Thase M E, Kupfer D J, Fasiczka A J, Buysse D J, Simons A D, Frank E
Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania, USA.
Biol Psychiatry. 1997 May 1;41(9):964-73. doi: 10.1016/S0006-3223(96)00259-4.
There is little agreement as to the best definition of a categorically abnormal electroencephalographic (EEG) sleep profile to characterize major depressive disorder. Therefore, a series of classification, replication, and validation analyses were conducted to identify such a profile. The EEG sleep studies of healthy controls (n = 44), depressed inpatients (n = 44), and depressed outpatients (n = 181) were utilized, including subgroups of patients studied both before and after nonpharmacologic treatment with either cognitive behavior therapy (CBT) or interpersonal psychotherapy (IPT). A discriminant index score (based on reduced REM latency, increased REM density, and decreased sleep efficiency) was found to: 1) reliably discriminate between depressed inpatients, depressed outpatients, and controls; 2) show good test-retest reliability; and 3) identify a subset of depressed outpatients who were older, manifested a broader array of EEG sleep disturbances, and were less responsive to CBT or IPT. Posttreatment studies of patients indicated that normal sleep profiles were relatively stable, whereas abnormal profiles tended to normalize. These findings provide an empirically validated method that may improve the applicability, efficiency, and prognostic utility of EEG sleep studies of depressed patients.
关于用于表征重度抑郁症的绝对异常脑电图（EEG）睡眠特征的最佳定义，目前几乎没有共识。因此，进行了一系列分类、重复和验证分析，以确定这样一种特征。利用了健康对照者（n = 44）、住院抑郁症患者（n = 44）和门诊抑郁症患者（n = 181）的EEG睡眠研究，其中包括在接受认知行为疗法（CBT）或人际心理治疗（IPT）的非药物治疗之前和之后均接受研究的患者亚组。发现一个判别指数评分（基于缩短的快速眼动（REM）潜伏期、增加的REM密度和降低的睡眠效率）能够：1）可靠地区分住院抑郁症患者、门诊抑郁症患者和对照者；2）显示出良好的重测信度；3）识别出一部分年龄较大、表现出更广泛的EEG睡眠障碍且对CBT或IPT反应较差的门诊抑郁症患者。对患者的治疗后研究表明，正常睡眠特征相对稳定，而异常特征则趋于正常化。这些发现提供了一种经过实证验证的方法，可能会提高抑郁症患者EEG睡眠研究的适用性、效率和预后效用。
