Insomnia, worry, anxiety and depression as predictors of the occurrence and persistence of paranoid thinking
Insomnia, worry, anxiety and depression as predictors of the occurrence and persistence of paranoid thinking
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DOI：
10.1007/s00127-011-0433-1
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发表时间：
2012-08-01
影响因子：
4.4
通讯作者：
Bebbington, Paul
中科院分区：
文献类型：
--
作者：
Freeman, Daniel;Stahl, Daniel;Bebbington, Paul
我们的理论模型提出，失眠、担忧和负面情绪是偏执思维的重要决定因素。焦虑会产生对威胁的预期，抑郁会增加脆弱感，担忧会导致难以置信的想法，而失眠会加剧负面影响并造成感知状态的改变。该研究的目的是首次检验这些因素作为新偏执思维出现和现有偏执思维持续存在的预测因素。2000 年英国国家精神病学发病率调查中共有 2,382 名参与者在首次评估后 18 个月进行了随访。基线评估用于预测随访时偏执思维的发展和持续。数据经过加权以代表一般家庭人口。失眠、担忧、焦虑、抑郁和抑郁想法都是新的偏执狂的出现和现有偏执狂思维持续存在的重要预测因素。忧虑和失眠是最强的预测因素。例如，第一次评估时的失眠导致后来偏执思维的出现增加了三倍以上。研究表明，失眠、担忧、焦虑和抑郁是偏执思维新出现的潜在危险因素。研究结果还证实了一项新兴文献表明，焦虑、担忧和抑郁可能会鼓励偏执思维的持续存在。该研究提供了第一个将失眠与偏执联系起来的纵向证据。重要的临床意义是，对精神病患者常见的心理健康问题进行干预可能会带来减少偏执的额外好处。
Our theoretical model proposes that insomnia, worry, and negative affect are important determinants of paranoid thinking. Anxiety produces anticipation of threat, depression increases the sense of vulnerability, worry leads to implausible ideas, and insomnia exacerbates negative affect and creates an altered perceptual state. The study objective was to examine for the first time these factors as predictors of the onset of new paranoid thinking and of the persistence of existing paranoid thinking.A total of 2,382 participants in the 2000 British National Psychiatric Morbidity Survey were followed-up 18 months after their first assessment. Baseline assessments were used to predict the development and persistence of paranoid thinking at follow-up. Data were weighted to be representative of the general household population.Insomnia, worry, anxiety, depression and depressive ideas were each substantial predictors both of new inceptions of paranoia and of the persistence of existing paranoid thinking. Worry and insomnia were the strongest predictors. For example, insomnia at the first assessment led to a more than threefold increase in later inceptions of paranoid thinking.The study indicates that insomnia, worry, anxiety and depression are potential risk factors for new inceptions of paranoid thinking. The results also corroborate an emerging literature indicating that anxiety, worry and depression may encourage the persistence of paranoid thinking. The study provides the first longitudinal evidence linking insomnia and paranoia. The important clinical implication is that the use of interventions for common mental health difficulties in people with psychosis may have the additional benefit of reducing paranoia.