Rao U, Dahl R E, Ryan N D, Birmaher B, Williamson D E, Giles D E, Rao R, Kaufman J, Nelson B
University of Pittsburgh School of Medicine, Western Psychiatric Institute & Clinic, PA, USA.
Biol Psychiatry. 1996 Sep 15;40(6):474-84. doi: 10.1016/0006-3223(95)00481-5.
This study examined the relationship between longitudinal clinical course and sleep and cortisol findings in adolescent unipolar major depressive disorder (MDD). Subjects were 28 adolescents (15.4 +/- 1.3 years) systematically diagnosed with unipolar MDD and 35 group-matched normal controls who participated in EEG sleep and neuroendocrine studies. Follow-up clinical assessments were conducted 7.0 +/- 0.5 years later in 94% of the original cohort. Although initial group comparisons failed to show significant differences in biologic measures, analyses incorporating clinical follow-up reveal that changes in sleep and cortisol measures are associated with differential longitudinal course. Normal controls who would develop depression after the biologic studies had shown significantly higher density of rapid eye movements (REM) and a trend for reduced REM latency compared to controls with no psychiatric disorder at follow-up. Depressed subjects with a recurrent unipolar course showed a trend towards elevated plasma cortisol near sleep onset compared to MDD subjects with no further episodes during the follow-up interval.
本研究探讨了青少年单相重度抑郁症（MDD）的纵向临床病程与睡眠及皮质醇研究结果之间的关系。研究对象为28名青少年（15.4±1.3岁），他们被系统诊断为单相MDD，以及35名年龄匹配的正常对照者，这些人参与了脑电图睡眠和神经内分泌研究。在原队列的94%中，7.0±0.5年后进行了随访临床评估。尽管最初的组间比较未能显示生物学指标存在显著差异，但纳入临床随访的分析表明，睡眠和皮质醇指标的变化与不同的纵向病程相关。在生物学研究后会患抑郁症的正常对照者，与随访时无精神障碍的对照者相比，其快速眼动（REM）密度显著更高，且有REM潜伏期缩短的趋势。与随访期间无进一步发作的MDD患者相比，单相复发性病程的抑郁症患者在睡眠开始时血浆皮质醇有升高趋势。
