慢性失眠与抑郁、躯体化症状的相关性研究
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摘要
目的:通过研究慢性失眠与抑郁、躯体化症状的关系,为慢性失眠患者提供更全面的诊断和治疗方法。方法:选取2017年8月至2018年4月在上海市第七人民医院失眠门诊就诊的126例慢性失眠患者,采用匹茨堡睡眠质量指数量表(PSQI)、汉密尔顿抑郁量表(HAMD)、躯体化症状自评量表(SSS)对患者进行评估,并对评估结果进行相关性分析。结果:126例慢性失眠患者中,伴有抑郁的占44.4%,伴有躯体化症状的占58.7%。慢性失眠患者PSQI(除入睡时间、催眠药物使用外)与HAMD(除迟缓外)、SSS总分及各因子得分均呈正相关(P<0.05)。结论:PSQI总分越高,抑郁程度越高,躯体化症状越严重。慢性失眠患者往往伴随抑郁症状、躯体化症状,早期发现及早干预,从而提高治疗慢性失眠的疗效。
Objective: By studying the relationship between chronic insomnia and depression, somatic symptoms, to provide more comprehensive diagnosis and treatment for patients with chronic insomnia. Methods: The 126 cases of chronic insomnia patients in Shanghai Seventh People's Hospital insomnia clinic from August 2017 to April 2018 were evaluated by Pittsburgh Sleep Quality Index(PSQI), Hamilton Depression Scale(HAMD) and Self-rating Somatization Symptoms Scale(SSS), and the correlation analysis of the evaluation results was carried out. Results: Among the 126 cases of chronic insomnia, 44.4% were accompanied by depression and 58.7% were accompanied by somatization symptoms. The total score and the scores of all factors in PSQI(except the time of sleep and the use of hypnotic drugs), HAMD(except for delay) and SSS of chronic insomnia was positively correlated(P<0.05). Conclusion: The higher the total scores of PSQI, the higher the degree of depression and the more serious the somatization symptoms. Depressive symptoms and somatization symptoms of chronic insomnia were detected and interposed as early as possible, so as to improve the efficacy of chronic insomnia.
Objective: By studying the relationship between chronic insomnia and depression, somatic symptoms, to provide more comprehensive diagnosis and treatment for patients with chronic insomnia. Methods: The 126 cases of chronic insomnia patients in Shanghai Seventh People's Hospital insomnia clinic from August 2017 to April 2018 were evaluated by Pittsburgh Sleep Quality Index(PSQI), Hamilton Depression Scale(HAMD) and Self-rating Somatization Symptoms Scale(SSS), and the correlation analysis of the evaluation results was carried out. Results: Among the 126 cases of chronic insomnia, 44.4% were accompanied by depression and 58.7% were accompanied by somatization symptoms. The total score and the scores of all factors in PSQI(except the time of sleep and the use of hypnotic drugs), HAMD(except for delay) and SSS of chronic insomnia was positively correlated(P<0.05). Conclusion: The higher the total scores of PSQI, the higher the degree of depression and the more serious the somatization symptoms. Depressive symptoms and somatization symptoms of chronic insomnia were detected and interposed as early as possible, so as to improve the efficacy of chronic insomnia.
引文
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[2]Morin C M,Benca R.Chronic insomnia[J].Lancet,2012,379(9821):1129-1141.
[3]Fava M,Asnis G M,Shrivastava R K,et al.Improved insomnia symptoms and sleep-related next-day functioning in patients with comorbid major depressive disorder and insomnia following concomitant zolpidem extendedrelease12.5mg and escitalopram treatment:a randomized controlled trial[J].J Clin Psychiatry,2011,72(7):914-928.
[4]刘永珍,尹静,武月红,等.门诊慢性失眠患者躯体化症状自评量表的临床应用[J].脑与神经疾病杂志,2017,25(8):486-489.
[5]National Institutes of Health.National institutes of health state of the science conference statement on manifestations and management of chronic insomnia in adults[J].Sleep,2005,28(9):1049-1057.
[6]张明圆.精神科评定量表手册[M].2版.长沙:湖南科学技术出版社,1998:121-126.
[7]庄琦,毛家亮,李春波,等.躯体化症状自评量表的初步编制及信度和效度研究[J].中华行为医学与脑科学症状,2010,19(9):847-850.
[8]李荣,蔡志强.失眠症患者的焦虑、抑郁症状的调查[J].中国行为医学科学杂志,2002,11(5):530.
[9]李岩,侯彦波,王红,等.原发性与继发性失眠患者睡眠质量与焦虑抑郁情绪的研究[J].吉林医学杂志,2009,30(19):2264-2267.
[10]Mohammadi M R,Davidian H,Noorbala A A,et al.An epidemiological survey of psychiatric disorders in I-ran[J].Clinical Practice and Epidemiology in Mental Health,2005,1(1):1-8.
[11]刘玉局.不同性别躯体化障碍临床对照分析[J].中国健康心理学杂志,2004,12(6):411-412.
[12]Pearson N J,Johnson L L,Nahin R L.Insomnia,trouble sleeping,and complementary and alternative medicine:analysis of the 2002 national health interview survey data[J].Archives Of Internal Medicine,2006,166(16):1775-1782.
[13]Huang Z,Liang P,Jia X,et al.Abnormal amygdala connectivity in patients with primary insomnia:evidence from resting state fMRI[J].Eur J Radiol,2012,81(6):1288-1295.
[14]Kirmayer L J,Robbins J M,Dworkind M,et a1.Somatization and the recognition of depression and anxiety in primary care[J].Am JPsychiatry,1993,150(5):734-741.