长期高海拔暴露下焦虑、抑郁及失眠的网络分析  

Network analysis of depression,anxiety,insomnia under long-term high-altitude exposure

作　　者：范豪杰 蔡珂而 邓浩伟 侯月皎 成祥 朱玲玲 范明 王笃明[1] 赵永岐 FAN Haojie;CAI Keer;DENG Haowei;HOU Yuejiao;CHENG Xiang;ZHU Lingling;FAN Ming;WANG Duming;ZHAO Yongqi(Zhejiang Sci-Tech University,Hangzhou 310018,China;Academy of Military Medical Sciences,Academy of Military Sciences,Beijing 100850,China;School of Information Sciences&Engineering,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]浙江理工大学,杭州310018 [2]军事科学院军事医学研究院,北京100850 [3]兰州大学信息科学与工程学院,兰州730000

出　　处：《军事医学》2024年第6期401-406,共6页Military Medical Sciences

基　　金：国防科工局重点研究项目(JKCY2019548B001)。

摘　　要：目的 探究长时间旅居高原人群的焦虑、抑郁及睡眠网络结构。方法 选择303名连续驻留高原时间超过6个月以上者,使用睡眠失眠严重指数量表(ISI)、患者健康问卷(PHQ-9)、广泛性焦虑障碍量表(GAD-7)等工具对其失眠、抑郁、焦虑进行评估,并应用网络分析方法分析以上症状组成网络的中心节点和桥状节点。结果 抑郁、焦虑、失眠3种症状中度以上检出率分别为38.9%(95%置信区间:33.4%~44.5%)、23.1%(95%置信区间:18.3%~27.9%)、18.5%(95%置信区间:14.1%~22.9%)。在抑郁-焦虑-失眠的心理网络中,ISI6“他人眼中睡眠对生活质量影响”为最中心的节点,其次是ISI2“睡眠维持困难”、GAD2“无法控制担忧”、GAD5“无法静坐”、PHQ3“睡眠问题”。在抑郁-焦虑-失眠的桥状心理网络中,5个桥状节点分别为:PHQ2“心情低落沮丧”、PHQ3“睡眠问题”、GAD5“无法静坐”、GAD7“害怕”、GAD4“难以放松”。结论 无论是整个网络的中心节点还是桥状节点,与睡眠相关的症状在整个网络结构中都有着重要的作用,“心情低落沮丧”作为桥状节点,对于焦虑-抑郁的共病网络有着重要的作用。对这些关键症状进行干预和防治可能对长期驻留高海拔人群的心理状态有所改善。Objective To explore the network structure of anxiety,depression and sleep among individuals under long-term high-altitude exposure.Methods A total of 303 subjects who had resided at high altitudes for more than 6 months on end were selected.The insomnia severity index(ISI),patient health questionnaire(PHQ-9),and generalized anxiety disorder scale(GAD-7)were employed to assess insomnia,depression and anxiety before network analysis was conducted to identify the central and bridge nodes in the symptom network.Results The incidence of moderate or severe depression,anxiety and insomnia were 38.9%[95%confidence interval(CI):33.4%-44.5%],23.1%(95%CI:18.3%-27.9%),and 18.5%(95%CI:14.1%-22.9%),respectively.“Noticeability of sleep problems by others”had the highest expected influence centrality,followed by“sleep maintenance”“uncontrollable worry”“restlessness”and“sleep problems”.Five bridge symptoms were identified:“sad mood”“sleep problems”“restlessness”“feeling afraid”and“trouble relaxing”.Conclusion Sleep-related symptoms play a crucial role in the overall network structure,serving as both central and bridge nodes.Additionally,the“feeling down or depressed”acts as a bridge node and holds importance in the comorbidity network of anxiety and depression.Targeting these key symptoms through intervention and prevention strategies may improve the psychological well-being of individuals with long-term residence in high-altitude regions.

关 键 词：焦虑 抑郁 失眠 高原 网络分析 

分 类 号：B849[哲学宗教—应用心理学]