抑郁症共病阻塞性睡眠呼吸暂停患者的前瞻性记忆损伤特点分析

目的 分析抑郁症共病阻塞性睡眠呼吸暂停（OSA）患者基于事件前瞻性记忆（EBPM）和基于时间前瞻性记忆（TBPM）的损伤特点。方法 选取2018年1月至2019年2月合肥市第四人民医院收治的78例抑郁症住院患者,依据是否合并OSA分为共病组（抑郁症合并OSA）25例,抑郁症组（抑郁症但无OSA）53例。另从社会公开招募33例患有OSA但无抑郁症的患者设为OSA组,将无OSA及抑郁症的健康者34例设为对照组。4组对象均进行多导睡眠呼吸监测及前瞻性记忆测试,比较其EBPM、TBPM评分的差异,分析共病组患者的前瞻性记忆损伤特点。结果 共病组患者EBPM和TBPM评分均低于抑郁症组、OSA组、对照组,差异均有统计学意义（P<0.05）。抑郁症组患者EBPM评分低于对照组,差异有统计学意义（P<0.05）,EBPM评分低于OSA组,但差异无统计学意义（P>0.05）,而TBPM评分低于OSA组和对照组,但差异均无统计学意义（P>0.05）。OSA组EBPM和TBPM评分均低于对照组,差异均无统计学意义（P>0.05）。结论 抑郁症共病OSA患者存在前瞻性记忆损伤,表现为EBPM和TBPM均受损。临床应重视筛查抑郁症共病OSA的患者,从而采取有效的治疗措施。     

妊娠期女性前瞻性记忆与回溯性记忆研究

目的 研究妊娠期女性前瞻性记忆（PM）和回溯性记忆（RM）功能,了解妊娠对记忆功能的影响。方法 随机选取2015年10～12月在安徽省立医院待产的50例符合入组标准的足月妊娠期女性作为研究组,随机选取50例健康非妊娠女性作为对照组,实施PM和RM的问卷调查。结果 研究组PM评分为（16.84±4.89）分,对照组PM评分为（13.34±3.49）分,差异有统计学意义（t=4.418,P<0.05）。研究组RM评分为（15.70±5.04）分,对照组RM评分为（14.82±3.81）分,差异无统计学意义（t=0.985,P>0.05）。结论 妊娠期女性存在记忆功能受损,其中以PM损害为主。     

精神分裂症患者前瞻性记忆的研究进展

本文对前瞻性记忆的评估方法及精神分裂症患者前瞻性记忆损害的特点和机制进行综述。     

心理干预对抑郁症病人睡眠的作用

目的 探讨心理干预对抑郁症病人睡眠的作用.方法 将80例符合CCMD-3诊断标准且伴有睡眠障碍的抑郁症病人随机分为观察组(40例)和对照组(40例).对照组采用常规治疗护理,观察组在此基础上给予支持性心理治疗、认知行为疗法、森田疗法等心理干预措施,并对患者及家属进行健康指导,以匹兹堡睡眠质量指数(PSQI)记录和评价干预效果.结果 观察组病人在干预后4周睡眠状况明显改善,在干预后8周睡眠质量接近正常水平.睡眠指标与干预前比较有统计学意义(P＜0.01),干预后效果与对照组比较有统计学意义(P＜0.01).结论 实施心理干预可改善病人睡眠状况,对疾病的康复有重要的帮助作用.     

抑郁症患者客观睡眠与临床特征的相关性

目的 分析抑郁症患者的客观睡眠,探讨患者睡眠状况与抑郁症状的关系.方法 34例抑郁症患者为抑郁症组,21例健康者为健康对照组,两组均进行多导睡眠监测(polysomnography,PSG).采用汉密尔顿抑郁量表(HAMD-24)对抑郁症组临床症状进行评估.结果 (1)与健康对照组相比,抑郁症组总睡眠时间(TST)减少[(463.90±45.76) min比(426.57±83.85) min(P ＜0.05)],睡眠潜伏期(SL)延长[(20.47 ±5.94) min比(46.49±55.42) min(P ＜0.01)]、快眼动睡眠(REM)减少[(81.91 ±29.05) min比(55.66±39.76) min(P＜0.05)]及快眼动睡眠比例(REM％)[(17.28±6.00)％比(12.91±8.65)％(P＜0.05)]降低.(2) Pearson相关分析显示,抑郁症组的HAMD-24得分与N3(r=-0.353,P＜0.05)存在负相关.结论 抑郁症患者的睡眠状况较正常存在明显变化;抑郁症患者抑郁程度越重,深睡眠时间就越少,睡眠紊乱状况也越重.     

