Daccò Silvia, Grassi Massimiliano, Wolpe Zach, Bruner Melissa, Caldirola Daniela, Perna Giampaolo, Defillo Archie
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Personalized Medicine Center for Anxiety and Panic Disorders, Humanitas San Pio X Hospital, Milan, Italy.
Front Psychiatry. 2025 Apr 25;16:1449360. doi: 10.3389/fpsyt.2025.1449360. eCollection 2025.
Depression and sleep disorders are strongly linked, with sleep centers (SCs) reporting depressive symptoms in up to 63% of patients and depression diagnoses in 22%. Despite this, routine depression screening is not standard in SCs. This study aimed to identify patients meeting criteria for a current major depressive episode (cMDE) among those self-reporting clinically significant depressive symptoms (CSDS) in U.S. SCs.
This retrospective sub-analysis of an ongoing multicenter trial included 147 adults (22-75 years) referred for sleep disorder evaluation. Participants underwent psychiatric assessments using the Mini-International Neuropsychiatric Interview and Patient Health Questionnaire-9 (PHQ-9), with CSDS defined as PHQ-9 ≥10. Descriptive statistics were compared between patients with/without a confirmed cMDE using non-parametric tests. Additional Mann-Whitney U tests assessed sleep characteristics by cMDE, major depressive disorder (MDD), and bipolar disorder (BD) (statistical significance, p < 0.05).
Of 147 patients, 57 (38.8%) had a PHQ-9 score ≥10. Among them, 23 (40.3%) were diagnosed with cMDE: 17 (29.8%) met cMDD criteria, and 6 (10.5%) had BD, type I. A significantly lower cMDE prevalence was observed in patients without CSDS. Sleep characteristics showed no significant differences except for a lower N3 percentage in cMDE. BD, type I was associated with higher obstructive sleep apnea comorbidity compared to cMDD.
Our findings suggest major depression prevalence in SCs is five times higher than in the general population, highlighting the need for routine depression screening and psychiatric confirmation. This also aids in identifying comorbidities and fostering tailored interventions to improve outcomes.
抑郁症与睡眠障碍紧密相关，睡眠中心（SCs）报告称，高达63%的患者有抑郁症状，22%的患者被诊断为抑郁症。尽管如此，常规抑郁症筛查在睡眠中心并非标准流程。本研究旨在确定美国睡眠中心自我报告有临床显著抑郁症状（CSDS）的患者中符合当前重度抑郁发作（cMDE）标准的患者。
这项对正在进行的多中心试验的回顾性子分析纳入了147名接受睡眠障碍评估的成年人（22 - 75岁）。参与者使用迷你国际神经精神访谈和患者健康问卷-9（PHQ-9）进行精神评估，CSDS定义为PHQ-9≥10。使用非参数检验比较有/无确诊cMDE的患者之间的描述性统计数据。另外的曼-惠特尼U检验按cMDE、重度抑郁症（MDD）和双相情感障碍（BD）评估睡眠特征（统计学显著性，p < 0.05）。
在147名患者中，57名（38.8%）的PHQ-9评分≥10。其中，23名（40.3%）被诊断为cMDE：17名（29.8%）符合cMDD标准，6名（10.5%）为I型BD。在无CSDS的患者中观察到cMDE患病率显著较低。除了cMDE中N3百分比更低外，睡眠特征无显著差异。与cMDD相比，I型BD与更高的阻塞性睡眠呼吸暂停合并症相关。
我们的研究结果表明，睡眠中心的重度抑郁症患病率比普通人群高五倍，凸显了常规抑郁症筛查和精神科确诊的必要性。这也有助于识别合并症并促进针对性干预以改善治疗效果。
