伴非自杀性自伤行为的青少年抑郁障碍患者睡眠情况与认知功能的相关性分析

Correlation of cognitive function and Sleep in adolescent depressive disorder patients with non-suicidal self-injury behavior

目的分析伴非自杀性自伤(non-suicidal self-injury,NSSI)行为青少年抑郁障碍患者睡眠情况与认知功能的关联。方法选取某精神专科医院门诊就诊的青少年抑郁障碍患者共100例,依据有无NSSI行为,使用汉密尔顿抑郁量表(HAMD-17)评估抑郁程度;以中国简版神经认知成套测验(C-BCT)评估认知功能;使用匹兹堡睡眠质量指数量表(PSQI)评估睡眠情况;比较两组患者相关量表及测试得分的差异,并分析NSSI组患者认知功能与睡眠情况的相关性。结果两组一般资料差异无统计学意义(P>0.05),NSSI组HAMD-17(P<0.01)、PSQI评分(P<0.05)高于非NSSI组,NSSI组C-BCT测试(P<0.05)评分低于非NSSI组。多元线性回归分析显示,日间功能障碍对信息处理速度有显著的影响(B=-1.081,P<0.05);睡眠时间对注意力(B=-4.099,P<0.01)、工作记忆力(B=-2.472,P<0.05)、综合+执行功能(B=-3.103,P<0.05)有显著影响;睡眠障碍对工作记忆力(B=-3.169,P<0.05)有显著影响;睡眠质量对综合+执行能力(B=-8.604,P<0.01)有显著影响。二元Logistics回归分析表明,睡眠时间不足是注意力的风险因素(OR=11.572,P<0.01),睡眠效率下降是工作记忆力的风险因素(OR=2.160,P<0.05)。结论伴NSSI行为的青少年抑郁障碍患者认知功能及睡眠情况受损更严重,认知功能与睡眠情况存在相关性,其中日间功能障碍、睡眠时间、睡眠障碍及睡眠质量是认知功能的影响因素。

Objective To analyze the association between cognitive function and sleep in adolescent depressive disorder patients with non-suicidal self-injury(NSSI)behavior.Methods A total of 100 patients with adolescent de-pressive disorder who attended our outpatient clinic from December 2021 to January 2023 were selected and divided into NSSI and non-NSSI groups based on the presence or absence of NSSI behaviors;the same scales and tests were evalu-ated to individuals in both groups,and general information was compared using the self-made clinical characteristics information table.The degree of depression was assessed using the Hamilton Depression Inventory(HAMD-17).Cog-nitive function was assessed by the Chinese Brief Neurocognitive Test(C-BCT).Sleep was assessed by the Pittsburgh Sleep Quality Index(PSQI).The differences in the scores of relevant scales and tests between the two groups were com-pared,and the correlation between cognitive function and sleep in the NSSI group was analyzed.Results The differ-ences in general information between the two groups were not statistically significant(P>0.05).HAMD-17(P<0.01)and PSQI scores(P<0.05)were higher in the NSSI group than in the non-NSSI group,and C-BCT test score scores(P<0.05)were lower in the NSSI group than in the non-NSSI group.Multiple linear regression analysis showed that daytime dysfunction had a significant effect on information processing speed(B=-1.081,P<0.05).Sleep duration had a significant effect on attention(B=-4.099,P<0.01),working memory(B=-2.472,P<0.05),and comprehensive abilities with executive function(B=-3.103,P<0.05).Sleep disturbance had a significant effect on working memory(B=-3.169,P<0.05).And sleep quality had a significant effect on comprehensive abilities with executive func-tion(B=-8.604,P<0.01).Binary Logistics regression analysis showed that lack of sleep is risk factor for attention(OR=11.572,P<0.01).Decreased sleep efficiency is risk factor for working memory(OR=2.160,P<0.05).Con-clusion Cognitive function and sleep status were more severely impaired in adolescents of depressive disorders with NSSI behaviors,and cognitive function was correlated with sleep status,with daytime dysfunction,sleep duration,sleep disturbance and sleep quality as influencing factors of cognitive function.