【摘要】 目的 比较伴与不伴忧郁特征抑郁症患者在客观睡眠指标的差异及其相关因素。方法 2021年12月1日～2022年11月28日对50例抑郁症患者采用《简明国际神经精神访谈》（MINI 5.0）忧郁特征模块进行评估，并将患者分为伴忧郁特征组（27例）和不伴忧郁特征组（23例），采用Mann-Whitney U秩和检验比较两组的人口学资料，汉密尔顿抑郁量表17项（HAMD-17）得分、客观睡眠指标以及生活习惯和生活方式的差异；采用肯德尔和谐系数分析两组客观睡眠结构指标与生活习惯、生活方式的相关性关系。结果 伴忧郁特征抑郁症患者临床症状严重程度更高（P<0.001）。两组患者客观睡眠指标不存在显著差异。伴忧郁特征抑郁患者睡眠时间与HAMD-17总分、喝牛奶相关（P<0.05）睡眠效率与婚姻状况、喝牛奶相关（P<0.05），睡眠R期占比与家庭居住地、每天久坐少动时间相关（P<0.001）,N1期占比与家庭居住地相关（P<0.05）,N3期占比与受教育程度和HAMD-17相关（P<0.05）,REM持续时间与每天久坐少动时间相关（P<0.001）,NREM持续时间与BMI、婚姻状况、睡前使用电脑/手机相关（P<0.05）SWS持续时间与受教育程度和HAMD-17总分相关（P<0.05）。不伴忧郁特征忧郁症患者N2期占比与受教育程度和家庭居住地相关（P<0.05）,R期占比与受教育程度、家庭居住地相关（P<0.05）,REM持续时间与受教育程度、家庭居住地相关（P<0.001），睡眠潜伏期与HAMD-17总分相关（P<0.05）。结论 伴忧郁特征抑郁症可能是抑郁症更为严重的一种亚型；伴忧郁特征抑郁症患者客观睡眠指标可能更易受到环境、生活习惯和生活方式等其他因素影响，因而伴忧郁特征抑郁症患者的睡眠问题治疗中需纳入更多的生活和环境因素，培养良好的生活习惯和生活方式。更多还原

【Abstract】 Objective To compare the differences in objective sleep indicators and related factors between melancholic features patients with and non-melancholic features patients. Methods Fifty patients with depression were evaluated using the depressive feature module of the brief international neuropsychiatric interview(MINI 5.0) on December 1, 2021～November 28, 2022, and the patients were divided into a group with melancholic features(27 cases) and a group with non-melancholic features(23 cases). and the Mann-Whitney U rank sum test was used to compare the demographic data,Hamilton depression scale-17(HAMD-17)scores, objective sleep indicators, and living habits and lifestyle differences between the two groups;Kendall harmony coefficient was used to analyze the objective sleep structure indicators and living habits, lifestyle correlations. Results Patients with depression with melancholic features had a higher severity of clinical symptoms(P<0.001). There was no significant difference in objective sleep indicators between the two groups. Sleep time in patients with melancholic features was associated with HAMD-17 scores, milk drinking(P<0.05),sleep efficiency was associated with marital status and milk drinking(P<0.05), the proportion of sleep in the R phase was related to the family residence, sedentary and inactive time per day(P<0.001), and the proportion of N1 phase was related to the family residence(P<0.05), N3 period proportion was associated with education level and HAMD-17 scores(P<0.05), REM duration was associated with sedentary and inactive time per day(P<0.001), NREM duration was associated with BMI, marital status and computer/mobile phone use before bed(P<0.05) SWS duration correlated with educational attainment and HAMD-17 scores(P<0.05). The proportion of patients with melancholic depressive disorder in N2 stage was related to education level and family residence(P<0.05), the proportion of stage R was related to education level and family residence(P<0.05), and the duration of REM was related to education level and family residence(P<0.001), sleep latency was associated with HAMD-17 scores(P<0.05).Conclusion Depression with melancholic features may be a more severe subtype of depression; the objective sleep indicators of patients with depression with melancholic characteristics may be more susceptible to other factors such as environment,living habits and lifestyle, so that more life and environmental factors should be included in the treatment of sleep problems in patients with depression with melancholic characteristics, and good living habits and lifestyles should be cultivated.更多还原