Hubain P P, Staner L, Dramaix M, Kerkhofs M, Papadimitriou G, Mendlewicz J, Linkowski P
Department of Psychiatry, Erasme Hospital, University of Brussels, Belgium.
Biol Psychiatry. 1998 Feb 1;43(3):220-9. doi: 10.1016/S0006-3223(97)80434-9.
The present study further examined relationships between postdexamethasone cortisol plasma values and sleep electroencephalogram (EEG) parameters.
The dexamethasone suppression test (DST) and polysomnographic recordings were performed in a sample of 300 inpatients with primary major depressive disorder (MDD) (102 men and 198 women, mean age 44 +/- 12 years, range 20-74 years) consecutively admitted to Erasme Hospital (Brussels, Belgium) between 1981 and 1992.
The DST was abnormal in 40% of the sample. Postdexamethasone cortisol plasma values at 4:00 PM were significantly influenced by age, but not by gender. They were also significantly and positively correlated with weight loss, total scores on the Hamilton Depression Rating Scale, total scores on the Newcastle Scale, percentage of awakenings during sleep, and percent of stage 1. They were significantly and negatively correlated with percent of stage 2, slow-wave sleep, and REM sleep. Multiple regression analyses were conducted in two successive steps. First among clinical variables, only age and depressive symptom severity remained correlated with postdexamethasone plasma cortisol values. In the second step, with age and severity held constant, postdexamethasone plasma cortisol values were positively associated with amount of wake time and stage 1, and negatively with amount of slow-wave sleep.
These findings provide further indirect support for an overarousal state in MDD with sympathoadrenal system hyperactivity and impaired sleep continuity. They also underline the importance of taking into account various clinical confounding factors in the interpretation of both DST and sleep EEG results.
本研究进一步探讨了地塞米松后血浆皮质醇值与睡眠脑电图（EEG）参数之间的关系。
对1981年至1992年间连续入住比利时布鲁塞尔埃拉斯穆斯医院的300例原发性重度抑郁症（MDD）住院患者（102名男性和198名女性，平均年龄44±12岁，年龄范围20 - 74岁）进行了地塞米松抑制试验（DST）和多导睡眠图记录。
40%的样本DST结果异常。下午4点的地塞米松后血浆皮质醇值受年龄显著影响，但不受性别影响。它们还与体重减轻、汉密尔顿抑郁量表总分、纽卡斯尔量表总分、睡眠期间觉醒百分比以及第1阶段百分比显著正相关。它们与第2阶段百分比、慢波睡眠百分比和快速眼动睡眠百分比显著负相关。进行了两个连续步骤的多元回归分析。首先，在临床变量中，只有年龄和抑郁症状严重程度与地塞米松后血浆皮质醇值相关。在第二步中，在年龄和严重程度保持不变的情况下，地塞米松后血浆皮质醇值与清醒时间和第1阶段的时长呈正相关，与慢波睡眠时长呈负相关。
这些发现为MDD中存在交感肾上腺系统功能亢进和睡眠连续性受损的过度觉醒状态提供了进一步的间接支持。它们还强调了在解释DST和睡眠EEG结果时考虑各种临床混杂因素的重要性。
