Preliminary support for the role of reward relevant effort and chronotype in the depression/insomnia comorbidity.
Preliminary support for the role of reward relevant effort and chronotype in the depression/insomnia comorbidity.
复制标题
初步支持奖励相关努力和时间型在抑郁/失眠共病中的作用。
DOI：
10.1016/j.jad.2018.08.057
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发表时间：
2019
影响因子：
6.6
通讯作者：
Gehrman,PhilipR
中科院分区：
文献类型：
--
作者：
Boland,ElaineM;Bertulis,Kassondra;Leong,ShirleyH;Thase,MichaelE;Gehrman,PhilipR
背景抑郁症患者失眠与许多不良结局有关，包括治疗反应降低、复发可能性增加和功能障碍加重。鉴于抑郁症和失眠症的频繁并发症，研究相关的两种疾病，特别是奖励处理和昼夜节律中断的系统和过程，可能有助于解析这一复杂的comormality.MethodsA试点研究的样本进行了10个退伍军人临床显着的抑郁症和失眠症状。参与者完成了客观（活动记录）和主观（睡眠日记）的睡眠，自我报告的时间型，和行为任务评估奖励相关的努力之前和之后6个会议的认知行为治疗Increasing. ResultsIncreasingandDepression显着改善CBT-I。主观睡眠参数显着改善与大的效应量。体动仪的结果是不显着的，但影响大小的睡眠效率和发病潜伏期的中等范围。CBT-I后，时间型显著向早晨型转变，基线时较早的时间型与治疗后奖励努力增加相关。在时间型，抑郁症和失眠的变化与努力的变化无关。LimitationsFindings是有限的小样本量和缺乏随机对照group.ConclusionsFindings应被解释为假设产生的服务，旨在进一步研究揭示潜在的机制抑郁症/失眠comorbital。鼓励对抑郁症中奖励处理障碍的现有数据集中的睡眠数据进行分析，以及旨在探索抑郁症中潜在睡眠，昼夜节律和奖励相互作用的原始项目。
BackgroundThe presence of insomnia in the context of depression is linked to a number of poor outcomes including reduced treatment response, increased likelihood of relapse, and greater functional impairment. Given the frequent co-occurrence of depression and insomnia, research into systems and processes relevant to both disorders, specifically reward processing and circadian rhythm disruption, may help parse this complex comorbidity.MethodsA pilot study was conducted on a sample of 10 veterans with clinically significant depression and insomnia symptoms. Participants completed objective (actigraphy) and subjective (sleep diary) assessments of sleep, self-reports of chronotype, and behavioral tasks assessing reward relevant effort before and after 6 sessions of Cognitive Behavioral Therapy for Insomnia.ResultsInsomnia and depression significantly improved following CBT-I. Subjective sleep parameters significantly improved with large effect sizes. Actigraphy results were nonsignificant, but effect sizes for sleep efficiency and onset latency were in the medium range. Chronotype shifted significantly toward morningness following CBT-I, and an earlier chronotype at baseline was associated with increased reward effort following treatment. Changes in chronotype, depression and insomnia were not associated with changes in effort.LimitationsFindings are limited by small sample size and lack of randomized control group.ConclusionsFindings should be interpreted as hypothesis generating in the service of furthering research aimed at uncovering potential mechanisms underlying the depression/insomnia comorbidity. Analyses of sleep data in extant datasets of reward processing impairments in depression as well as original projects aimed at exploring potential sleep, circadian rhythm, and reward interactions in depression are encouraged.