Relationship of sleep disturbance and therapeutic effect of depression in elderly inpatients: an observational 1-year follow-up study
10.3760/cma.j.issn.1006-7884.2015.06.004
- VernacularTitle:老年抑郁障碍患者睡眠紊乱与抑郁疗效关系的一年随访研究
- Author:
Xinyu SUN
1
;
Tao LI
;
Yao CHENG
;
Jinxia GAO
;
Weihua ZHANG
Author Information
1. 100191,北京大学第六医院北京大学精神卫生研究所卫生部精神卫生学重点实验室(北京大学)
- Publication Type:Journal Article
- Keywords:
Aged;
Depressive disorder;
Sleep disorders;
Follow-up studies
- From:
Chinese Journal of Psychiatry
2015;48(6):339-344
- CountryChina
- Language:Chinese
-
Abstract:
Objects Sleep disturbance as one common complaint of the aged in clinical practice was associated with depressive disorders intimately and complicatedly.In this study,the changes of sleep disturbance in elderly inpatients with depression in the acute treatment duration and its association with 1-year outcome were observed,so as to give reference for reasonable treatment of sleep disturbance in the aged.Methods In an observationally naturalistic study,69 consecutive elderly inpatient with ICD-10 criteria for depressive disorders were included.The sleep disturbance was assessed with the Pittsburgh Sleep Quality Index (PSQI) at baseline,2-week,4-week treatment and 1-year follow-up,and total score of 8 or higher was defined as having sleep disturbance.The HAMD and HAMA for illness severity,and MMSE for cognitive functioning was assessed simuhaneously.At the 1-year follow-up,the Global Assessment Function (GAF) was used for assessing social functioning as well.Results The PSQI scores at baseline,2-week,3-week and 1-year follow-up were (15.4±3.8),(12.0±4.6),(9.4±4.3) and (8.5±4.7),and repeated measured variance of analysis showed the differences of scores between 2-week,4-week and baseline were statistically significant (F=48.85,40.92;both P＜0.05),while the difference between 4-week and 1-year follow-up was not significant (F=1.86,P=0.178).At 2-and 4-week treatment,the rate of co-therapy of hypnotics was higher inpatients with sleep disturbance.The decreased rates ofPSQI score at 2-week was correlated to the decreased rate of HAMD score at 2-week (r=0.33,P=0.006) and 4-week (r=0.40; P=0.001),but not at 1-year follow-up (r=0.16,P=0.228).At 1-year follow-up,having sleep disturbance was significantly associated with higher HAMD score (OR=11.56,Wald X2=4.26; P＜0.05),but the associations with HAMA,MMSE and GAF scores were not significant.Conclusion Sleep disturbance in the elderly inpatients with depression could be improved with effective antidepressant treatment,and improvement in early treatment phase could predict better therapeutic effect in the acute phase.The residual sleep disturbance at 1-year follow-up may be an important residual symptom of depression.
