三个症状（例如，失眠的认知行为疗法）可能对缓解轮班工人的失眠和抑郁症状至关重要。
