Sleep in Adolescents With Bipolar I Disorder: Stability and Relation to Symptom Change
Sleep in Adolescents With Bipolar I Disorder: Stability and Relation to Symptom Change
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DOI：
10.1080/15374416.2016.1188699
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发表时间：
2017-01-01
影响因子：
4.2
通讯作者：
Singh, Manpreet K.
中科院分区：
文献类型：
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作者：
Gershon, Anda;Singh, Manpreet K.
睡眠障碍是双相情感障碍（BD）的常见特征，但对青少年BD睡眠障碍的轨迹知之甚少。使用纵向数据，本研究评估了与对照组相比，诊断为BD的青少年睡眠障碍的稳定性及其预测症状进展的能力。符合BD I诊断标准的13 - 19岁青少年（n = 19，16.2 +/- 1.75岁，57.9%女性，68.4%白人）和精神健康年龄相当的对照组（n = 21，15.7 +/- 1.48岁。52.4%的女性，57.1%的高加索人）分别在工作日和周末使用自我报告问卷评估睡眠开始潜伏期，觉醒次数和觉醒时间。在两个时间点（T1和T2，间隔约12个月）评估睡眠指数和躁狂症状（杨氏躁狂量表）和抑郁症状（儿童抑郁量表）。相关性用于检查睡眠指数在不同时间点的稳定性，回归模型用于检查T1睡眠对T2症状的影响。BD青少年在大多数睡眠指标上表现出低稳定性，而对照组在所有睡眠指标上表现出高稳定性。在控制T1抑郁症状后，更多的T1周末觉醒和周末觉醒时间预测BD青年的T2抑郁症状显著更大，但在对照组中则不然。T1睡眠和T2躁狂症状之间没有显着的关联。这些研究结果表明，增加觉醒和清醒的周末可能是一个重要的治疗目标，以减少抑郁症的青少年与BD。
Sleep disturbances are common features of bipolar disorder (BD), yet little is known about trajectories of sleep disturbances in youth with BD. Using longitudinal data, this study assessed the stability of sleep disturbances and their ability to predict symptom progression in adolescents diagnosed with BD compared to controls. Thirteen-to 19-year-olds meeting diagnostic criteria for BD I (n = 19, 16.2 +/- 1.75 years, 57.9 % female, 68.4% Caucasian) and psychiatrically healthy age-comparable controls (n = 21, 15.7 +/- 1.48 years. 52.4% female, 57.1% Caucasian) were assessed for sleep onset latency, number of awakenings, and wake time, separately for weekdays and weekends using a self-report questionnaire. Sleep indices and symptoms of mania (Young Mania Rating Scale) and depression (Children's Depression Rating Scale) were assessed at two time points, T1 and T2, approximately 12 months apart. Correlations were used to examine stability of sleep indices across time points and regression models to examine the effects of T1 sleep on T2 symptoms. Adolescents with BD showed low stability on most sleep indices, whereas controls showed high stability on all sleep indices. After controlling for T1 depression symptoms, more T1 weekend awakenings and weekend wake time predicted significantly greater T2 depression symptoms in youth with BD but not in controls. No significant associations were found between T1 sleep and T2 mania symptoms. These findings suggest that increased awakenings and wakefulness on weekends may represent an important therapeutic target for reducing depression in adolescents with BD.