Woodward S H, Friedman M J, Bliwise D L
National Center for Post-Traumatic Stress Disorder, DVAMC, Palo Alto, CA 94303, USA.
Biol Psychiatry. 1996 Feb 1;39(3):182-92. doi: 10.1016/0006-3223(95)00104-2.
The sleep of 27 unmedicated Vietnam combat-related posttraumatic stress disorder (PTSD) inpatients was monitored for 3 nights. Depressive comorbidity was considered both as a diagnostic category using DMS-III-R criteria, and as a continuous variable using the Beck Depression Inventory (BDI). Data collected included sleep architecture features that have discriminated unipolar depressives from controls in many prior studies, rapid eye movement (REM) sleep latency, and slow-wave sleep time, as well as two additional indices that have sometimes discriminated depressives from controls in waking studies-baseline heart rate and facial electromyography. Structured Clinical Interview for the DSM-III-R (SCID)-diagnosed PTSD+major depressive disorder (MDD) patients failed to exhibit shorter REM latencies, greater REM percents of sleep, or greater REM densities than PTSD-MDD patients, but did exhibit less slow wave sleep. PTSD+MDD patients also exhibited less facial (mentalis) electromyographic activity. REM densities and baseline heart rates were equivocal. REM density, baseline heart rate, and mentalis electromyography all correlated with the BDI, the former two positively, the last, negatively. In summary, SCID-diagnosed PTSD+MDD patients failed to exhibit the classic REM sleep architectural modifications associated with unipolar depression, despite the fact that several other psychophysiologic indices of dysphoria were detectable in their sleep.
对27名未接受药物治疗的与越南战争相关的创伤后应激障碍（PTSD）住院患者的睡眠进行了3晚监测。共病抑郁既作为使用DMS-III-R标准的诊断类别，也作为使用贝克抑郁量表（BDI）的连续变量。收集的数据包括在许多先前研究中区分单相抑郁症患者与对照组的睡眠结构特征、快速眼动（REM）睡眠潜伏期、慢波睡眠时间，以及在清醒研究中有时可区分抑郁症患者与对照组的另外两个指标——基线心率和面部肌电图。经《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）结构化临床访谈（SCID）诊断为PTSD+重度抑郁症（MDD）的患者，与PTSD-MDD患者相比，并未表现出更短的REM潜伏期、更高的REM睡眠百分比或更高的REM密度，但慢波睡眠确实更少。PTSD+MDD患者的面部（颏肌）肌电图活动也更少。REM密度和基线心率不明确。REM密度、基线心率和颏肌肌电图均与BDI相关，前两者为正相关，后者为负相关。总之，经SCID诊断为PTSD+MDD的患者并未表现出与单相抑郁症相关的典型REM睡眠结构改变，尽管在他们的睡眠中可检测到其他几种烦躁不安的心理生理指标。
