失眠与抑郁关系2008-2013年研究进展及存在问题

Relationship between insomnia disorder and depression: Update and future direction

失眠障碍和抑郁症是成人和儿童最常见的精神障碍之一。以前的观点认为,失眠症状是抑郁症的一个常见伴随症状,会随着抑郁症的缓解而消失。但逐渐积累的证据显示,失眠症状不仅是抑郁症起病及复发的危险因素,也是抑郁症治疗后的残留症状。最新的《精神障碍诊断与统计手册第5版》和《睡眠障碍国际分类第3版》将失眠障碍看作是与其他精神障碍共病的状态,这将对未来失眠症的诊疗和临床研究产生重要的影响。本文主要就2008-2013年关于失眠(障碍或症状)和抑郁症的研究进展,讨论失眠与抑郁症在疾病层面及症状层面上的关系。

Both insomnia disorder and major depressive disorder are one of the most common mental disorders in adults and children. Previously,researchers considered that insomnia（ symptom） is a secondary symptom of depression and w ill subside after the remission of depression. Recently, more evidence suggests that insomnia（ symptom） is not only an independent risk factor of the onset and the relapse of depression, but also a residual symptom of remitted depression. In these regards,the new ly published The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders（ DSM-5） and The International Classification of Sleep Disorders-Third Edition（ ICSD-3） suggest that insomnia disorder is a comorbid condition rather than a secondary symptom of other mental disorders,w hich w ill exert great impacts on the diagnosis and management as w ell as the clinical research of insomnia disorder. This review discusses the recent advances in the relationship betw een insomnia and depression,in terms of syndromal and symptomatic levels.