Yang Hang-Ju, Cheng Wan-Ju, Hsiao Mi-Chun, Huang Sheng-Che, Kubo Tomohide, Hang Liang-Wen, Lee Wei-Sheng
Department of Emergency Medicine, Jen Ai Hospital Dali Branch, Taichung, Taiwan.
Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan.
Front Psychiatry. 2023 Aug 10;14:1214143. doi: 10.3389/fpsyt.2023.1214143. eCollection 2023.
Patients with depressive disorder demonstrate rest-activity rhythm disturbances and cognitive function impairment. This study examined the association of individual rest-activity rhythm changes over time with mood symptoms and attention.
We recruited 15 adult outpatients with a diagnosis of major depressive disorder from a single medical center and observed them for 12 months. Weekly rest-activity parameters, including rhythm characteristics generated from nonparametric circadian rhythm analysis, were retrieved from actigraphy data. Attention was evaluated weekly with a smartphone-based psychomotor vigilance test upon awakening. Depressive symptom severity was evaluated using the Beck Depression Inventory (BDI) fortnightly. The association of rest-activity parameters with BDI score and attention was examined using generalized linear mixed regression. A fixed-effects analysis was used to examine the association between rest-activity parameters and depressive episodes.
An advanced bedtime and most active continuous 10 h starting time were associated with depressive symptom severity but also associated with higher vigilance test performance. A longer sleep duration, mainly due to an earlier bedtime, was associated with depressive symptom severity. Compared to remission, sleep duration was 27.8 min longer during depressive episodes, and bed time was 24 min earlier. A shorter sleep duration and increased activity during sleep were associated with poorer attention.
Rest-activity rhythms change with mood symptoms among patients with depressive disorder. The circadian rhythms of rest-activity among patients with depressive disorder should be distinguished during various mood states in future studies.
抑郁症患者表现出休息 - 活动节律紊乱和认知功能损害。本研究调查了个体休息 - 活动节律随时间的变化与情绪症状和注意力之间的关联。
我们从单一医疗中心招募了15名诊断为重度抑郁症的成年门诊患者，并对他们进行了12个月的观察。从活动记录仪数据中获取每周的休息 - 活动参数，包括通过非参数昼夜节律分析生成的节律特征。每周在醒来时使用基于智能手机的精神运动警觉性测试评估注意力。每两周使用贝克抑郁量表（BDI）评估抑郁症状严重程度。使用广义线性混合回归分析休息 - 活动参数与BDI评分和注意力之间的关联。采用固定效应分析来检验休息 - 活动参数与抑郁发作之间的关联。
较提前的就寝时间和最活跃的连续10小时开始时间与抑郁症状严重程度相关，但也与更高的警觉性测试表现相关。较长的睡眠时间，主要是由于较早的就寝时间，与抑郁症状严重程度相关。与缓解期相比，抑郁发作期间睡眠时间长27.8分钟，就寝时间早24分钟。较短的睡眠时间和睡眠期间活动增加与较差的注意力相关。
抑郁症患者的休息 - 活动节律随情绪症状而变化。在未来的研究中，应在不同情绪状态下区分抑郁症患者的休息 - 活动昼夜节律。