睡眠管理对抑郁症病人疗效及不良反应的影响

为探讨不同睡眠管理方法对抑郁症病人疗效及不良反应的影响 ,我们将 98例抑郁症病人分为两组进行了初步研究。现报告如下。1　资料与方法1 1　一般资料　 98例抑郁症病人均符合CCMD 2 R和DSM Ⅲ诊断标准 ,并排除躯体器质性病变。将病人随机分为两组。满足睡眠组 (A组 ) 4 8例 ,男 2 8例 ,女 2 0例 ,平均年龄 38 5 1± 7 6 1岁 ,平均病程 3 0 1± 1 2 1年 ,阿米替林平均始服剂量为 98 87± 18 77mg/d ,阿普唑伦每晚 2片 ,谷维素 30mg/d。定时叫醒组 (B组 ) 5 0例 ,男 2 9例 ,女 2 1例 ,平均年龄 37 0 1± 7 81岁 ,平均病程 2 98± 1 14…     

曲唑酮治疗抑郁症睡眠障碍病人多导睡眠图变化

目的:探讨抑郁症合并睡眠障碍病人多导睡眠图特点,并与正常人比较,探讨曲唑酮治疗效果及多导睡眠图(PSG)变化。方法:应用Polysmith型多导睡眠图,对21名抑郁症合并睡眠障碍病人及10名正常对照者进行测定,抑郁症病人曲唑酮治疗2mo后复查多导睡眠图,并进行治疗前后抑郁自评量表、汉密尔顿焦虑量表测定。测量数据以(?)±s表示,统计方法采用SPSS 11.0进行分析。结果:与正常对照者比较,抑郁症合并睡眠障碍病人觉醒时间、快动眼(REM)睡眠、S2显著延长,总睡眠时间、睡眠效率、REM睡眠潜伏期、慢波(S3+S4)睡眠明显缩短。抑郁症组曲唑酮治疗后PSG显示总睡眠时间延长[治疗前(350±s 30)min,治疗后(393±27)min,P<0.01],睡眠效率增加[治疗前(74.0±2.0)%,治疗后(86±4)%,P<0.05],觉醒时间缩短[治疗前(82±7)min,治疗后(19±5)min,P<0.01],REM睡眠缩短[治疗前(107±13)min,治疗后(98±7)min,P<0.01],S2缩短[治疗前(189±5) min,治疗后(181±4)min,P<0.05],慢波睡眠延长[治疗前(40±3)min,治疗后(69.0±2.0) min,P<0.01]。睡眠潜伏期、REM睡眠潜伏期、REM睡眠次数、S1未见明显变化(P>0.05)。抑郁自评量表和汉密尔顿焦虑量表评分改善。结论:抑郁症合并睡眠障碍病人PSG指标异常,曲唑酮治疗后睡眠好转,精神量表及PSG异常指标有改善。     

抑郁症患者精神焦虑与多导睡眠图参数相关性研究

目的 探讨抑郁症患者精神焦虑与多导睡眠图(PSG)参数相关性.方法 选取2018年6月至2020年5月佛山市第三人民医院功能检查科接收的抑郁症患者68例作为研究对象,按汉密尔顿抑郁24项(Hamilton depressive 24,HAMD 24)量表第10项(HAMD-10)评分内容,以HAMD-10≥1分为研究组...     

