Department of Psychiatry, Stellenbosch University, Tygerberg, Western Cape, South Africa.
Department of Psychiatry, Lentegeur Hospital, Cape Town, Western Cape, South Africa.
Psychiatry Res. 2022 Nov;317:114821. doi: 10.1016/j.psychres.2022.114821. Epub 2022 Sep 2.
Sleep disturbances and suicidality are common presentations of mood and anxiety disorders. If not closely monitored post-discharge, patients may be at an increased risk of symptom worsening and completed suicide. We explored the associations between telephone mood monitoring, suicidality, and sleep quality in a clinical sample. Fifty inpatients (mean age = 39.49, SD = 11.17; female = 74%) with a mood and/or anxiety disorder were telephonically monitored weekly post-discharge for16 weeks for depression and mania. Suicidality and sleep quality were assessed at intake (pre-discharge), and at weeks 4, 8, 12, and 16 post-discharge. ANOVA indicated that suicidality significantly decreased, and sleep quality improved over 16 weeks. Linear regression analysis indicated that depression severity at week 1 post-discharge significantly predicted suicidality and sleep quality at week 16. Mania severity at week 1 post-discharge predicted sleep quality, but not suicidality, at week 16. Participants generally had positive experiences of the monitoring and perceived it as helpful. Monitoring of mood state, suicidality, and sleep quality post-discharge may allow for early detection of relapse when initiated at 1-week post-discharge. This is a potentially cost-effective intervention and may relieve the burden on the mental healthcare system, especially when face-to-face consultations are not possible.
睡眠障碍和自杀意念是情绪和焦虑障碍的常见表现。如果在出院后没有密切监测,患者可能会面临症状恶化和自杀完成的风险增加。我们在临床样本中探讨了电话情绪监测、自杀意念和睡眠质量之间的关联。50 名患有情绪和/或焦虑障碍的住院患者(平均年龄=39.49,SD=11.17;女性=74%)在出院后每周通过电话接受抑郁和躁狂的监测,共 16 周。自杀意念和睡眠质量在入院时(出院前)以及出院后第 4、8、12 和 16 周进行评估。方差分析表明,自杀意念在 16 周内显著下降,睡眠质量有所改善。线性回归分析表明,出院后第 1 周的抑郁严重程度显著预测出院后第 16 周的自杀意念和睡眠质量。出院后第 1 周的躁狂严重程度预测了睡眠质量,但没有预测自杀意念。参与者对监测普遍有积极的体验,认为其具有帮助作用。在出院后第 1 周开始进行情绪状态、自杀意念和睡眠质量的监测,可能有助于及早发现复发。这是一种具有成本效益的干预措施,可以减轻精神卫生保健系统的负担,特别是在无法进行面对面咨询时。