Sleep Disturbance Predicts Posttraumatic Stress Disorder and Depressive Symptoms: A Cohort Study of Chinese Adolescents
Sleep Disturbance Predicts Posttraumatic Stress Disorder and Depressive Symptoms: A Cohort Study of Chinese Adolescents
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睡眠障碍可预测创伤后应激障碍和抑郁症状：中国青少年的队列研究
DOI：
10.4088/jcp.15m10206
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发表时间：
2017-07-01
影响因子：
5.3
通讯作者：
Liu, Xianchen
中科院分区：
文献类型：
--
作者：
Fan, Fang;Zhou, Ya;Liu, Xianchen
目的：研究2008年汶川大地震后青少年睡眠障碍与创伤后应激障碍（PTSD）和抑郁症状之间的横向和纵向关系。方法：研究对象为1,573名青少年（初次调查时平均年龄= 15.0岁，标准差= 1.3岁; 46%为男性）。采用匹兹堡睡眠质量指数量表、创伤后应激障碍自评量表和儿童抑郁自评量表，分别评估2008年5月12日汶川地震后12个月（T12 m）和24个月（T24 m）的睡眠、创伤后应激障碍症状和抑郁症状。在T12 m和T24 m时，分别有38.3%和37.5%的参与者报告睡眠障碍，22.5%和14.0%的参与者报告PTSD症状，41.0%和38.3%的参与者报告抑郁症状。T12 m和T24 m时PTSD和抑郁症状的患病率随睡眠障碍和睡眠时间的缩短而显著增加。在调整T12 m时的人口统计学、地震暴露和PTSD/抑郁症状后，T12 m时的睡眠障碍与T24 m时PTSD（比值比[OR] = 1.80; 95%CI，1.17-2.75）和抑郁症状（OR = 1.51; 95%CI，1.14-2.02）的风险增加显著相关。结论：汶川大地震后12个月和24个月，青少年中存在睡眠障碍、PTSD和抑郁症状，且持续时间较长。睡眠障碍可预测PTSD和抑郁症状的发展和持续。早期评估和治疗睡眠障碍可能是预防和干预青少年创伤幸存者PTSD和抑郁的重要策略。(C)版权所有2016 Physicians Postgraduate Press，Inc.
Objective: To examine the cross-sectional and longitudinal associations between sleep disturbance and posttraumatic stress disorder (PTSD) and depressive symptoms in a large cohort of adolescents exposed to the 2008 Wenchuan earthquake in China.Methods: Participants were 1,573 adolescents (mean age at initial survey = 15.0 years, SD = 1.3 years; 46% male) in the Wenchuan Earthquake Adolescent Health Cohort (WEAHC) in Dujiangyan, China, 20 km away from the east epicenter. The Pittsburgh Sleep Quality Index, Post-Traumatic Stress Disorder Self-Rating Scale, and Depression Self-Rating Scale for Children were used to assess participants' sleep, PTSD symptoms, and depressive symptoms, respectively, at 12 months (T12m) and 24 months (T24m) after the Wenchuan earthquake that occurred on May 12, 2008.Results: At T12m and T24m, 38.3% and 37.5% of participants reported sleep disturbance, 22.5% and 14.0% reported PTSD symptoms, and 41.0% and 38.3% reported depressive symptoms, respectively. The prevalence rates of PTSD and depressive symptoms at T12m and T24m significantly increased with sleep disturbance and short sleep duration. After adjusting for demographics, earthquake exposure, and PTSD/depressive symptoms at T12m, sleep disturbance at T12m was significantly associated with increased risk for PTSD (odds ratio [OR] = 1.80; 95% CI, 1.17-2.75) and depressive symptoms (OR = 1.51; 95% CI, 1.14-2.02) at T24m. Furthermore, sleep disturbance predicted the persistence of PTSD (OR = 2.35; 95% CI, 1.43-3.85) and depressive symptoms (OR = 2.41; 95% CI, 1.80-3.24).Conclusions: Sleep disturbance, PTSD, and depressive symptoms were prevalent and persistent in adolescents at 12 and 24 months after exposure to the Wenchuan earthquake. Sleep disturbance predicts the development and persistence of PTSD and depressive symptoms. Early assessment and treatment of sleep disturbance may be an important strategy for prevention and intervention of PTSD and depression in adolescent trauma survivors. (C) Copyright 2016 Physicians Postgraduate Press, Inc.