Sleep disturbance and depression recurrence in community-dwelling older adults: a prospective study.
Sleep disturbance and depression recurrence in community-dwelling older adults: a prospective study.
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DOI：
10.1176/appi.ajp.2008.07121882
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发表时间：
2008-12
期刊：
影响因子：
--
通讯作者：
Irwin MR
中科院分区：
文献类型：
--
作者：
Cho HJ;Lavretsky H;Olmstead R;Levin MJ;Oxman MN;Irwin MR
先前的抑郁发作被认为会增加患抑郁症的风险。然而，在既往有抑郁症的老年人中，目前尚不清楚睡眠障碍是否独立于其他抑郁症状预测抑郁症复发。一项为期两年的前瞻性队列研究对351名60岁及以上的社区老年人进行了研究：145名有严重或非严重抑郁症病史的人完全缓解，206人没有抑郁症或任何精神疾病的既往病史。参与者在基线、6周、1年和2年时被评估抑郁发作、抑郁症状、睡眠质量和慢性内科疾病。23名既往有抑郁症的受试者(16.9%)在随访期间发生了抑郁发作，而在没有精神疾病史的组中只有一人(0.5%)。在既往有抑郁症的人群中，通过睡眠障碍可以预测抑郁症的复发，而且这种关联与其他抑郁症状、慢性内科疾病和抗抑郁药物的使用无关。这项研究首次证明，睡眠障碍是社区老年人抑郁复发的独立危险因素。为了确定有抑郁风险的老年人，可以采用两步策略，包括评估先前抑郁发作的存在以及睡眠障碍。
A prior depressive episode is thought to increase the risk of depression. However, among older adults with prior depression, it is unclear whether sleep disturbance predicts depression recurrence independent of other depressive symptoms. A 2-year prospective cohort study was conducted with 351 community-dwelling older adults ages 60 years and older: 145 persons with a history of major or nonmajor depression in full remission and 206 without a prior history of depression or any mental illness. The participants were assessed at baseline, 6 weeks, 1 year, and 2 years for depressive episodes, depressive symptoms, sleep quality, and chronic medical disease. Twenty-three subjects (16.9%) with prior depression developed depressive episodes during follow-up, compared to only one person in the group without prior mental illness (0.5%). Within the group with prior depression, depression recurrence was predicted by sleep disturbance, and this association was independent of other depressive symptoms, chronic medical disease, and antidepressant medication use. This study is the first to demonstrate that sleep disturbance acts as an independent risk factor for depression recurrence in community-dwelling older adults. To identify older adults at risk for depression, a two-step strategy can be employed, which involves assessment of the presence of a prior depressive episode along with sleep disturbance.
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