The Clinical Characteristics And The Polysomnography Study Of Unipolar And Bipolar Depression

Unipolar depression is a kind of psychiatric disorders characterized by depressed mood.Its clinical syndromes incluing depressed mood,retardation,reduction of movement and speech,lose of interest in job,and so on.Bipolar depression , is also a serious diseases with high morbidity mortality. It is difficult to identificated the two affective disorders. According to the literatures home and abroad ,about 40% of bipolar depression patients were misdiagnosed as unipolar depression,so misdiagnosis of unipolar depression episode is more often the case . Single use of antidepressant for bipolar depression will increase the risk of switching to manic episode and the possibility of developing to rapid cyclicaltype ,which will make the clinical tharapy much complicated. Most researches supported that there existed a significant difference between the two on pathogenesis so they were considered to be two kinds of essentially different diseases.Sleep disorders is an important component of self-rating scale of depressive syndrome which is one of the common clinical symptoms in the early period of depression. Some studies on sleep involving the etiology of depression ,but the mechanism is unclear . At present,studies of sleep on mental disorder are mainly concentrated on unipolar depression,bipolar depression are seldom studied.The relationship between affective disorder and OSAS is not clear,the reports is too limited and controversy.it's reported that The prevalence of sleep apnea syndrome among affective disorder patients is relatively high ,but some preferssor rejected.. Some studies found that the low blood oxygen saturation was related with the relatively high of depression score, specially for women.Polysomnogram ,is refered to by recording the physiological signals ,such as EEG , EMG, respiration , blood oxygen during the whole night sleep ,then obtainning the concrete data of dynamic changes after analysising . It is an important tool for study of sleep structure and the sleep-breathing rhythms.Objective This study is to investigate the characterizations of unipolar and bipolar depressionand the sleep electroencephalogram and the sleep-breathing rhythms.Method Object;Study Group: 21 hospitalized or out-patients patients with UD or BD in the Department of Guangzhou psychiatry hospital during 2008-2010. Control group: 6 healthy people.Method:1 Depressive and Anxiety emotion was evaluated with HAMD-24 edition.2 Using polysomnogram to record the whole night sleep in order to evaluate the sleep state3The subject sleep is evaluated with PSQIStastic analysis:T test for the numerical variable data of the Gaussian distribution, rank sum test for the numerical variable data of the nonnormal distribution, and Chi-square test for categorical variable data: statistical significance was designated at P<0.05. Multiple linear regression analysis in PSG,HAMD,HAMA and AHI.ResultsThe results :1 general data:Thera are no sexual differences between the depression group and control group.(P>0.05). Thera are significant differences in age between the depression group and control group.(P>0.05). There are significant differences in age onset between unipolar depression group and bipolar depression group(P<0.05),and There are no significant differences in duration between unipolar depression group and bipolar depression group.(P>0.05)2Clinic characteristics: 2.1As compared with the bipolar depression group,the unipolar depression group demonstrate statistical differences in somato scores,no statistical difference in cognition disturbance scores,day-night change,retarded scores,sleep disturbance scores,hopelessness scores,HAMD total score。As compared with the control group,the study group demonstrate significant differences (P>0.05)in somato scores,cognition disturbance scores,day-night change scores,retarded scores,sleep disturbance scores,hopelessness scores,HAMD total score ,no differences in weight change scores.2.2As compared with the control group,the study group depression demonstrate significant differences (P>0.05)in somato scores, no differences in cognition disturbance scores,day-night change scores,retarded scores,sleep disturbance scores,hopelessness scores,HAMD total score. There are significant differences in somatization between the unipolar and bipolar depression group .2.3As compared with the control group, the study group depression demonstrate significant differences (P>0.05)in PSQI. There are no differences in somato scores between the unipolar and bipolar depression group .2.4 Somato scores is significant with subjective sleep quality daytime function , weight change scores is significant with subjective sleep quality in unipolar depression group.2.5 Somato scores is significant with sleep daytime dysfunction in bipolar depression group .3 Polysomnogram:3.1There are significant differences in SE,SL,REM,REM%,REML between the study group and control group.(P<0.05)。There are significant differences in SL,S1,SWS,REM,S1%,SWS%,REM%,SE between the unipolar depression group between the control group. There are significant differences in AT,SE between bipolar depression group and control group. There are significant differences in SWS,SWS% between unipolar depression group and bipolar depression group.3.2There are significant differences in SE,REM,SWS%,REM% between female patients and male patients in the study group.,There are significant differences in TST,SPT,AHI,REM%,between female and male s in the control group.3.3 As unipolar depression is concerned,sleep disorder fact is significant with REM,REML;hopelessness scores is significant with REML;somatization is significant with REM,S2%,REML; HAMA total score is significant with S1,S2%,REM;sleep onset time is significant with TRT,TST,SE,AT,AT/TST,SPT,S2,S2%.sleep efficiency is significant with TRT,sleep disturbance is significant with S2,S2%.3.4 As bipolar depression is concerned, PSQI total score is significant with SPT,SE,AT,AT/TST,S2%,REM. subjective sleep quality is significant with SPT,SE,S2,AT,AT/TST,S2%;sleep onset time is significant with SPT,SE,S2,AT,AT/TST,S2%;sleep duration is significant with SPT,SE,REM,AT,AT/TST;sleep efficiency is significant with SWS,REM%,sleep disturbance is significant with S2%;sleep disturbance is significant with SE,S1,S2%,SWS,AT,AT/TST,S2%;sleep daytime dysfunction is significant with SPT,SE,REM,AT,AT/TST,S2%.4 AHI is significant with somato scores,retarded scores,day-night change scores ;hypopnea is significant somato scores,retarded scores,day-night change scores and cognition disturbance scores.Conclusion1 The characteristics of both unipolar and bipolar depression are different.2 Compared with the control group,the changes of polysomnogram of both unipolar and bipolar depression are characteristic. However,compared to the unipolar depression group ,the bipolar depression have not demonstrate too much differences .4 The sleep disturbance of the unipolar and bipolar depression patients is significant with the depression and anxiety symptoms.