抑郁症患者睡眠障碍情况调查及影响因素分析

吴桂红　马灵亚　何红娟　赵建利

[摘要] 目的 調查抑郁症患者睡眠障碍情况，并分析其影响因素。 方法 选取2016年9月至2018年9月我院心身障碍科186例抑郁症患者，按照匹兹堡睡眠质量指数问卷（Pittsburgh sleep quality index，PSQI），将总分≥8分的患者归入睡眠障碍组（105例），总分<8分的患者归入非睡眠障碍组（81例）。采用问卷调查方式，给患者发放一般情况调查表、汉密尔顿抑郁量表（Hamilton depression scale，HAMD）、汉密尔顿焦虑量表（Hamilton anxiety scale，HAMA）、社会支持评定量表（Social support rate scale，SSRS）、特质应对方式问卷（Trait coping style questionnaire，TCSQ）、生活事件量表（Life event scale，LES），比较睡眠障碍组与非睡眠障碍组的一般情况和各项问卷结果，将其中具有统计学意义的变量代入Logistic回归分析，找出抑郁症患者睡眠障碍的独立影响因素。 结果 （1）PSQI问卷结果显示，总分≥8分的患者有105例，占比56.45%;（2）睡眠障碍组患者的平均年龄较非睡眠障碍组大，HAMD评分、HAMA评分均较非睡眠障碍组高，主观社会支持评分较非睡眠障碍组低，负性事件刺激量大于非睡眠障碍组，差异有统计学意义（P<0.05）;（3）Logistic回归分析显示，年龄、不良情绪、主观社会支持、负性生活事件均为抑郁症患者睡眠障碍的独立影响因素（P<0.05）。 结论 睡眠障碍在抑郁症患者中较为常见，年龄、不良情绪、主观社会支持和负性生活事件是影响其睡眠质量的独立因素。

[关键词] 抑郁症;睡眠障碍;影响因素; HAMD评分

[中图分类号] R749.4          [文献标识码] B          [文章编号] 1673-9701（2021）04-0138-04

Investigation of sleep disorders in the patients with depression and analysis on the influencing factors

WU Guihong   MA Lingya   HE Hongjuan   ZHAO Jianli

Department of Psychosomatic Disorder， Shaoxing 7th People′s Hospital in Zhejiang Province， Shaoxing   312000， China

[Abstract] Objective To investigate the situation of sleep disorders in patients with depression and analyze its influencing factors. Methods From September 2016 to September 2018， A total of 186 patients with depression in our department of psychosomatic disorders were selected. According to the Pittsburgh sleep quality index questionnaire（PSQI）， patients with a total score of ≥8 were classified into the sleep disorder group（105 cases）， and patients with a total score of <8 were classified into the non-sleep disorder group（81 cases）. A questionnaire survey was used， and the patients were given general questionnaires， Hamilton depression scale（HAMD）， Hamilton anxiety scale（HAMA）， social support rate scale（SSRS）， trait coping style questionnaire（TCSQ）， and life event scale（LES）. The general situation and the results of various questionnaires were compared between the sleep disorder group and the non-sleep disorder group. The statistically significant variables were substituted into Logistic regression analysis， and the independent influencing factors of sleep disorders in the patients with depression were identified. Results （1）PSQI questionnaire results showed that there were 105 patients with a total score ≥8， accounting for 56.45%; （2）The average age of patients in the sleep disorder group was older than that in the non-sleep disorder group. HAMD score and HAMA score were higher than those in the non-sleep disorder group， the subjective social support score was lower than that in the non-sleep disorder group， and the amount of negative event stimulation was greater than that in the non-sleep disorder group. The differences were statistically significant（P<0.05）; （3）Logistic regression analysis showed that age， unhealthy emotions， subjective social support， and negative life events were all independent influencing factors of sleep disorders in the patients with depression（P<0.05）. Conclusion Sleep disorders are relatively common among patients with depression. Age， negative mood， subjective social support， and negative life events are independent factors that affect their sleep quality.

[Key words] Depression; Sleep disorders; Influencing factors; HAMD scores

随着时代的发展，人们的生活节奏越来越快，生活压力越来越大，抑郁症患者逐年增多。临床上，大多数抑郁症患者以情绪低落、兴趣下降、思维迟缓为主要症状[1]，但也有60%～70%的患者在就诊时主诉躯体不适，其中睡眠障碍就是典型的躯体不适之一[2]。常见的睡眠障碍有入睡困难、觉醒频繁、早醒等，这些都严重影响患者的生活质量，加重患者不良情绪，甚至会增加患者自杀的风险[3]。有学者发现，睡眠持续时间缩短往往是抑郁症患者的重要前驱症状，并且60%左右抑郁症患者的首发症状即为失眠，因此认为睡眠障碍也是抑郁症的特征之一[4]。还有研究显示，睡眠障碍的程度对抑郁症预后具有一定的预测价值，睡眠越差，不良情绪越严重[5]。目前，有关抑郁症睡眠障碍的发病机制并不清楚，研究其影响因素有助于临床及时预防和干预，减少不良事件的发生。本文以我院心身障碍科收治抑郁症患者为研究对象，通过发放问卷和量表的方式进行调查。现报道如下。

1 资料与方法

1.1 一般资料

选取2016年9月至2018年9月我院心身障碍科接受住院治疗的186例抑郁症患者作为研究对象。……