JAMA Netw open:在儿童和青少年中,睡眠紊乱和抑郁症状之间的双向纵向联系是什么?

2022-08-28 liangying MedSci原创

睡眠紊乱与儿童期抑郁症状的加强和巩固有关,而这些症状反过来又与持续的睡眠障碍有关。

抑郁症是全球第三大致残原因,也是一种全年龄段的疾病,儿童时期是最早出现的时期,累积患病率为(2%-4%),在青春期急剧增加,在成年早期达到20%左右的峰值。了解儿童和青少年时期睡眠紊乱和抑郁之间的纵向、双向联系,对于制定预防和干预方案至关重要。

本研究的目的是测试儿童和青少年时期睡眠紊乱和抑郁症状之间的双向关联和级联过程

使用魁北克儿童发展前瞻性队列研究(QLSCD;1997年进行中)。QLSCD的目标是识别与长期社会心理和学术适应相关的早期儿童因素。数据收集跨越8个阶段,从5岁(2003年)到17岁(2015年)。在儿童时期(5、7、8岁)和青少年时期(10、12、13、15、17岁),通过交叉滞后模型检验了相关性。

主要结局是睡眠障碍抑郁症状。父母报告的睡眠障碍包括睡眠持续时间、在床上醒着的时间、白天嗜睡、睡眠交谈、梦游、夜惊和噩梦。抑郁症状在儿童期由父母报告(儿童行为检查表和修订的安大略儿童健康研究量表),在青少年期由自我报告(青少年心理健康和社会适应不良评估)。

最后分析了1689名儿童(852名女性[50.4%)和1113名青少年(595名女性[53.5])的数据。在儿童时期,所有时间点的抑郁症状和睡眠干扰之间都存在显著的双向关联,表明存在级联过程。在青少年时期,10到12岁之间发现了从抑郁症状到睡眠紊乱的显著双向关联,反之亦然。在12-13岁之间,抑郁症状与睡眠紊乱中度相关,但反向相关不显著。交叉滞后估计在13岁后不显著。这种关联并没有因为性别或青春期的不同而发生变化。

交叉滞后模型对青春期睡眠障碍和抑郁之间相互关联的估计

这些发现表明,睡眠紊乱与儿童期抑郁症状的加强和巩固有关,而这些症状反过来又与持续的睡眠障碍有关。对早期睡眠紊乱和抑郁进行及时和适当的干预可防止这两个领域出现的螺旋效应。

参考文献:Marino C, Andrade B, Montplaisir J, et al. Testing Bidirectional, Longitudinal Associations Between Disturbed Sleep and Depressive Symptoms in Children and Adolescents Using Cross-Lagged Models. JAMA Netw Open. 2022;5(8):e2227119. doi:10.1001/jamanetworkopen.2022.27119

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    2023-06-11 feather89
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    2022-09-24 canlab
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    2022-08-28 循证小兵

    #睡眠紊乱##抑郁#这项研究一个大的特色是统计#建模#,采用的是cross-lagged model,这是值得大家学习的#统计#,很多症状之间可能是交叉影响,共同演进的,而不是经典#回归#模型中,一个变量是另一个变量的独立影响因素。

    0

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    2022-08-27 肿瘤克星

    JAMA上文章都是顶级的,谢谢梅斯及时上新

    0

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