Ma Hui-Ying, Xu Yi-Fan, Qiao Dan, Wen Yu-Jiao, Zhao Ting, Wang Xiao-Pan, Liang Tai-Ling, Li Xin-Rong, Liu Zhi-Fen
Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Sleep Med. 2023 Jun;106:116-122. doi: 10.1016/j.sleep.2023.01.021. Epub 2023 Jan 29.
Previous studies have shown that abnormal sleep architectures are the important indicator for diagnosing MDD and predicting the efficacy of antidepressants. However, few studies have focused specifically on adolescents.
To explore the relationship between abnormal sleep features, including PSG parameters and scale evaluation, and the onset of adolescent MDD, as well as early SSRIs efficacy.
102 adolescent MDD patients (age 12 to 19-year-old) and 41 similarly age-marched controls were recruited. Demographic data, the HAMD and the PSQI scale assessment scores were collected at baseline, latter two were also collected at follow-up. Part of the participants underwent a minimum 7-d medication-free period, and two consecutive night polysomnography. In the follow-up study, MDD patients were treated with standardized SSRIs. Treatment response was assessed every two weeks.
MDD subjects' parental marital status, REM-sleep latency, N2, N2%, N3, REM-sleep duration, REM % showed significant differences at baseline. REM-sleep latency showed significant prediction of the onset of MDD. The HAMD and PSQI scale assessment scores decreased over time in the follow-up study. Specifically, the sleep disorder factor score of HAMD, the scores of PSQI sleep latency, sleep disorder, sleep efficiency and total score showed significantly differences between responder and non-responder groups. PSQI baseline moderate group showed significant prediction of the early efficacy of SSRIs.
Abnormal sleep PSG parameters and self-evaluation could be predictors for the adolescent MDD onset and early SSRIs efficacy.
先前的研究表明，异常的睡眠结构是诊断重度抑郁症（MDD）和预测抗抑郁药疗效的重要指标。然而，很少有研究专门针对青少年。
探讨包括多导睡眠图（PSG）参数和量表评估在内的异常睡眠特征与青少年MDD发病以及早期选择性5-羟色胺再摄取抑制剂（SSRIs）疗效之间的关系。
招募了102名青少年MDD患者（年龄12至19岁）和41名年龄相仿的对照者。在基线时收集人口统计学数据、汉密尔顿抑郁量表（HAMD）和匹兹堡睡眠质量指数（PSQI）量表评估分数，后两者在随访时也进行收集。部分参与者经历了至少7天的无药期，并进行了连续两晚的多导睡眠监测。在随访研究中，MDD患者接受标准化的SSRIs治疗。每两周评估一次治疗反应。
MDD受试者的父母婚姻状况、快速眼动（REM）睡眠潜伏期、N2期、N2%、N3期、REM睡眠时间、REM%在基线时存在显著差异。REM睡眠潜伏期对MDD发病有显著预测作用。在随访研究中，HAMD和PSQI量表评估分数随时间下降。具体而言，HAMD的睡眠障碍因子得分、PSQI的睡眠潜伏期、睡眠障碍、睡眠效率和总分在反应者和无反应者组之间存在显著差异。PSQI基线中度组对SSRIs的早期疗效有显著预测作用。
异常的睡眠PSG参数和自我评估可能是青少年MDD发病和早期SSRIs疗效的预测指标。
