伴失眠的抑郁症患者睡眠认知特征及其对睡眠质量的影响
Beliefs and attitudes on sleep and its influence on sleep quality in depressive patients comorbid with insomnia
投稿时间:2022-05-03  修订日期:2022-08-16
DOI:
中文关键词:  抑郁症  失眠  失眠认知行为治疗  信念与态度
英文关键词:Major Depressive Disorders  Insomnia  CBT-I  Beliefs and attitudes
基金项目:首都卫生发展科研专项项目(首发2020-3-2124);北京市属医院科研培育项(PX2019067)
作者单位地址
孟繁强 首都医科大学附属北京安定医院 北京市西城区德外大街安康胡同5号北京安定医院
杨丽娟 首都医科大学附属北京安定医院 北京市西城区德外大街安康胡同5号北京安定医院
张居易 首都医科大学附属北京安定医院 
李占江 首都医科大学附属北京安定医院 
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中文摘要:
      目的 了解伴失眠的抑郁症患者对睡眠的信念与态度,并探讨其对睡眠质量的影响。方法 纳入在首都医科大学附属北京安定医院就诊、符合《精神障碍诊断与统计手册(第4版)》(DSM-IV)诊断标准的伴失眠的抑郁症患者(n=61)和原发性失眠患者(n=62)为研究对象,并招募健康对照组(n=64)。三组被试均接受睡眠功能失调信念和态度量表(DBAS)及匹兹堡睡眠质量指数量表(PSQI)评定,伴失眠的抑郁症患者同时接受汉密尔顿抑郁量表17项版(HAMD-17)评定。采用协方差分析比较三组被试PSQI和DBAS评分。采用多元线性回归分析伴失眠的抑郁症患者PSQI评分的影响因素。结果 伴失眠的抑郁症患者组及原发性失眠组PSQI评分均高于对照组(t=18.932、187.610,P均<0.01),两组DBAS评分均低于对照组(t=-5.561、-5.791,P均<0.01)。以伴失眠的抑郁症患者PSQI评分作为因变量,建立的多元线性回归方程具有统计学意义(F=14.095,R2=0.327,P<0.01),DBAS中对睡眠的预测与控制因子及年龄是伴失眠的抑郁症患者睡眠质量的影响因素(B=-0.100、-0.279,P<0.05或0.01)。结论 伴失眠的抑郁症患者比正常人存在更多的睡眠相关错误认知,且不良认知可能是其睡眠质量的影响因素。
英文摘要:
      Objective To investigate the beliefs and attitudes towards sleep in depression patients comorbid with insomnia, and to explore its influence on sleep quality. Methods Depression patients with insomnia (n=61) and patients with primary insomnia (n=62) who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria in Beijing Anding Hospital affiliated to Capital Medical University were enrolled, and 64 healthy controls were recruited. All three groups received assessment of Sleep Dysfunction Belief and Attitude Scale (DBAS) and Pittsburgh Sleep Quality Index (PSQI), and depression patients with insomnia were evaluated with Hamilton Depression Scale 17-item (HAMD-17). The PSQI and DBAS scores of the three groups were compared by analysis of covariance. Multiple linear regression was used to analyze the influencing factors of PSQI score in depression patients with insomnia. Results The PSQI scores of depression patients with insomnia and primary insomnia group were higher than those of the control group (t=18.932, 187.610, P<0.01), and the DBAS scores of the two groups were lower than those of the control group (t=-5.561, -5.791, P<0.010). Taking the PSQI score of depression patients with insomnia as the dependent variable, the established multiple linear regression equations were statistically significant (F=14.095, R2=0.327, P<0.010). The prediction and control of sleep in DBAS and age were the influencing factors of PSQI score in these patients (B=-0.100, -0.279, P<0.05 or 0.01). Conclusion Compared with the normal, depression patients with insomnia have more dysfunctional beliefs and attitudes towards sleep, and poor cognition may be the influencing factor of their sleep quality.
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