抑郁症病人维生素 D和 C反应蛋白与糖脂代谢的相关性

目的探讨抑郁症病人维生素 D和 C反应蛋白与血糖、血脂水平的关系。方法收集 2018年 11月至 2019年 5月在安徽医科大学附属心理医院住院治疗的 296例抑郁症病人进行问卷调查,包括人口学特征和生活行为方式等。并采空腹静脉血,检测病人 25?羟维生素 D［25?hydroxyvitamin D,25(OH)D］、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇( HDL?C)以及超敏 C反应蛋白( hs?CRP)的水平。采用方差分析和线性回归分析抑郁症病人维生素 D水平与上述代谢指标及 C反应蛋白的关系、 C反应蛋白与代谢指标的关系。结果抑郁症病人 25(OH)D、空腹血糖、总胆固醇、三酰甘油、 HDL?C和 hs?CRP的均值分别为( 41.11±11.75)nmol/L、(5.15±0.92)mmol/L、(4.46±1.17)mmol/L、(1.48±1.08)mmol/L、(1.28±0.26)mmol/L和( 1.24±1.51) mmol/L。维生素 D严重缺乏者 49例( 16.6%)维生素 D轻度缺乏 194例( 65.5%),维生素 D非缺乏为 53例( 17.9%)。方差分析结果显示,抑郁病人不同维生素 D状态时的空腹,血糖、总胆固醇、三酰甘油、 HDL?C以及 hs?CRP间均差异有统计学意义( P＜0.05),不同 C反应蛋白组的空腹血糖、总胆固醇、三酰甘油以及 HDL?C间均差异有统计学意义( P＜0.05)。调整混杂因素后,线性回归分析的结果显示,随着维生素 D水平的升高,空腹血糖( β＝-0.018,P＜0.001)、总胆固醇( β＝-0.027,P＜0.001)、三酰甘油( β＝-0.007,P＝0.009)以及 hs?CRP(β＝-0.031,P＜0.001)水平逐渐降低, HDL?C(β＝0.005,P＝0.001)水平逐渐升高;随着 C反应蛋白水平的升高,空腹血糖( β＝0.199,P＜0.001)、总胆固醇( β＝0.204,P＝0.001)、三酰甘油( β＝0.133,P＜0.001)水平逐渐升高, HDL?C(β＝-0.072,P＜0.001)水平逐渐降低。维生素 D缺乏且伴有高 hs?CRP病人的空腹血糖、总胆固醇、三酰甘油水平最高、 HDL?C水平最低。结论抑郁症病人维生素 D和高 hs?CRP与糖脂代谢存在交互作用。维生素 D缺乏且伴有高 hs?CRP病人存在最为严重的糖脂代谢异常,但因果关系不明确。     

首发型未服药非器质性睡眠障碍患者前瞻性记忆与工作记忆相关分析

目的 探讨首发型未服药非器质性睡眠障碍（NI）患者前瞻性记忆与工作记忆之间的相关性。方法 将2015年1月至2016年1月在安徽省精神卫生中心首次就诊未服药的80例NI患者设为观察组（NI组）,同时期选择与其人口学资料相匹配的80例合肥社区志愿者作为健康对照组（HC组）,采用基于事件前瞻性记忆（EBPM）范式和基于时间前瞻性记忆（TBPM）范式评估两组患者EBPM、TBPM得分,通过客体、语音及空间工作记忆测试评估两组患者的反应时间及错误数,比较两组研究对象EBPM、TBPM得分及客体、语音及空间工作记忆反应时长及错误数。采用Pearson相关分析NI组前瞻性记忆与工作记忆相关性。结果 NI组在EBPM和TBPM得分低于HC组,差异有统计学意义[(1 448.95±294.54)ms比(1 310.20±180.30)ms;(1 485.26±271.59)ms比(1 397.68±268.08)ms,P均<0.05],NI组在工作记忆中客体和空间工作记忆的反应时长均长于HC组,差异均有统计学意义; Pearson相关分析显示,NI组EMPI得分与客体工作记忆反应呈负相关（r=-0.310,P=0.005）。结论 NI患者存前瞻性记忆与工作记忆损伤,前瞻性记忆损伤与工作记忆损伤有一定相关性。     

