Insomnia disorder in adolescence: Diagnosis, impact, and treatment.
Insomnia disorder in adolescence: Diagnosis, impact, and treatment.
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DOI：
10.1016/j.smrv.2017.06.009
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发表时间：
2018-06
影响因子：
10.5
通讯作者：
Baker FC
中科院分区：
文献类型：
--
作者：
de Zambotti M;Goldstone A;Colrain IM;Baker FC
精神障碍在青少年中非常常见;它在年龄较大的青少年和女孩中特别明显，其患病率与其他主要精神疾病（例如，抑郁症）。然而，青春期失眠症的特征不明确，认识不足，诊断不足，治疗不足，青春期后出现的女性失眠症的原因在很大程度上是未知的。失眠症超越了睡眠不佳或睡眠状态误解的个人投诉，并且有新的证据支持青少年失眠症状与几个生物系统的改变有关，包括功能性皮质改变和全身炎症。失眠症与抑郁症和其他精神疾病相关，是青少年自杀和物质使用的独立风险因素，提高了在青春期早期治疗失眠症状可能降低这些不良后果风险的可能性。认知行为治疗已被证明对青少年失眠有效，在线方法似乎提供了有前途的成本效益选择。目前的证据表明，青春期失眠是一个独立的实体，值得关注的公共卫生问题本身。
Insomnia disorder is very common in adolescents; it is particularly manifest in older adolescents and girls, with a prevalence comparable to that of other major psychiatric disorders (e.g., depressive disorders). However, insomnia disorder in adolescence is poorly characterized, under-recognized, under-diagnosed, and under-treated, and the reason for the female preponderance for insomnia that emerges after puberty is largely unknown. Insomnia disorder goes beyond an individual complaint of poor sleep or a sleep state misperception, and there is emerging evidence supporting the association of insomnia symptoms in adolescents with alterations in several bio-systems including functional cortical alterations and systemic inflammation. Insomnia disorder is associated with depression and other psychiatric disorders, and is an independent risk factor for suicidality and substance use in adolescents, raising the possibility that treating insomnia symptoms in early adolescence may reduce risk for these adverse outcomes. Cognitive behavioral treatments have proven efficacy for adolescent insomnia and online methods seem to offer promising cost-effective options. Current evidence indicates that insomnia in adolescence is an independent entity that warrants attention as a public health concern in its own right.
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