| 项心明,马亚荣,张杰,何红波.青少年抑郁障碍患者与双相情感障碍患者睡眠特征及其对自杀风险的影响[J].四川精神卫生杂志,2022,35(6):543-549.Xiang Xinming,Ma Yarong,Zhang Jie,He Hongbo,Sleep characteristics and their impact on suicide risk among adolescents with depressive disorder and bipolar disorder[J].SICHUAN MENTAL HEALTH,2022,35(6):543-549 |
| 青少年抑郁障碍患者与双相情感障碍患者睡眠特征及其对自杀风险的影响 |
| Sleep characteristics and their impact on suicide risk among adolescents with depressive disorder and bipolar disorder |
| 投稿时间：2022-02-18 |
| DOI：10.11886/scjsws20220218001 |
| 中文关键词: 青少年 抑郁障碍 双相情感障碍 多导睡眠监测 自杀风险 |
| 英文关键词:Adolescents Depressive disorder Bipolar disorder Polysomnography Suicide risk |
| 基金项目:广州市科技计划项目（项目名称：ECT治疗青少年抑郁障碍临床疗效与认知损害相关神经可塑性研究，项目编号：202102020045） |
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| 中文摘要: |
| 目的 比较青少年抑郁障碍患者和双相情感障碍患者睡眠结构特征的差异，探讨睡眠指标等因素对患者自杀风险的影响。方法 回顾性查阅广州医科大学附属脑科医院2019年1月1日-2021年6月30日符合《国际疾病分类（第10版）》（ICD-10）诊断标准的抑郁障碍（n=97）和双相情感障碍（n=52）住院青少年患者病历资料，收集患者的年龄、性别、体质量指数（BMI）、精神科诊断、自杀风险评估量表（NGASR）评分及多导睡眠监测（PSG）结果。根据NGASR评分结果，将患者分为两组：0~5分为自杀低风险组（n=32），>5分为自杀高风险组（n=117）。以既往文献中80例正常青少年的PSG数据作为对照组资料。建立多元线性回归模型探讨青少年情感障碍患者自杀风险的影响因素。结果 自杀高风险组睡眠效率和N2期睡眠占比均低于自杀低风险组（Z=-2.138、-2.520，P均<0.05）。抑郁组总睡眠时间、N2期睡眠时间以及REM期睡眠时间均少于双相组（t=-2.822、-3.087、-2.277，P<0.05或0.01）；抑郁组和双相组REM期睡眠占比均低于对照组（t=-2.369、-2.069，P均<0.05）。线性回归分析显示，青少年情感障碍患者自杀风险的影响因素包括N1期睡眠时间（β=0.019，P<0.05）、性别（男性vs.女性，β=-4.051，P<0.01）以及诊断（双相情感障碍vs.抑郁障碍，β=-1.429，P<0.05）。结论 与青少年双相情感障碍患者相比，青少年抑郁障碍患者存在睡眠连续性差、浅睡眠更少的特点。N1期睡眠时间、女性以及诊断为抑郁障碍是青少年情感障碍患者自杀的影响因素。 |
| 英文摘要: |
| Objective To compare the differences in sleep structure characteristics between adolescents with depressive disorder and adolescents with bipolar disorder， and to explore the impact of sleep indicators and other factors on the suicide risk of adolescents with affective disorder.Methods The medical records of adolescents with depressive disorder （n=97） and bipolar disorder （n=52） who met the International Classification of Diseases， tenth edition （ICD-10） and hospitalized in the Affiliated Brain Hospital of Guangzhou Medical University from January 1， 2019 to June 30， 2021 were retrospectively reviewed. Data including age， gender， body mass index （BMI）， psychiatric diagnosis， the Nurses' Global Assessment of Suicide Risk （NGASR） score and polysomnography （PSG） results of the patients were collected. Then patients were divided into two groups according to NGASR score， scored 0~5 were in the low risk group （n=32） and scored above 5 were in the high risk group （n=117）. Meantime， the PSG data of normal adolescents （n=80） in the previous literature were collected as the control group. Thereafter， a multiple linear regression model was established to explore the related factors affecting suicide risk in adolescents with affective disorder.Results The sleep efficiency and the proportion of stage N2 sleep in high risk group were lower than those in low risk group （Z=-2.138， -2.520， P<0.05）. The total sleep time， N2 sleep duration and rapid eye movement （REM） sleep time in depression group were less than those in bipolar group （t=-2.822， -3.087， -2.277， P<0.05 or 0.01）. The proportion of REM sleep in depression group and bipolar group were lower than those in control group （t=-2.369， -2.069， P<0.05）. Linear regression analysis denoted that the factors affecting the suicide risk in adolescents with affective disorder included stage N1 sleep duration （β=0.019， P<0.05）， gender （male vs. female， β=-4.051， P<0.01） and psychiatric diagnosis （bipolar disorder vs. depressive disorder， β=-1.429， P<0.05）.Conclusion In contrast to adolescents with bipolar disorder， the sleep structure of adolescents with depressive disorder is characterized by poor sleep continuity and less light sleep. Furthermore， the N1 sleep duration， female gender and diagnosis of depressive disorder are risk factors affecting the suicide in adolescents with affective disorder. |
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