抑郁和焦虑对老年心律失常患者睡眠质量及心率变异的影响

目的探讨抑郁和焦虑对老年心律失常患者睡眠质量及心率变异的影响。方法选择心律失常患者168例为研究对象,其中仅合并焦虑者41例,仅合并抑郁者52例,同时存在焦虑和抑郁者33例,共126例,为观察组,未合并抑郁、焦虑情绪者42例,为对照组,分析患者抑郁及焦虑对睡眠质量及心率变异的影响。结果观察组睡眠质量总分、睡眠有效、入睡时间、睡眠质量、睡眠障碍、睡眠时间等均显著高于对照组（P〈0.01）,焦虑组、抑郁组、焦虑及抑郁组SDNN、SDANN、rMSSD、PNM50均显著对照组（P〈0.01）。结论老年心律失常患者焦虑、抑郁可影响患者睡眠质量,并对心律失常产生不利影响。     

The relationship between changes in REM sleep and clinical improvement in depressed patients treated with amitriptyline

EEG sleep recordings were obtained on consecutive nights from six hospitalized depressed patients before, during, and after treatment with amitriptyline for a total of 370 nights of data, about 85% of all nights of the study. Amitriptyline significantly reduced time spent in rapid eye movement (REM) sleep and prolonged the REM latency throughout the treatment period. Three patients who improved during treatment showed a REM rebound when amitriptyline was discontinued, whereas three patients who did not improve showed no REM rebound.     

Bupropion response on sleep quality in patients with depression: Implications for increased cardiovascular disease risk

Depression could be an independent risk factor for cardiovascular disease. We assessed bupropion response in depressed patients by polysomnography (PSG) and cardiopulmonary coupling (CPC) variables. Nineteen subjects participated in a two-session, two consecutive night PSG protocol. Participants received either placebo or bupropion-SR 150 mg, orally, in a randomized, double-blind cross-over fashion on night two. Outcome variables were: sleep stages, REM latency, stable, unstable sleep and very low frequency coupling (VLFC). CPC analysis uses heart rate variability and the electrocardiogram's R-wave amplitude fluctuations associated with respiration to generate frequency maps. Bupropion increased REM latency (p=0.043) but did not impact PSG sleep continuity, architecture and CPC variables. A trend (p=0.092) was observed towards increasing VLFC duration. Bupropion increased the number of stable–unstable sleep transitions (p=0.036). Moderate to strong correlations between PSG and CPC variables were found on placebo and bupropion nights. Limitations include a small sample size, limited power to detect CPC changes and lack of normal controls for comparison. Increased stable–unstable sleep transitions and VLFC duration may indicate vulnerability to cardiovascular disease due to their association with low heart rate variability that has been associated with increased mortality raising the question whether the beneficial effects of the antidepressant medication outweighs the impact on cardiopulmonary dynamics.     

青绪管理对脑梗死患者焦虑、抑郁及睡眠障碍的影响研究

目的探讨情绪管理对脑梗死患者焦虑抑郁及睡眠障碍的影响。方法选择本院2013年3-9月收治的90例脑梗死患者,随机分为两组,常规组45例患者给予常规护理,包括健康教育、气道管理、康复指导等,研究组45例患者在常规组的基础上给予情绪管理,护理前后采用汉密尔顿焦虑、抑郁量表（HAMA、HAMD）及匹兹堡睡眠质量指数（PSQI）评价患者负性情绪及睡眠质量的改善情况。结果护理后两组HAMA、HAMD评分均较护理前降低（P〈0．05）,但研究组HAMA、HAMD评分均明显低于对照组;护理后两组PSQI评分均降低（P〈0．05）。研究组PSQI评分明显低于对照组,差异有统计学意义（P〈O．05）。结论情绪管理可有效改善脑梗死患者负性情绪及睡眠障碍情况,利于患者病情恢复,值得应用。     

Pain depression and sleep disorders among methadone maintenance treatment patients

Background

The success of rehabilitation is not influenced solely by drug abstinence, but also by the state of general health and well-being, which for patients in methadone maintenance treatment (MMT) frequently is compromised by experiencing pain, depression and sleep disorders. Accordingly, this study sought to (1) characterize clusters of MMT patients who experienced different levels of these symptoms and (2) examine the association between these clusters and quality of life (QOL) measures.

Methods

A convenience sample of MMT patients (n = 73) completed surveys containing four scales (Numeric Rating Scale on Pain, Center for Epidemiological Studies—Depression Scale, General Sleep Disturbance Scale, and Short Form-36 QOL). Homogenous clusters based on the symptom severity of pain, depression and sleep disturbances were created using a two-stage process of: hierarchical clustering and K-means cluster analysis.

