Sleep complaints and depression in an aging cohort: A prospective perspective
Sleep complaints and depression in an aging cohort: A prospective perspective
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DOI：
10.1176/ajp.157.1.81
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发表时间：
2000-01-01
影响因子：
17.7
通讯作者：
Strawbridge, WJ
中科院分区：
文献类型：
--
作者：
Roberts, RE;Shema, SJ;Strawbridge, WJ
目的：大多数关于睡眠障碍和抑郁症之间关系的研究都着眼于横截面数据。作者使用了来自50岁或以上社区居民的面板研究的两波数据来前瞻性地调查这个问题。方法：对1994年和1995年阿拉米达县（加州）研究（N=2,370）调查的一个亚组的重度抑郁发作和睡眠问题的症状数据进行了检查。作者研究了年龄，性别，教育，婚姻状况，社会孤立，功能障碍，经济压力和饮酒的影响。抑郁症是用12个项目来测量的，这些项目涵盖了DSM-IV诊断抑郁症发作的标准，包括失眠和嗜睡。结果：1994年失眠和嗜睡的患病率分别为23.1%和6.7%。睡眠是抑郁症的一个重要相关因素，女性、年龄较大、社会孤立、教育程度低、经济压力和功能障碍也是如此。当对睡眠问题和抑郁症进行前瞻性研究时，控制其他变量的影响，1994年的睡眠问题预测了1995年的抑郁症。然而，重性抑郁发作的其他症状--快感缺乏、无意识的感觉、精神激动/迟缓、情绪障碍、死亡的想法--是未来重性抑郁的更强的预测因子。结论：睡眠障碍和其他诊断为抑郁症的症状与未来抑郁症的风险密切相关。睡眠障碍似乎是抑郁症的一个不太重要的预测因素。需要更多的流行病学研究，以确定抑郁症状的范围对临床抑郁症风险的相对贡献。
Objective: Most research on the association between sleep disturbances and depression has looked at cross-sectional data. The authors used two waves of data from a panel study of community residents aged 50 years or more to investigate this issue prospectively. Method: Data on symptoms of major depressive episodes and sleep problems were examined for a subgroup of the 1994 and 1995 surveys of the Alameda County (California) Study (N=2,370). The authors examined the effects of age, gender, education, marital status, social isolation, functional impairment, financial strain, and alcohol use. Depression was measured with 12 items that covered the DSM-IV diagnostic criteria for major depressive episodes, including insomnia and hypersomnia. Results: The prevalences were 23.1% for insomnia and 6.7% for hypersomnia in 1994. Sleep was a significant correlate of depression, as were being female, older age, social isolation, low education, financial strain, and functional impairment, When sleep problems and depression were examined prospectively, with controls for the effects of the other variables, sleep problems in 1994 predicted depression in 1995. However, other symptoms of major depressive episodes-anhedonia, feelings of worthlessness, psychomotor agitation/retardation, mood disturbance, thoughts of death-were much stronger predictors of future major depression. Conclusions: Sleep disturbance and other symptoms that are diagnostic for major depression are strongly associated with the risk of future depression. Sleep disturbance appears to be a less important predictor of depression. More epidemiologic research is needed on the relative contributions of the range of depressive symptoms to the risk of clinical depression.