Akiskal H S, Lemmi H, Dickson H, King D, Yerevanian B, Van Valkenburg C
J Affect Disord. 1984 Jun;6(3-4):287-95. doi: 10.1016/s0165-0327(84)80007-5.
In this clinical, psychometric and polysomnographic study, primary dysthymics (N = 20) were compared with anxious depressives (N = 22), and non-psychiatric controls (N = 11). Beck and MMPI depression scores were similar in the two affective groups. Prominent insomnia occurred in 82% of the anxious group; hypersomnia was more characteristic of the dysthymic group. On night 1, the anxious group had the poorest sleep efficiency (P less than 0.001), while dysthymics had the highest REM% (P less than 0.05) and shortest REM latency (P less than 0.01). On night 2, differences tended to be minimized, although the number of awakenings was still high (P less than 0.05) in the anxious group, and REM% was highest (P less than 0.01) and REM latency shortest (P less than 0.01) in the dysthymics. These findings suggest that patients with primary anxiety disorders experience greater sleep continuity difficulties on the adaptation night. Despite significant clinical overlap in depressive symptomatology between the two groups, REM% and REM latency appear as sturdy psychophysiological markers in differentiating primary dysthymics and anxious depressives on both nights. These data suggest that distinct anxious depressive and subaffective dysthymic subtypes can be distinguished within the universe of the atypical depressions.
在这项临床、心理测量和多导睡眠图研究中，对原发性心境恶劣患者（N = 20）、焦虑性抑郁患者（N = 22）和非精神科对照者（N = 11）进行了比较。两个情感障碍组的贝克抑郁量表和明尼苏达多相人格调查表抑郁得分相似。82%的焦虑组患者存在明显的失眠；而睡眠过多是心境恶劣组更具特征性的表现。在第1晚，焦虑组的睡眠效率最差（P < 0.001），而心境恶劣组的快速眼动睡眠比例最高（P < 0.05）且快速眼动睡眠潜伏期最短（P < 0.01）。在第2晚，差异趋于最小化，尽管焦虑组的觉醒次数仍然较多（P < 0.05），且心境恶劣组的快速眼动睡眠比例最高（P < 0.01）且快速眼动睡眠潜伏期最短（P < 0.01）。这些发现表明，原发性焦虑症患者在适应期夜晚睡眠连续性困难更大。尽管两组在抑郁症状学上有明显的临床重叠，但快速眼动睡眠比例和快速眼动睡眠潜伏期在区分两晚的原发性心境恶劣患者和焦虑性抑郁患者时似乎是可靠的心理生理指标。这些数据表明，在非典型抑郁症范围内可以区分出不同的焦虑性抑郁和亚情感性心境恶劣亚型。
