失眠症患者抑郁障碍及相关因素的研究  

Factors associated with depressive disorder in patients referred to insomnia

作　　者：张瑛[1] 吴恒趋[1] 宋峥宏[1] 孙亚蒙[1] 林岩[1] 苗玲[1] 李焰生[1] 

机构地区：[1]上海交通大学医学院附属仁济医院神经内科,上海201207

出　　处：《中国行为医学科学》2007年第8期699-701,共3页Chinese Journal of Behavioral Medical Science

摘　　要：　目的评估失眠症患者抑郁障碍的共病率及其相关因素。方法对失眠专病门诊就诊的失眠患者进行前瞻性登记，连续收集专病门诊中符合ICD-10非器质性失眠症诊断标准、并能配合问卷及量表调查的患者，通过自编问卷进行详细的人口学资料及失眠临床特征调查，应用汉密顿抑郁量表（HDRS17）进行抑郁障碍的筛选，同时应用多元Logistic回归分析，研究失眠症患者存在抑郁障碍的相关因素。结果52．8％失眠症患者存在抑郁障碍，14．0％为重度抑郁。总睡眠时间少（OR1．618，95％CI1．239～2．114）、经济状况较差（OR1．755，95％CI1．210～2．544）、生活不规律（OR2．395，95％CI1．321～4．343）、女性（OR1．899，95％CI1．139—3．166）为失眠症患者合并抑郁障碍的独立危险因素。结论失眠症患者有较高的抑郁障碍共病率，对总睡眠时间少、经济状况较差、生活不规律、女性的失眠人群要特别重视与抑郁障碍其病的可能。Objective To evaluate the rate and relavent factors for depressive disorder comorbidity with insomnia. Methods Consecutive patients diagnosed according to the ICD-10 diagnostic criteria of nonorganic insomnia were collected prospectively in sleep disorder clinic and those who were unable to answer the questionnaire were excluded. Data about demographic and clinical features were obtained from a questionnaire. The 17-item Hamilton Depression Rating Scale（ HDRS17 ） was used to identify the presence of depressive disorder. Muhivariable logistic regression analysis was employed to evaluate associations between demographic and clinical features and the depressive disorder. Results Among the sample of patients with insomnia, 52.8% （ n = 162 ） had depressive disorder and 14.0% with major depression. Factors independently associated with depressive disorder included shorter sleep duration （OR 1. 618, 95% CI 1. 239 - 2. 114） , lower economic status （ OR 1. 755, 95% CI 1. 210 - 2.544） ,irregular lifestyle （ OR 2.395,95% CI 1. 321 - 4. 343） and female （ OR 1. 899,95% CI 1. 139 - 3. 166）. Conclusion The incidence of depressive disorder among patients with insomnia is high. The possibility of a concomitant depressive disorder should be strongly considered in patients with insomnia with any of these characteristics.

关 键 词：失眠症 抑郁障碍 相关因素 

分 类 号：R686[医药卫生—骨科学]