重性抑郁障碍患者睡眠与躯体症状特征及其相关性研究

A study on the characteristics of sleep and somatic symptoms and their correlation in patients with major depressive disorder

目的探讨重性抑郁障碍患者睡眠、躯体症状的特征,以及两者相关性。方法纳入197例首发未治疗重性抑郁障碍患者,采用匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评估睡眠质量,并据此评分是否大于7分将患者分为失眠组与非失眠组,采用躯体化症状自评量表(somatic self-rating scale,SSS)、17项汉密尔顿抑郁量表(17-item Hamilton depression scale,HAMD17)评估躯体化症状和抑郁症状。结果有152例患者存在失眠(77.2%),其SSS评分(47.43±10.83 vs.39.87±10.42)、SSS躯体化因子分(18.18±5.60 vs.15.49±4.86)、PSQI总分(12.86±3.28 vs.5.47±1.66)及PSQI各因子分高于无失眠患者,且心血管症状(69.7%vs.48.9%)、肌肉酸痛(67.8%vs.46.7%)、咽部不适(55.3%vs.35.6%)、尿频尿急(50.0%vs.28.9%)发生率及严重程度较高(P<0.05)。多因素线性回归显示头晕头痛(β=0.161,P=0.037)、憋闷叹气(β=0.154,P=0.046)与PSQI总分相关联,手脚发麻抽搐(β=0.285,P<0.001)、头晕头痛(β=0.198,P=0.007)与PSQI睡眠障碍因子分相关联,头晕头痛(β=0.248,P<0.001)、胃肠道症状(β=0.221,P<0.001)、心血管症状(β=0.193,P=0.006)与HAMD17评分相关联。结论重性抑郁障碍患者普遍存在失眠,失眠患者多项躯体症状发生率及严重程度高于无失眠患者,其中头晕头痛与失眠及抑郁程度联系紧密。

ObjectiveTo investigate the characteristics of sleep and somatic symptoms and their correlation in patients with major depressive disorder.MethodsA total of 197 patients with first-episode untreated major depressive disorder were selected.The Pittsburgh sleep quality index (PSQI) was used to assess the quality of sleep,and the group was divided into insomnia and non-insomnia groups according to whether the score was>7.The 17-item Hamilton depression scale (HAMD17) and Somatic Self-rating Scale (SSS) were used to assess clinical symptoms.ResultsThere were 152patients with insomnia (77.2%),and their SSS score (47.43±10.83 vs.39.87±10.42),SSS-S factor score (18.18±5.60 vs.15.49±4.86),PSQI total score (12.86±3.28 vs.5.47±1.66) and PSQI factor score were higher in those with than those without insomnia,and the incidence and severity of cardiovascular symptoms (69.7%vs.48.9%),muscle soreness (67.8%vs.46.7%),throat discomfort (55.3%vs.35.6%),and urinary frequency and urgency (50.0%vs.28.9%) were higher (P<0.05).Multiple linear regression analysis showed that dizziness and headache (β=0.161,P=0.037) and stifled sighing (β=0.154,P=0.046) were associated with PSQI score,numbness and twitching of the hands and feet (β=0.285,P<0.001),dizziness and headache (β=0.198,P=0.007) were associated with sleep disturbance factor score,and dizziness and headache (β=0.248,P<0.001),gastrointestinal symptoms (β=0.221,P<0.001) and cardiovascular symptoms (β=0.193,P=0.006) were associated with HAMD17 score.ConclusionInsomnia is prevalent in patients with major depressive disorder,and the incidence and severity of several somatic symptoms are higher in patients with insomnia than those without insomnia,among which dizziness and headache are more strongly associated with insomnia and depression.Major depressive disorder Insomnia Somatic symptoms.