Results

Based on the levels of symptoms, MMT patients were grouped as High (n = 29), Moderate (n = 26) or Low (n = 18) symptom cluster members. The High symptom cluster group reported the highest severity levels of pain, depression and sleep disorders. Also, this group had the lowest scores on all QOL indices (p < 0.05). Although pain, depression and sleep disorders effectively distinguish symptom clusters of MMT patients, pain was the single most important symptom differentiating MMT patients.

Conclusions

Successful rehabilitation will necessitate interventions that target MMT patients with high levels of pain, depression and sleep disorders. To the best of our knowledge this study was innovative in its approach to identify the presence of this high risk group by using cluster methodology in the MMT population.     

Smoking and everyday prospective memory: A comparison of self-report and objective methodologies

Aims

To examine whether persistent smoking leads to impairments in self-reported and objective measures of prospective memory (PM: the cognitive ability to remember to carry out activities at some future point in time).

Methods

An opportunity sample of 18 existing smokers and 22 who had never smoked were compared. An existing-groups design was utilised, comparing a smoking group with a never-smoked control group as the independent factor. Scores on the sub-scales of the Prospective and Retrospective Memory Questionnaire (PRMQ) and scores on the Cambridge Prospective Memory Test (CAMPROMPT) constituted the dependent factors. Age, mood, other drug use, strategy scores and IQ were also measured. Each participant was tested in a laboratory setting. Self-reported PM lapses were measured using the PRMQ. The CAMPROMPT was used as an objective measure of PM. Alcohol and other drug use were assessed by a Recreational Drug Use Questionnaire. The Hospital Anxiety and Depression Scale gauged levels of anxiety and depression. A strategy scale measured the number of strategies used to aid memory. The National Adult Reading Test measured IQ.

Results

After observing no between-group differences on age, mood, alcohol use, strategy use, and IQ, smokers and the never-smoked did not differ on the self-reported lapses measured on the PRMQ. However, smokers recalled significantly fewer items on the CAMPROMPT than the never-smoked group.

Conclusion

The results of the present study suggest that persistent smoking leads to impairments in everyday PM.     

抑郁症患者的认知功能特点

目的 研究伴或不伴有精神病性症状的抑郁症患者认知功能损害的特点.方法 与80例健康对照组进行比较,80例抑郁症患者组均符合ICD-10抑郁发作诊断标准,汉密尔顿抑郁量表评分（Hamilton Depression Scale,HAMD17）≥17分.分别采用言语流畅性测验（动物数）、威斯康星卡片分类测验-改良版（modified Wisconsin card sorting test,M-WCST）（48张）、汉诺塔测验、连线测验A和B等神经心理工具进行认知功能评定;采用简明精神病评定量表（Brief Psychiatry Rating Scale,BPRS）筛查和评定出22例伴有精神病性症状的抑郁症患者.结果 （1）与正常组比较,抑郁症患者各项神经心理学测验成绩均差,并且差异有显著性（P＜0.05）.（2）有精神病性症状的抑郁症患者与无精神病性症状的抑郁症患者比较,伴有精神病性症状的患者各项神经心理成绩均差于无精神病性症状者,仅连线测验A时间分别为（77.2±49.3）s,（59.2±29.3）s,连线测验B时间分别为（121.6±40.0）s,（84.7±36.4）s,差异有显著性（P＜0.05）.结论 与健康对照比较,抑郁症患者存在广泛的认知损害,有精神病性症状的患者认知损害程度更严重.     

Effects of trazodone on EEG sleep and clinical state in major depression

The effects of the antidepressant trazodone on clinical state and on EEG sleep in eight outpatients with a major depressive disorder were investigated in a single blind study. A medication period of 5 weeks was preceded and followed by one week placebo treatment. Five subjects showed a positive treatment response. Trazodone did not influence sleep continuity and slow wave sleep, but did suppress REM sleep significantly. A significant increase of REM sleep latency was also found. These results are in contrast with earlier reports on trazodone's effects on EEG sleep but are in accordance with the general finding that antidepressants influence REM sleep characteristics without necessarily affecting sleep continuity.