Yuan Shiqi, Wang Ruiyang, Shi Yongyan, Zhao Yixin, Tao Haojuan, Wu Guowei, Tan Liwen, Ouyang Xuan
Department of Psychiatry, National Clinical Research Center for Mental Disorders and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
BMC Psychiatry. 2025 Jun 2;25(1):570. doi: 10.1186/s12888-025-06998-8.
Insomnia has been associated with obsessive-compulsive disorder (OCD), as well as depression and anxiety. However, their interactions and the influence of depression and anxiety on this relationship remain unclear. We aimed to assess the bridge and central symptoms of the insomnia-obsessive-compulsive (OC) network model and explore the impact of depression and anxiety on these connections.
A total of 1,046 patients were included in our study. The severity of insomnia, OC, depression, and anxiety were measured using the Pittsburgh Sleep Quality Index, Yale-Brown Obsessive-Compulsive Scale, Zung's Self-Rating Anxiety Scale, and Zung's Self-Rating Depression Scale, respectively. Stability analyses of marginal weights were conducted to assess network robustness.
The network analysis revealed that compulsive behaviors and low sleep quality were shown to be the most central symptoms in the insomnia-OC network, with compulsive behaviors and daytime dysfunction acting as bridge symptoms. Daytime dysfunction, obsessive thoughts, anxiety and panic were found to be bridge symptoms in the insomnia-OC-anxiety network. In the insomnia-OC-depression network, daytime dysfunction, obsessive thoughts, and rhythm disturbances were possible bridge symptoms.
Compulsive behaviors and daytime dysfunction were linked to insomnia and OC. In the insomnia-OC-anxiety network, anxiety and panic played a central role, while depressed mood was prominent in the insomnia-OC-depression network model. Targeting compulsive behaviors and improving daytime functioning may help reduce insomnia in individuals with OCD. Additionally, addressing anxiety and panic, and rhythm disturbances may further alleviate the psychological distress in these patients.
失眠与强迫症（OCD）以及抑郁和焦虑有关。然而，它们之间的相互作用以及抑郁和焦虑对这种关系的影响仍不清楚。我们旨在评估失眠 - 强迫（OC）网络模型的桥梁症状和核心症状，并探讨抑郁和焦虑对这些联系的影响。
我们的研究共纳入了1046名患者。分别使用匹兹堡睡眠质量指数、耶鲁 - 布朗强迫量表、zung氏自评焦虑量表和zung氏自评抑郁量表来测量失眠、OC、抑郁和焦虑的严重程度。进行边缘权重的稳定性分析以评估网络稳健性。
网络分析显示，强迫行为和低睡眠质量是失眠 - OC网络中最核心的症状，强迫行为和日间功能障碍为桥梁症状。在失眠 - OC - 焦虑网络中，日间功能障碍、强迫观念、焦虑和恐慌是桥梁症状。在失眠 - OC - 抑郁网络中，日间功能障碍、强迫观念和节律紊乱可能是桥梁症状。
强迫行为和日间功能障碍与失眠和OC相关。在失眠 - OC - 焦虑网络中，焦虑和恐慌起核心作用，而在失眠 - OC - 抑郁网络模型中，抑郁情绪较为突出。针对强迫行为并改善日间功能可能有助于减少OCD患者的失眠。此外，解决焦虑和恐慌以及节律紊乱可能会进一步减轻这些患者的心理困扰。
