Giles D E, Perlis M L, Reynolds C F, Kupfer D J
Department of Psychiatry, University of Rochester Medical Center, NY 14642, USA.
Depress Anxiety. 1998;8(2):58-64.
This study was designed to evaluate the effect of race, specifically African-American, on electroencephalographic (EEG) sleep and clinical symptom profile in unipolar major depression. A clinical research database was used to identify appropriate subjects and a double-matched historical case-control design was implemented. African-American depression patients were double matched within protocol to Euro-American depressed patients. Age, sex, and protocol of origin were matching variables. African-American depressed patients had less total sleep, less slow wave sleep, more stage 2 sleep, longer rapid eye movement (REM) sleep latency, less REM sleep, and lower REM density than Euro-American depressed patients. African-American depressed patients did not differ from Euro-American patients in symptom severity, age of onset, number of episodes, socio-economic status, and, as planned, did not differ in age and sex distribution. Depressive symptom constellation also did not distinguish the two groups. African-American depressed patients demonstrated differences in EEG sleep profile, with less total sleep, overall lighter nonREM sleep, and relatively preserved REM sleep, despite a clinical symptom profile that did not differ from Euro-American depressed patients. The sleep profile appeared to be consonant with the sleep findings in chronic insomnia. The pathological implications of these differences remained to be explored in careful prospective studies of African-American depressed patients and in well-characterized, racially matched normal control comparisons.
本研究旨在评估种族,特别是非裔美国人,对单相重度抑郁症患者脑电图(EEG)睡眠及临床症状特征的影响。利用临床研究数据库确定合适的研究对象,并采用双匹配历史病例对照设计。非裔美国抑郁症患者在研究方案内与欧美裔抑郁症患者进行双匹配。年龄、性别和来源研究方案为匹配变量。与欧美裔抑郁症患者相比,非裔美国抑郁症患者的总睡眠时间更少、慢波睡眠更少、第二阶段睡眠时间更多、快速眼动(REM)睡眠潜伏期更长、REM睡眠更少且REM睡眠密度更低。非裔美国抑郁症患者与欧美裔患者在症状严重程度、发病年龄、发作次数、社会经济地位方面并无差异,且按照计划,在年龄和性别分布上也无差异。抑郁症状群也无法区分这两组患者。尽管非裔美国抑郁症患者的临床症状特征与欧美裔抑郁症患者并无差异,但他们在EEG睡眠特征方面存在差异,总睡眠时间更少,非快速眼动睡眠总体更浅,而REM睡眠相对保留。这种睡眠特征似乎与慢性失眠的睡眠研究结果一致。这些差异的病理意义仍有待在对非裔美国抑郁症患者进行的仔细前瞻性研究以及特征明确、种族匹配的正常对照比较中加以探索。