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首页> 外文期刊>Child and adolescent psychiatric clinics of North America >The Complex Role of Sleep in Adolescent Depression
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The Complex Role of Sleep in Adolescent Depression

机译：睡眠在青少年抑郁症中的复杂作用

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In this discussion, we had 2 related goals. First, it is clear that insomnia is a significant problem in adolescence. Successful treatment of insomnia is an important goal in its own right. However, the primary goal in our recent research, consistent with the National Institute for Mental Health's focus on mental disorders and the future research priorities from the National Institutes of Health state-of-the-science conference on insomnia, 47 has been to improve the treatment of youth depression beyond the modest effects achieved with depression-focused interventions. We hypothesize that joint treatment of sleep and mood disorder, with treatment elements specific to each, may increase depression response and remission rates. This approach is suggested by the high comorbidity of insomnia with depression, by the emerging indications that sleep disturbances may play a causal role in the onset of many (but not all) depressive episodes, by preliminary adult outcome trials in which treatment of insomnia also improved depression outcomes, and by other uncontrolled pilots of youth insomnia treatment. There is also evidence that insomnia interferes with patients' ability to benefit from depression-focused CBT, suggesting that insomnia CBT might enable depression CBT to be more successful. Overall, our approach is also consistent with the primary prevention of secondary disorders model advocated by several researchers in other clinical contexts 143-145 and specifically in the case of insomnia and mood disorder. 51,52,61 Developmental timing may be important, too. Animal and human research suggests that puberty is a unique period for establishing future behavioral patterns and habits 146; intervening in this developmental period may assist youth to establish healthy patterns that will serve them well into the future. If we find that this novel intervention improves outcomes across a broad range of critical and prevalent adverse outcomes for teens (eg, depression, suicidality, insomnia, educational attainment, and others), the public health implications will be large. Even perhaps more startling for public health implications, and a fascinating domain for future research, is to treat insomnia as a prevention for youth depression.
机译：在此讨论中，我们有2个相关目标。首先，很明显，失眠是青春期的重要问题。成功地治疗失眠症本身就是一个重要目标。但是，与我们国家心理健康研究所对精神障碍的关注以及美国国立卫生研究院失眠问题科学会议47的未来研究重点相一致，我们最近的研究的主要目标是改善心理健康状况。青年抑郁症的治疗方法，除了以抑郁症为重点的干预措施所取得的适度效果之外。我们假设对睡眠和情绪障碍的联合治疗，以及每种治疗的特有治疗元素，可能会增加抑郁症的反应和缓解率。初步的成人结局试验（其中失眠的治疗方法也得到了改善）是由于失眠与抑郁症的高合并症，新出现的迹象表明睡眠障碍可能在许多（但不是全部）抑郁症发作中起因果作用，提示了这种方法。抑郁的结果，以及由其他失控飞行员进行的青少年失眠治疗。还有证据表明，失眠会干扰患者从以抑郁为中心的CBT中获益的能力，这表明失眠CBT可能使抑郁CBT更成功。总体而言，我们的方法还与其他研究人员在其他临床背景下143-145所倡导的继发性疾病的一级预防模型相一致，特别是在失眠和情绪障碍的情况下。 51,52,61发展的时机也很重要。动物和人类研究表明，青春期是建立未来行为模式和习惯的独特时期146。在这个发展时期进行干预可能会帮助青少年建立健康的模式，并在将来为他们服务。如果我们发现这种新颖的干预措施可以改善青少年的一系列严重和普遍的不良后果（例如抑郁，自杀，失眠，受教育程度等），那么对公共健康的影响将是巨大的。对于公共卫生的影响甚至是更令人吃惊的，对于未来的研究而言，一个引人入胜的领域是将失眠作为预防青年抑郁症的方法。

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