Subjective Sleep Quality And Risk Factors Of Patients With Major Depressive Disorder In Community

Objective:The objectives of this study were to describe the subjective sleep quality of patients with depression in community and analyze related risk factors.Methods:The data were collected from the epidemiological survey of mental disorders in Tianjin in 2011.A multi-stage and proportional probability sampling method was used to randomly select 15538 residents aged?18 years and living time?3months in 18 districts and counties of Tianjin as interviewees.In the first stage,the risk grade of mental disorder was evaluated by general health questionnaire and 8mental disorder scanning questions,the subjective sleep quality was measured by Pittsburgh Sleep quality Index questionnaire.According to the screening results,the interviewees were classified as high,medium and low risk levels of mental disorders.Then,100%high-risk group,40%medium-risk group and 10%low-risk group were randomly selected for diagnostic assessment by SCID-I/P.Finally,4438 people(97.3%)completed the survey,439 people suffered from major depressive disorder,of which 157 were Current depressive episode.Using Chi-square test to analyze the subjective sleep quality of different groups,the effect of depressive symptoms on subjective sleep quality in patients with depression by Nonparametric Mann-Whitney U test;Logistic regression was adopted to analyze risk factors of subjective sleep quality in patients with major depression.Statistical significance was evaluated using two-sided design-based tests and the p<0.05 level of significance.Results:1.The sleep quality of patients with current major depressive disorder was poor than patients with previous major depressive disorder(27.9%vs.9%,?~2=36.022,p<0.001),and low sleep efficiency(11%vs.6.1%,?~2=9.040,P=0.029),short sleep time(9.1%vs.3.9%,?~2=18.934,P<0.001=,long sleep latency(37.7%vs.29%,?~2=13.188,P=0.004),sleep disturbance is common(21.4%vs.10.8%,?~2=12.898,P=0.005),Daytime dysfunction is obvious(35.7%vs.14.3%,?~2=31.558,P<0.001).2.There were significant differences in PSQI scores between the patients with positive(95)vs.negative(61)(Z=2.198,P=0.028)of psychomotor agitation or hysteresis symptoms and those with positive(85)vs.negative(72)(Z=3.335,P=0.001)of suicidal ideation or attempted symptoms in patient with current major depressive disorder.There was a significant difference in PSQI scores between patients with fatigue or energy deficiency symptoms positive(226)and negative(50)(Z=2.382,P=0.017)in patient with previous major depressive disorders.3.In patients with current major depressive disorder,marriage(OR=0.250,95%CI=0.082~0.757)is the protective factor of subjective sleep quality,while smoking(OR=0.372,95%CI=0.143~0.969),psychomotor agitation or retardation(OR=2.348,95%CI=1.018~5.413),suicidal ideation or attempted(OR=2.735,95%CI=1.049~7.132)are the risk factors of subjective sleep quality.Among the patients with previous major depressive disorder,living in rural(OR=2.212,95%CI=1.039~4.711)and high years of education(13?~:OR=7.860,95%CI=2.254~27.410)were the protective factors of sleep quality,no work(OR=0.458,95%CI=0.227~0.921)and GHQ?4(OR=0.241,95%CI=0.132~0.439)were the risk factors of subjective sleep quality.Conclusion:1.Patients with major depressive disorder have poor subjective sleep quality,prolonged sleep latency,short duration,low sleep efficiency,sleep disturbance and daytime dysfunction.After the depressive symptoms of patients with previous major depressive disorder resolved,Sleep problems sustain.2.This study found that marriage is a protective factor for subjective sleep quality in patients with current major depressive disorder,and smoking,psychomotor agitation or retardation,and suicidal ideation or behavior are risk factors for subjective sleep quality.For the people with previous major depressive disorder,living in rural and high years of education is the protective factor of their subjective sleep quality,but no work,poor mental health status is the risk factor of sleep quality.