Differentiation Across Bipolar Disorder and Major Depressive Disorder by Whole-Night Polysomnographic Findings.

IF 4.5 2区医学 Q1 PSYCHIATRY Journal of Clinical Psychiatry Pub Date : 2024-08-14 DOI:10.4088/JCP.23m15210

Meihong Xiu, Wenxin Li, Yu Lan, Kaiwen Li, Xiaoe Lang

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Abstract.

Background: There is growing evidence that understanding the role of sleep disturbance in bipolar disorder (BD) and major depressive disorder (MDD) is helpful when studying the high heterogeneity of patients across psychiatric disorders.

Objective: The present study was designed to investigate the transdiagnostic role of sleep disturbance measured by polysomnography (PSG) in differentiating from MDD with BD.

Methods: A total of 256 patients with MDD and 107 first-episode and never medicated patients with BD using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria were recruited. All patients completed 1 night of PSG recording, and the changes in objective sleep structure parameters were determined by PSG analysis.

Results: We showed that patients with MDD had statistically longer rapid eye movement (REM) latency, a higher percentage of stage N2 sleep, and lower percentages of stage N3 sleep and REM sleep than those with BD after controlling for confounding factors (all P < .05). Moreover, using the logistic regression analysis, we identified that REM latency was associated with BD diagnosis among the PSG sleep features. The cutoff value for PSG characteristics to differentiate BD from MDD was 261 in REM latency (sensitivity: 41.4% and specificity: 84.1%).

Conclusions: Our findings suggest that PSG-measured sleep abnormalities, such as reduced REM latency, may be a diagnostic differentiating factor between MDD and BD, indicating their roles in identifying homogeneous transdiagnostic subtypes across psychiatric disorders.

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通过整夜多导睡眠图结果区分双相情感障碍和重度抑郁障碍。

摘要：背景：越来越多的证据表明，了解睡眠障碍在双相情感障碍（BD）和重度抑郁障碍（MDD）中的作用有助于研究精神病患者的高度异质性：本研究旨在探讨多导睡眠图（PSG）测量的睡眠障碍在区分双相情感障碍（BD）和重度抑郁障碍（MDD）中的跨诊断作用：根据《精神疾病诊断与统计手册》第四版的标准，共招募了 256 名 MDD 患者和 107 名首次发病且从未接受过药物治疗的 BD 患者。所有患者均完成了一晚的 PSG 记录，并通过 PSG 分析确定了客观睡眠结构参数的变化：结果：在控制了混杂因素后，我们发现与 BD 患者相比，MDD 患者的眼球快速运动（REM）潜伏期更长，N2 期睡眠比例更高，N3 期睡眠和 REM 睡眠比例更低（均 P < .05）。此外，通过逻辑回归分析，我们发现在 PSG 睡眠特征中，REM 潜伏期与 BD 诊断相关。区分 BD 和 MDD 的 PSG 特征的临界值是快速动眼潜伏期 261（敏感性：41.4%，特异性：84.1%）：我们的研究结果表明，PSG测量到的睡眠异常（如快速眼动潜伏期缩短）可能是MDD和BD的诊断区分因素，这表明它们在识别精神疾病的同质跨诊断亚型方面发挥了作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Psychiatry 医学-精神病学

CiteScore

7.40

自引率

1.90%

发文量

审稿时长

3-8 weeks

期刊介绍： For over 75 years, The Journal of Clinical Psychiatry has been a leading source of peer-reviewed articles offering the latest information on mental health topics to psychiatrists and other medical professionals.The Journal of Clinical Psychiatry is the leading psychiatric resource for clinical information and covers disorders including depression, bipolar disorder, schizophrenia, anxiety, addiction, posttraumatic stress disorder, and attention-deficit/hyperactivity disorder while exploring the newest advances in diagnosis and treatment.