Insomnia in Patients With Depression: A STAR*D Report
Insomnia in Patients With Depression: A STAR*D Report
复制标题
DOI：
10.1017/s1092852900029266
复制
发表时间：
2010-06-01
期刊：
影响因子：
3.3
通讯作者：
Trivedi, Madhukar H.
中科院分区：
文献类型：
--
作者：
Sunderajan, Prabha;Gaynes, Bradley N.;Trivedi, Madhukar H.
失眠是抑郁症中常见的症状，对功能和生活质量有重大影响。然而，对于代表性的寻求治疗的抑郁症患者失眠症状的患病率和相关特征知之甚少。方法：采用STAR*D （Sequenced Treatment Alternatives to relief Depression）试验数据进行分析。STAR*D从美国各地的初级（n=18）和精神科护理（n=23）诊所招募了3743名被诊断为非精神病性重度抑郁症（MDD）的成年门诊患者。比较有失眠症状者（84.7%）和无失眠症状者（15.3%）的基线社会人口学和临床特征。结果：最常见的表现是同时出现睡眠、夜间和清晨失眠症状（27.1%）。在这三种类型的失眠症状中，半夜失眠症状是最常见的单独出现（13.5%），并合并一种或多种其他类型（82.3%）。失眠症状与更严重的抑郁症的几个指标有关。只有一小部分有失眠症状的参与者在研究开始时接受了睡眠障碍的治疗，绝大多数接受治疗的人仍然报告有失眠症状。结论：在典型临床环境中寻求非精神病性重度抑郁症治疗的门诊患者中，失眠症状非常普遍，治疗不足，并且表明更严重的抑郁症。神经网络光谱。2010;15(6):394-404。
Introduction: Insomnia symptoms, which are common in depression, have a significant impact on function and quality of life. However, little is known about the prevalence and associated features of insomnia symptoms in representative treatment-seeking patients with depression.Methods: Data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial were analyzed. STAR*D recruited 3,743 adult outpatients diagnosed with nonpsychotic major depressive disorder (MDD) from primary (n=18) and psychiatric care (n=23) clinics across the United States. Baseline sociodemographic and clinical features were compared between those with insomnia symptoms (84.7%) and those without (15.3%).Results: The most common presentation was the simultaneous presence of sleep onset, mid-nocturnal, and early morning insomnia symptoms (27.1%). Of these three types of insomnia symptoms, mid-nocturnal insomnia symptoms were the most commonly found alone (13.5%) and in combination with one or more other types (82.3%). Insomnia symptoms were associated with several indicators of a more severe depressive illness. Only a small proportion of participants with insomnia symptoms were receiving treatment for sleep disturbances at study initiation, and the vast majority of those receiving treatment still reported having insomnia symptoms.Conclusion: In outpatients who seek treatment for nonpsychotic MDD in typical clinical settings, insomnia symptoms are very common, undertreated, and indicative of a more severe depression. CNS Spectr. 2010;15(6):394-404.