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首页> 外文期刊>The journal of clinical psychiatry >Poor sleep at baseline predicts worse mood outcomes in patients with co-occurring bipolar disorder and substance dependence
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Poor sleep at baseline predicts worse mood outcomes in patients with co-occurring bipolar disorder and substance dependence

机译：基线时睡眠不足预示着并发双相情感障碍和物质依赖患者的情绪转归较差

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Background: Sleep problems are common in patients with bipolar disorder and have been shown to predict subsequent mood symptoms. Sleep problems have also been shown to lead to worse substance use outcomes in individuals with substance use disorder. However, the relationship between sleep and clinical outcomes in a population with co-occurring bipolar disorder and substance use disorder is unclear. Method: This secondary analysis included 60 outpatients (mean age = 38.1 years; recruited via advertisements, fliers, clinician referrals, and hospital treatment programs) who met DSM-IV criteria for both bipolar disorder and substance use disorder (assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders) and who participated in a randomized clinical trial comparing integrated group therapy for bipolar disorder and substance use disorder to group drug counseling for substance use disorder alone. A 12-week treatment period preceded a 24-week follow-up. Poor sleep was assessed with the Pittsburgh Sleep Quality Index, which provides 7 component subscores and an overall sleep score. Data were collected from August 2003 through April 2007. Results: When analyses were controlled for baseline mood, substance use, and treatment condition, baseline sleep score predicted mood over the course of the 12-week treatment (β = 0.28; P < .05) and 24-week follow-up (β = 0.46; P < .01): worse sleep was associated with worse mood outcomes. Sleep was not associated with substance use outcomes. Conclusions: Impaired sleep is a prognostic factor for mood outcomes in patients with co-occurring bipolar and substance use disorders. Further investigation is warranted into the long-term clinical outcomes of poor sleep in this population with co-occurring bipolar disorder and substance use disorder so that appropriate interventions can be developed.
机译：背景：睡眠障碍在躁郁症患者中很常见，已被证明可以预测随后的情绪症状。睡眠问题也被证明会导致药物滥用障碍患者的药物滥用后果恶化。然而，在并发双相情感障碍和物质使用障碍的人群中，睡眠与临床结局之间的关系尚不清楚。方法：该二级分析包括60名门诊患者（平均年龄= 38.1岁;通过广告，传单，临床医生推荐和医院治疗计划招募），这些患者均符合双相情感障碍和物质使用障碍的DSM-IV标准（通过结构化临床访谈进行了评估） （DSM-IV轴I障碍），并参加了一项随机临床试验，该研究比较了躁郁症和药物滥用综合疗法与仅针对药物滥用症的药物咨询分组。在进行24周的随访之前，需要进行12周的治疗。匹兹堡睡眠质量指数评估了不良睡眠，该指数提供7个子项评分和总体睡眠评分。从2003年8月到2007年4月收集了数据。结果：当控制了基线情绪，药物使用和治疗条件的分析后，基线睡眠评分可预测12周治疗过程中的情绪（β= 0.28; P <.05 ）和24周的随访（β= 0.46; P <.01）：较差的睡眠与较差的情绪结果相关。睡眠与药物使用结果无关。结论：睡眠障碍是双相情感障碍和药物滥用合并症患者情绪转归的预后因素。有必要对这一人群同时患有双相情感障碍和物质使用障碍的睡眠不足的长期临床结果进行进一步调查，以便制定适当的干预措施。

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