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抑郁症患儿的认知功能、生活质量与睡眠障碍的关联

Association of Cognitive Function, Quality of Life, and Sleep Disorders in Children With Depression.

作者信息

Xu Li, Chen Yuewei, Liu Meili, He Huiwen, Shen Yanmei, Xie Jianhui

机构信息

Department of Neurology, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), 410007 Changsha, Hunan, China.

Department of Pediatrics, The Second Xiangya Hospital of Central South University, 410007 Changsha, Hunan, China.

出版信息

Actas Esp Psiquiatr. 2025 Aug;53(4):693-700. doi: 10.62641/aep.v53i4.1866.

Abstract

BACKGROUND

Children with depression frequently experience sleep disorders, which may significantly impact their cognitive function and quality of life. Investigating the relationship between sleep quality, cognitive performance, and quality of life in this population is essential for developing targeted interventions.

METHODS

From February 2022 to January 2024, 78 children diagnosed with depression at the Hunan Children's Hospital were assessed using the 17-item Hamilton Rating Scale for Depression (HAMD-17). Based on their HAMD-17 scores, participants were categorized into mild, moderate, and severe depression groups, with 26 children in each group. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), cognitive function was assessed via the Wisconsin Card Sorting Test (WCST), and quality of life was measured using the 36-item Short Form Health Survey (SF-36). Correlations between PSQI, WCST, and SF-36 scores were analyzed for all groups.

RESULTS

Compared to the control group, the depression group of children with depression had significantly higher levels of depression and significantly lower levels of quality of life, sleep quality, and cognitive function (p < 0.05). Further analysis showed that sleep quality in children with depression worsened with increasing severity of depression, as evidenced by a gradual increase in PSQI scores (p < 0.05). Cognitive function assessment (WCST scores) revealed that with increasing depression severity, the number of classifications completed by children decreased, while the total number of errors, perseverative errors, and non-perseverative errors all significantly increased (p < 0.001). Quality of life assessment (SF-36 scores) showed that increasing depressive symptoms significantly affected the quality of life of children, with an overall significant decrease in scores (p < 0.05). Correlation analysis further revealed that cognitive function was closely related to sleep quality in children with depression. Specifically, the number of classifications completed was significantly negatively correlated with PSQI scores (r = -0.5534, p < 0.0001), while the total number of errors, perseverative errors, and non-perseverative errors were all significantly positively correlated with PSQI scores (r = 0.6769, 0.6988, and 0.6937, respectively, all p < 0.0001). In addition, four dimensions of quality of life (social function, physical function, role function, and cognitive function) were all significantly negatively correlated with sleep quality (r = -0.6866, -0.5309, -0.5823, -0.5698, respectively, all p < 0.0001).

CONCLUSION

Poor sleep quality in children with depression is positively correlated with poor cognitive function and poor quality of life. Routine evaluation of sleep disturbances in this population can provide critical insights for timely intervention and management.

摘要

背景

患有抑郁症的儿童经常出现睡眠障碍,这可能会对他们的认知功能和生活质量产生重大影响。研究该人群中睡眠质量、认知表现和生活质量之间的关系对于制定有针对性的干预措施至关重要。

方法

2022年2月至2024年1月,对湖南省儿童医院78名被诊断为抑郁症的儿童使用17项汉密尔顿抑郁评定量表(HAMD-17)进行评估。根据HAMD-17评分,参与者被分为轻度、中度和重度抑郁症组,每组26名儿童。使用匹兹堡睡眠质量指数(PSQI)评估睡眠质量,通过威斯康星卡片分类测验(WCST)评估认知功能,使用36项简明健康调查(SF-36)测量生活质量。分析所有组中PSQI、WCST和SF-36评分之间的相关性。

结果

与对照组相比,抑郁症患儿组的抑郁水平显著更高,而生活质量、睡眠质量和认知功能水平显著更低(p < 0.05)。进一步分析表明,抑郁症患儿的睡眠质量随着抑郁严重程度的增加而恶化,PSQI评分逐渐升高证明了这一点(p < 0.05)。认知功能评估(WCST评分)显示,随着抑郁严重程度的增加,儿童完成的分类数量减少,而错误总数、持续性错误和非持续性错误均显著增加(p < 0.001)。生活质量评估(SF-36评分)表明,抑郁症状的增加显著影响儿童的生活质量,评分总体显著下降(p < 0.05)。相关分析进一步揭示,抑郁症患儿的认知功能与睡眠质量密切相关。具体而言,完成的分类数量与PSQI评分显著负相关(r = -0.5534,p < 0.0001),而错误总数、持续性错误和非持续性错误均与PSQI评分显著正相关(分别为r = 0.6769、0.6988和0.6937,均p < 0.0001)。此外,生活质量的四个维度(社会功能、身体功能、角色功能和认知功能)均与睡眠质量显著负相关(分别为r = -0.6866、-0.5309、-0.5823、-0.5698,均p < 0.0001)。

结论

抑郁症患儿睡眠质量差与认知功能差和生活质量差呈正相关。对该人群的睡眠障碍进行常规评估可为及时干预和管理提供关键见解。

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