30多年来焦虑或抑郁障碍患者的睡眠障碍及人格障碍的影响
Sleep Disturbance in People with Anxiety or Depressive Disorders over 30 Years, and the Influence of Personality Disorder.
作者信息
King Jacob D, Yang Min, Tyrer Helen, Tyrer Peter
机构信息
Division of Psychiatry, Imperial College London, London, UK.
Faculty of Health Art and Design, Swinburne University of Technology, Melbourne, Australia.
出版信息
Behav Sleep Med. 2024 Dec 16;23(2):1-13. doi: 10.1080/15402002.2024.2441795.
OBJECTIVES
Sleep disturbance is commonly reported by people with anxiety, depressive, and personality disorders, but longitudinal studies exploring the interplay of the three with disturbed sleep have not previously been described.
METHODS
In this study, sleep disturbance was examined among 89 patients initially presenting with anxiety or depressive disorders who provided follow-up at 12- and 30-year time points in the Nottingham Study of Neurotic Disorder. Multilevel models were used to identify factors most predictive of changes in sleep quality over time.
RESULTS
There were strong associations between poor sleep and contemporaneous severity of personality disorder and the presence of other mental disorders at 12 and 30 years follow-up, but not with disorder presence at other time points. Improvements in personality disorder were associated with improvements in sleep between time points and attenuated the positive unadjusted effects of recovery from anxiety or depressive disorders to non-significance. Relapse into further episodes of mental disorder predicted poorer sleep, whereas worsening personality disorder was not predictive of significant changes when adjusting for other factors.
CONCLUSIONS
This study demonstrates the complex interplay between anxiety, depressive, and personality disorders and sleep disturbance over a long follow-up period. Future research might look to examine the relationship between personality disorder and disturbed sleep with interventional studies and by integrating personality trait research.
目的
焦虑症、抑郁症和人格障碍患者普遍存在睡眠障碍,但此前尚未有纵向研究探讨这三种疾病与睡眠障碍之间的相互作用。
方法
在这项研究中,对89名最初患有焦虑症或抑郁症的患者进行了睡眠障碍检查,这些患者参与了诺丁汉神经症研究,并在12年和30年时间点提供了随访数据。采用多水平模型来确定最能预测睡眠质量随时间变化的因素。
结果
在12年和30年的随访中,睡眠质量差与人格障碍的同期严重程度以及其他精神障碍的存在之间存在密切关联,但与其他时间点的疾病存在情况无关。人格障碍的改善与各时间点之间睡眠质量的改善相关,并减弱了焦虑症或抑郁症康复的未经调整的积极影响,使其变得不显著。再次发作精神障碍预示着睡眠质量较差,而在调整其他因素后,人格障碍的恶化并不能预测显著变化。
结论
这项研究证明了在长期随访期间,焦虑症、抑郁症和人格障碍与睡眠障碍之间存在复杂的相互作用。未来的研究可能会通过干预研究以及整合人格特质研究来探讨人格障碍与睡眠障碍之间的关系。
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Clin Psychol Eur. 2022-12-15
Sleep Med Rev. 2022-2
Personal Disord. 2022-3