Staner L, Van Veeren C, Stefos G, Hubain P P, Linkowski P, Mendlewicz J
Sleep Laboratory, Centre Hospitalier, Luxembourg.
Biol Psychiatry. 1998 Jun 1;43(11):817-21. doi: 10.1016/s0006-3223(97)00508-8.
Previous reports suggest an association between sleep-onset REM (SOREM) and some clinical characteristics in depressive illness such as age, psychosis, and depression severity. The present study is aimed at further investigating clinical and neuroendocrine correlates of SOREM, controlling for the age-related variability in clinical data.
Thyroid-stimulating hormone response to thyrotropin-releasing hormone, postdexamethasone cortisol levels, and clinical characteristics of 25 major depressive (MD) patients exhibiting SOREM in at least one of three consecutive recording nights were compared to those of 25 age- and sex-matched MD patients with three REM latencies above 50 min.
SOREM patients experienced more affective episodes leading to hospitalization and a shorter duration of current episode than patients with three REM latencies above 50 min. No association between psychosis and SOREM could be demonstrated, and hypothalamic-pituitary-adrenal or -thyroid axis disturbances were not more prevalent in SOREM patients.
Our results suggest that clinical history rather than cross-sectional clinical characteristics relates to the occurrence of SOREM in major depressed patients.
先前的报告表明，睡眠起始快速眼动（SOREM）与抑郁症的某些临床特征之间存在关联，如年龄、精神病性症状和抑郁严重程度。本研究旨在进一步探究SOREM的临床和神经内分泌相关性，同时控制临床数据中与年龄相关的变异性。
将连续三个记录夜晚中至少有一晚出现SOREM的25例重度抑郁（MD）患者的促甲状腺激素对促甲状腺激素释放激素的反应、地塞米松后皮质醇水平及临床特征，与25例年龄和性别匹配、快速眼动潜伏期超过50分钟的MD患者进行比较。
与快速眼动潜伏期超过50分钟的患者相比，SOREM患者因情感发作导致住院的次数更多，且当前发作的持续时间更短。未发现精神病性症状与SOREM之间存在关联，下丘脑-垂体-肾上腺或 -甲状腺轴紊乱在SOREM患者中并不更常见。
我们的结果表明，在重度抑郁症患者中，与SOREM发生相关的是临床病史而非横断面临床特征。
