Insomnia is associated with suicide attempt in middle-aged and older adults with depression.
Insomnia is associated with suicide attempt in middle-aged and older adults with depression.
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DOI：
10.1017/s104161021500174x
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发表时间：
2016-04
影响因子：
7
通讯作者：
Szanto K
中科院分区：
文献类型：
--
作者：
Kay DB;Dombrovski AY;Buysse DJ;Reynolds CF;Begley A;Szanto K
失眠的患病率随着年龄的增长而增加，与抑郁症密切相关，在几项研究中已被确定为自杀的危险因素。这项研究的目的是确定失眠的严重程度是否在有自杀未遂的人(n=72)、只考虑自杀的人(n=28)和患有抑郁症但没有自杀意念或未遂病史的人(n=35)之间存在差异。研究对象为患有抑郁症的中老年人(年龄44-87岁，男性=66岁)。失眠严重程度由汉密尔顿抑郁量表中的早、中、晚三个失眠项目的总和来衡量。一般线性模型考察了群体状态作为自变量和失眠严重程度作为因变量之间的关系。自杀未遂组的失眠严重程度高于自杀意念组和非自杀抑郁组(P<；0.05)。在调整了潜在的混杂因素后，差异仍然存在，这些因素包括人口统计学、认知能力、过去一个月的酒精依赖、抑郁情绪的严重程度、焦虑和身体健康负担。此外，自杀未遂组中更严重的失眠不能用人际关系困难、执行功能、苯二氮卓类药物的使用或创伤后应激障碍的存在来解释。我们的结果表明，失眠与自杀行为的关联可能比仅仅与自杀想法的存在更密切。因此，失眠是降低中老年人自杀风险的潜在治疗目标。
Insomnia increases in prevalence with age, is strongly associated with depression, and has been identified as a risk factor for suicide in several studies. The aim of this study was to determine whether insomnia severity varies between those who have attempted suicide (n = 72), those who only contemplate suicide (n = 28), and those who are depressed but have no suicidal ideation or attempt history (n = 35). Participants were middle-aged and older adults (Age 44–87, M = 66 years) with depression. Insomnia severity was measured as the sum of the early, middle, and late insomnia items from the Hamilton Rating Scale for Depression. General linear models examined relations between group status as the independent variable and insomnia severity as the dependent variable. The suicide attempt group suffered from more severe insomnia than the suicidal ideation and non-suicidal depressed groups (p < .05). Differences remained after adjusting for potential confounders including demographics, cognitive ability, alcohol dependence in the past month, severity of depressed mood, anxiety, and physical health burden. Moreover, greater insomnia severity in the suicide attempt group could not be explained by interpersonal difficulties, executive functioning, benzodiazepine use, or by the presence of post-traumatic stress disorder. Our results suggest that insomnia may be more strongly associated with suicidal behavior than with the presence of suicidal thoughts alone. Accordingly, insomnia is a potential treatment target for reducing suicide risk in middle-aged and older adults.