Sarıgedik Enes, Yurteri Nihal
Department of Child and Adolescent Psychiatry, Düzce University Faculty of Medicine, Düzce, Turkey.
Psychiatry Clin Psychopharmacol. 2021 Mar 1;31(1):90-97. doi: 10.5152/pcp.2021.20182. eCollection 2021 Mar.
This study aims to evaluate the sleep quality of adolescents with PTSD related to sexual abuse and to investigate the relationship between sleep quality, PTSD symptoms, and quality of life. Our study was designed as a cross-sectional study.
Forty adolescents who were diagnosed with PTSD related to sexual abuse and 40 healthy adolescents as a control group were included in the study. Structured interview scale Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) were applied to children by the clinician. All participants also filled out the Pediatric Quality of Life Inventory (PedsQL), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI).
The analyses of the data revealed that the quality of life scores of the case group was significantly associated with worse results. Sleeplessness index (ISI) and morning sleepiness scores (ESS) were higher in the case group than the control group ( < .001; < .001) and perceived quality of sleep (PSQI) was determined to be lower ( < .001). A statistically significant relationship between PTSD total score and PSQI ( < .001; = 0.550), ESS ( < .05; = 0.369), ISI ( < .001; = 0.613), and PedsQL ( < .001; = -0.473) were identified. PSQI, ESS, and ISI were also found to be correlated with each other (PSQI, ESS = 488; PSQI, ISI = 0.755; ESS and ISI = 0.514). Moreover, PSQI scores explain the deterioration in quality of life more significantly than CAPS-CA-TOTAL scores (PSQI = .008; CAPS = .572).
In cases with PTSD related to sexual abuse, we found that sleep affects the quality of life more than the symptoms of PTSD. Sleep-based approaches in PTSD may affect both quality of life and functionality positively, and PSQI may be used in clinical practice to assess both sleep and quality of life in the follow up of patients with PTSD related to sexual abuse.
本研究旨在评估遭受性虐待相关创伤后应激障碍（PTSD）青少年的睡眠质量，并调查睡眠质量、PTSD症状和生活质量之间的关系。我们的研究设计为横断面研究。
本研究纳入了40名被诊断为遭受性虐待相关PTSD的青少年以及40名健康青少年作为对照组。临床医生使用结构化访谈量表《儿童与青少年临床医生管理的PTSD量表》（CAPS-CA）对儿童进行评估。所有参与者还填写了儿童生活质量量表（PedsQL）、匹兹堡睡眠质量指数（PSQI）、爱泼华嗜睡量表（ESS）和失眠严重程度指数（ISI）。
数据分析显示，病例组的生活质量得分与较差结果显著相关。病例组的失眠指数（ISI）和早晨嗜睡得分（ESS）高于对照组（P<.001；P<.001），而睡眠感知质量（PSQI）较低（P<.001）。PTSD总分与PSQI（P<.001；r = 0.550）、ESS（P<.05；r = 0.369）、ISI（P<.001；r = 0.613）和PedsQL（P<.001；r = -0.473）之间存在统计学显著关系。还发现PSQI、ESS和ISI之间相互关联（PSQI与ESS，r = 488；PSQI与ISI，r = 0.755；ESS与ISI，r = 0.514）。此外，PSQI得分比CAPS-CA总分更能显著解释生活质量的恶化（PSQI，P = .008；CAPS，P = .572）。
在遭受性虐待相关PTSD的病例中，我们发现睡眠对生活质量的影响大于PTSD症状。PTSD中基于睡眠的方法可能会对生活质量和功能产生积极影响，并且PSQI可用于临床实践中，在随访遭受性虐待相关PTSD患者时评估睡眠和生活质量。
