Construction and validation of Nomogram model for secondary insomnia after adolescent depression
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3760/cma.j.cn211501-20231016-00750
   		
        
        	
        		- VernacularTitle:青少年抑郁症患者继发性失眠的Nomogram模型构建与验证
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Yan XU
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Ouying SHEN
			        		
			        		;
		        		
		        		
		        		
			        		Shilin CAO
			        		
			        		;
		        		
		        		
		        		
			        		Yourang PAN
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. 绍兴市第七人民医院儿童精神科,绍兴 312000
			        		
		        		
	        		
        		 
        	
        	
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Adolescent;
			        		
			        		
			        		
				        		Depression;
			        		
			        		
			        		
				        		Nomogram;
			        		
			        		
			        		
				        		Insomnia
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			Chinese Journal of Practical Nursing
	            		
	            		 2024;40(15):1184-1189
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	Objective:The Nomogram prediction model of secondary insomnia in adolescent depression patients was constructed to provide reference and basis for clinical prevention of secondary insomnia in adolescent depression patients.Methods:A total of 158 adolescent depression patients who were treated in the Department of Pediatric Psychiatry of Shaoxing Seventh People′s Hospital from May 2021 to March 2022 were selected as the research objects by convenient sampling method. According to the Pittsburgh Sleep Quality Index (PSQI) score, the group was divided into a normal sleep group (PSQI ≤ 7 points) and a secondary insomnia group (PSQI>7 points). A cross-sectional survey was conducted using the Hamilton Depression Scale, Hamilton Anxiety Scaleand Social Support Rating Scale. Multivariate binary Logistic regression was used to analyze the influencing factors of secondary insomnia and construct a Nomogram prediction model for secondary insomnia in adolescents with depression. The accuracy of the model was judged by receiver operating characteristic curve. In addition, 70 adolescent depression patients who were treated in Shaoxing Seventh People′s Hospital from May 2022 to March 2023 were selected for success rate prediction. The results were compared with the actual observed results, and the fitting degree of the model was evaluated by Hosmer-Lemeshow test.Results:There were 72 cases in the normal sleep group, including 40 males and 32 females, aged (15.34 ± 2.62) years old, and 86 cases in the secondary insomnia group, including 51 males and 35 females, aged (14.89 ± 2.13) years old. The results of multivariate analysis showed that depression ( OR=6.381, 95 % CI 1.548-26.295, P<0.05), anxiety ( OR=6.248, 95 % CI 1.445-27.005, P<0.05) and social support ( OR=0.586, 95 % CI 0.346-0.994, P<0.05) were independent influencing factors for the occurrence of secondary insomnia in the two groups. On this basis, a risk prediction model was established. The AUC was 0.999, the sensitivity was 98.80 %, the specificity was 98.60 %, and the Youden index was 0.974. The total prediction accuracy of the external validation model was 99.80 %. Conclusions:The Nomogram prediction model of secondary insomnia in adolescent depression patients has excellent predictive efficacy. The degree of depression, anxiety and social support are the main influencing factors of secondary insomnia in patients. Medical staff should provide more effective psychological support for patients.