Nakajima Suguru, Kaneko Yoshiyuki, Fujii Nobukuni, Kizuki Jun, Saitoh Kaori, Nagao Kentaro, Kawamura Aoi, Yoshiike Takuya, Kadotani Hiroshi, Yamada Naoto, Uchiyama Makoto, Kuriyama Kenichi, Suzuki Masahiro
Department of Psychiatry, Nihon University School of Medicine, Tokyo, Japan.
Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan.
Front Psychiatry. 2023 Apr 24;14:1114945. doi: 10.3389/fpsyt.2023.1114945. eCollection 2023.
In psychiatric disorders, comorbid depressive symptoms are associated with clinically important issues such as reduced quality of life, a poor prognosis, and increased suicide risk. Previous studies have found a close relationship between insomnia and depressive symptoms in major depressive disorder (MDD), and that actively improving insomnia heightens the improvement of depressive symptoms. This study aimed to investigate whether the association between insomnia and depressive symptoms is also found in other psychiatric disorders besides MDD. The subjects were 144 patients with MDD ( = 71), schizophrenia ( = 25), bipolar disorder ( = 22), or anxiety disorders ( = 26). Sleep status was assessed subjectively and objectively using the Athens Insomnia Scale (AIS) and sleep electroencephalography (EEG), respectively. Sleep EEG was performed using a portable EEG device. Depressive symptoms were assessed using the Beck Depression Inventory. Subjective insomnia, as defined by the AIS, was associated with depressive symptoms in all disorders. Moreover, in schizophrenia, a relation between depressive symptoms and insomnia was also found by objective sleep assessment methods using sleep EEG. Our findings suggest that the association between subjective insomnia and depressive symptoms is a transdiagnostic feature in major psychiatric disorders. Further studies are needed to clarify whether therapeutic interventions for comorbid insomnia can improve depressive symptoms in major psychiatric disorders, similar to MDD.
在精神疾病中，共病的抑郁症状与生活质量下降、预后不良和自杀风险增加等临床上的重要问题相关。先前的研究发现，重度抑郁症（MDD）中失眠与抑郁症状之间存在密切关系，积极改善失眠可增强抑郁症状的改善。本研究旨在调查除MDD外，其他精神疾病中是否也存在失眠与抑郁症状之间的关联。研究对象为144例患有MDD（n = 71）、精神分裂症（n = 25）、双相情感障碍（n = 22）或焦虑症（n = 26）的患者。分别使用雅典失眠量表（AIS）和睡眠脑电图（EEG）主观和客观地评估睡眠状况。睡眠EEG使用便携式EEG设备进行。使用贝克抑郁量表评估抑郁症状。AIS定义的主观失眠与所有疾病中的抑郁症状相关。此外，在精神分裂症中，通过使用睡眠EEG的客观睡眠评估方法也发现了抑郁症状与失眠之间的关系。我们的研究结果表明，主观失眠与抑郁症状之间的关联是主要精神疾病的一种跨诊断特征。需要进一步研究以阐明，与MDD类似，针对共病失眠的治疗干预是否能改善主要精神疾病中的抑郁症状。
