Wang Xianyang, Ren Lei, Zhao Xinxin, Shi Yifan, Li Jingwen, Wu Wenjun, Yu Huan, Lv Runxin, Liu Nian, Wu Xiatong, Dong Hailong, Zhao Guangchao, Wang Huaning, Cai Min
Department of Military Medical Psychology, Fourth Military Medical University, Xi'an 710032, Shaanxi, PR China; Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi, PR China.
Military Psychology Section, Logistics University of PAP, Tianjin 300309, PR China; Military Mental Health Services & Research Center, Tianjin 300309, PR China.
Physiol Behav. 2025 Apr 1;292:114833. doi: 10.1016/j.physbeh.2025.114833. Epub 2025 Jan 31.
Major depressive disorder (MDD) is a leading cause of disease burden in adolescents, with persistently rising prevalence. Anhedonia, core symptom of adolescent MDD, is associated with suicidality and poor clinical outcomes. Impaired sleep quality is proven to be a significant risk factor for adolescent MDD and potentially influence anhedonia symptoms. Understanding the interplay between sleep quality and anhedonia is crucial for early intervention and treatment.
This cross-sectional study recruited 200 drug-naïve adolescent MDD patients from Xijing Hospital. Depression, anhedonia and sleep quality were assessed during outpatient visits, using the Hamilton Depression Rating Scale, Snaith-Hamilton Pleasure Scale, and Pittsburgh Sleep Quality Index, respectively. Network analysis was applied to construct sleep quality network and its co-occurrence network with anhedonia. Centrality indices were computed to indicate central symptoms.
Adolescent MDD patients exhibited moderate depression and anhedonia levels, and are heavily accompanied with sleep complaints. The sleep quality network identified "subjective sleep quality" as the most central factor, mainly due to prolonged "sleep latency" and shortened "sleep duration". In the co-occurrence network, "sleep disturbances" had prominent bridging connection with anhedonia, suggesting its critical role in activating anhedonia symptoms.
Subjective sleep quality was the most central sleep complaints in adolescent MDD, while sleep disturbances were prominently associated with anhedonia. These findings underscore the importance of reducing sleep disturbances to alleviate anhedonia symptoms under clinical settings. Network analysis provides a nuanced understanding of the complex relationship of sleep quality and its association with anhedonia in adolescent MDD.
重度抑郁症（MDD）是青少年疾病负担的主要原因，其患病率持续上升。快感缺失作为青少年MDD的核心症状，与自杀行为及不良临床预后相关。睡眠质量受损已被证明是青少年MDD的重要危险因素，并可能影响快感缺失症状。了解睡眠质量与快感缺失之间的相互作用对于早期干预和治疗至关重要。
这项横断面研究从西京医院招募了200名未服用过药物的青少年MDD患者。在门诊就诊期间，分别使用汉密尔顿抑郁量表、斯奈斯 - 汉密尔顿愉悦量表和匹兹堡睡眠质量指数对抑郁、快感缺失和睡眠质量进行评估。应用网络分析构建睡眠质量网络及其与快感缺失的共现网络。计算中心性指标以指示核心症状。
青少年MDD患者表现出中度抑郁和快感缺失水平，并伴有严重的睡眠问题。睡眠质量网络将“主观睡眠质量”确定为最核心因素，主要原因是“睡眠潜伏期”延长和“睡眠时间”缩短。在共现网络中，“睡眠障碍”与快感缺失有显著的桥接连接，表明其在激活快感缺失症状中的关键作用。
主观睡眠质量是青少年MDD中最核心的睡眠问题，而睡眠障碍与快感缺失显著相关。这些发现强调了在临床环境中减少睡眠障碍以缓解快感缺失症状的重要性。网络分析为理解青少年MDD中睡眠质量及其与快感缺失的复杂关系提供了细致入微的视角。
