多种精神障碍患者睡眠质量的调查

A survey on sleep quality in the common mental disorders

目的研究精神障碍患者的睡眠特点和规律。方法以河北省精神疾病流行病学现场抽样调查中符合美国精神障碍诊断与统计手册第4版诊断标准的13种精神障碍患者1874例（患者组）为研究样本，以调查中无任何精神障碍者15117名为正常对照（对照组），采用匹兹堡睡眠质量指数中国修订版，评定两组最近1个月的睡眠质量，以〉7分为有睡眠问题；采用功能大体评定量表评定社会生活功能。结果（1）患者组有睡眠问题的发生率为48．61％（911例），高于正常人（5.55％，839例；尸〈0．01），其中以抑郁症者（69．92％）和广泛性焦虑障碍者（58．27％）为重。（2）患者组的睡眠质量问题表现为人睡时间长[（50±60）min]、总睡眠时间短[（7．1±4．3）h；P〈0．01]，对照组分别为（20±26）min和（8．4±2．4）h；抑郁症、心境恶劣障碍和广泛性焦虑障碍者早醒明显。（3）精神分裂症者[（1．0±1.4）分]和双相障碍者的[（0．7±1．3）分]催眠药物评分较高。（4）抑郁症[（1．8±1．2）分]和双相障碍[（1．6±1．3）分]患者日间功能最差。（5）患者组有睡眠问题者较无睡眠问题者的年龄偏大，教育水平低，功能损害更严重，女性多于男性，丧偶、农民、离退休、病退和家庭妇女有睡眠问题者较多。结论精神障碍患者睡眠障碍发生率高，表现为人睡困难和总睡眠时间短，其中抑郁症患者最为明显；有睡眠问题受多种因素的影响。

Objective To investigate the sleep characteristic in the common mental disorders. Methods Subjects came from the epidemiological survey of mental disorders in people aged 18 and older in Hebei Province, and 1874 subjects who were diagnosed one of 13 types of mental disorders according the DSM-Ⅳ criteria were contrasted to 15 117 ones without mental disorders. The Pittsburgh Sleep Quality Index （PSQI）, Global Assessment of Functioning Scale （GAF） was used to assess the sleep quality and generally social functioning. Results The prevalence of low sleep quality in people with different mental disorders ranged from 19.30% to 69. 92%, and the average prevalence of 48. 61% was higher than that in people without mental disorders （5. 55% ）. The prevalence of low sleep quality in major depression disorder and generalized anxiety disorder were reached to 69.92% and 58.27%. The common complaints of sleep were longer sleep latency and shorter sleep duration. The rate of hypnotic drug use was highest in patients with schizophrenia, then in ones with bipolar disorder. The age of ones with mental disorder with sleep disorders was elder than those without sleep disorders. The prevalence of sleep disorder was higher in lower- lever education, female, farmer, retired, loss of his/her spouse, hostess and student. The prevalence of sleep disturbance was not related to depression severity. Conclusions The prevalence of sleep disorder in people with mental disorders is high, which is related to many factors.