Teresi Giana I, Merranko John, Porta Giovanna, Bero Kelsey, Poling Kimberly D, Brent David A, Goldstein Tina R
Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Suicide Life Threat Behav. 2025 Apr;55(2):e13141. doi: 10.1111/sltb.13141. Epub 2024 Nov 5.
Suicidal thoughts and behaviors often onset during adolescence, constituting a major public health concern. Despite rising rates in youth, psychotherapeutic and pharmacological treatment outcomes remain meager, indicating a need to identify modifiable risk factors. Experts suggest sleep may serve as a promising clinical indicator of risk and treatment progress, yet few studies have examined acute temporal associations between sleep and suicidal ideation.
Participants were depressed and suicidal adolescents (age 13-19, n = 311) attending an intensive outpatient program (IOP). Patients completed weekly self-report assessments of sleep, depression, and suicidal ideation throughout IOP, with an average of 5 assessments over 30 days.
Greater overall sleep difficulties, as well as within-person increases in sleep difficulties, were predictive of greater depression severity and suicidal ideation at subsequent assessments, above and beyond previous levels of symptoms. The reverse associations were not found. Inclusion of within-person changes in sleep difficulties significantly improved model fit compared to inclusion of overall sleep difficulties alone.
This study provides additional evidence for a prospective relationship between worsening sleep difficulties and suicidal ideation in an IOP youth sample. Worsening sleep may be an important clinical indicator of subsequent depression and suicide risk among adolescents in treatment.
自杀念头和行为往往在青春期开始出现，这是一个重大的公共卫生问题。尽管青少年中的发生率不断上升，但心理治疗和药物治疗的效果仍然不佳，这表明需要确定可改变的风险因素。专家建议，睡眠可能是一个有前景的风险和治疗进展的临床指标，但很少有研究考察睡眠与自杀意念之间的急性时间关联。
参与者为参加强化门诊项目（IOP）的抑郁且有自杀倾向的青少年（年龄13 - 19岁，n = 311）。患者在整个IOP期间每周完成关于睡眠、抑郁和自杀意念的自我报告评估，在30天内平均进行5次评估。
总体睡眠困难增加，以及个体睡眠困难的增加，在后续评估中可预测更严重的抑郁和自杀意念，超出了先前的症状水平。未发现相反的关联。与仅纳入总体睡眠困难相比，纳入个体睡眠困难的变化显著改善了模型拟合。
本研究为IOP青少年样本中睡眠困难加剧与自杀意念之间的前瞻性关系提供了额外证据。睡眠恶化可能是治疗中青少年后续抑郁和自杀风险的重要临床指标。
