van der Tuin S, Booij S H, Oldehinkel A J, van den Berg D, Wigman J T W, Lång U, Kelleher I
University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Centre Psychopathology and Emotion Regulation, Groningen, the Netherlands.
Center for Integrative Psychiatry, Lentis, Groningen, the Netherlands.
Psychol Med. 2023 May 23;53(16):1-9. doi: 10.1017/S0033291723001459.
Psychotic disorders develop gradually along a continuum of severity. Understanding factors associated with psychosis development, such as sleep, could aid in identification of individuals at elevated risk. This study aimed to assess (1) the dynamic relationship between psychotic experiences (PEs) and sleep quality and quantity, and (2) whether this relationship differed between different clinical stages along the psychosis continuum.
We used daily diary data (90 days) of individuals ( = 96) at early stages (i.e. before a first diagnosis of psychosis) along the psychosis continuum. Multilevel models were constructed with sleep quality and sleep quantity as predictors of PEs and vice versa. Post-hoc, we constructed a multilevel model with both sleep quality and quantity as predictors of PEs. In addition, we tested whether associations differed between clinical stages.
Within persons, poorer sleep predicted next day PEs ( = -0.02, = 0.01), but not vice versa. Between persons, shorter sleep over the 90-day period predicted more PEs ( = -0.04, = 0.002). Experiencing more PEs over 90-days predicted poorer ( = -0.02, = 0.02) and shorter ( = -1.06, = 0.008) sleep. We did not find any significant moderation effects for clinical stage.
We found a bidirectional relationship between sleep and PEs with daily fluctuations in sleep predicting next day PEs and general patterns of more PEs predicting poorer and shorter sleep. Our results highlight the importance of assessing sleep as a risk marker in the early clinical stages for psychosis.
精神障碍沿着严重程度的连续谱逐渐发展。了解与精神病发展相关的因素，如睡眠，有助于识别风险升高的个体。本研究旨在评估：（1）精神病体验（PEs）与睡眠质量和数量之间的动态关系；（2）这种关系在精神病连续谱的不同临床阶段是否存在差异。
我们使用了处于精神病连续谱早期阶段（即首次诊断为精神病之前）的个体（n = 96）的每日日记数据（90天）。构建了以睡眠质量和睡眠数量作为PEs预测因子以及反之亦然的多层次模型。事后，我们构建了一个以睡眠质量和数量作为PEs预测因子的多层次模型。此外，我们测试了各临床阶段之间的关联是否存在差异。
在个体内部，较差的睡眠可预测次日的PEs（β = -0.02，p = 0.01），但反之则不然。在个体之间，90天内较短的睡眠时间可预测更多的PEs（β = -0.04，p = 0.002）。90天内经历更多的PEs可预测较差的（β = -0.02，p = 0.02）和较短的（β = -1.06，p = 0.008）睡眠。我们未发现临床阶段有任何显著的调节作用。
我们发现睡眠与PEs之间存在双向关系，睡眠的每日波动可预测次日的PEs，而更多PEs的总体模式可预测较差和较短的睡眠。我们的结果强调了在精神病临床早期阶段将睡眠作为风险标志物进行评估的重要性。
Zotero 插件