Sleep Medicine and Psychophysiology (수면정신생리)

KOREAN ACADEMY OF SLEEP MEDICINE (대한수면의학회)
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The Sleep Characteristics of Chronic Schizophrenia Patients with Insomnia in Community-based Mental Health Services

지역사회 정신보건 서비스를 이용하는 불면증을 동반한 만성 조현병 환자의 수면의 특징

  • Hwang, Dong-Ki (Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital) ;
  • Nam, Min (Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital) ;
  • Lee, Yu-Jin G. (Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital)
  • 황동기 (서울특별시 은평병원 정신건강의학과) ;
  • 남민 (서울특별시 은평병원 정신건강의학과) ;
  • 이유진 (서울특별시 은평병원 정신건강의학과)
  • Received : 2017.07.18
  • Accepted : 2017.09.13
  • Published : 2017.12.31
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Abstract

Objectives: To evaluate sleep characteristics and factors associated with sleep disturbance in schizophrenia patients with concurrent active psychotic symptoms and insomnia. Methods: Schizophrenia patients with insomnia and active psychotic symptoms (n = 63) were recruited from community-based mental rehabilitative facilities. Sleep scales such as the Korean version of the Insomnia Severity Index (ISI-K) and the Korean Version of the Pittsburgh Sleep Quality Index (PSQI-K) were evaluated and those with ISI-K >15 were included in the study. Psychotic, anxiety and depressive symptoms were rated with the Brief Psychotic Rating Scale (BPRS), the Korean Version of the Anxiety Sensitivity Index (K-ASI), and the Korean Version of the Beck Depression Inventory-I (K-BDI), respectively. Pearson correlation analyses were performed between the sociodemographic data, ISI-K and PSQI-K. Multiple linear regression analysis was conducted to investigate the factors which affected the ISI-K and PSQI-K. Results: The mean ISI-K and PSQI-K scores were $18.1{\pm}2.6$ and $12.0{\pm}2.2$, respectively. Pearson correlation analysis showed a negative correlation between age of onset and ISI-K score and positive correlations between BRPS and PSQI-K scores and between K-ASI and both ISI-K and PSQI-K scores. Multiple regression analyses for both ISI-K and PSQI-K with K-ASI, age of onset, and BPRS as covariates revealed K-ASI as the only significant remaining factor. Conclusion: Our study suggests that anxiety symptoms are associated with insomnia symptoms in schizophrenia patients regardless of depressive or psychotic symptoms.

목 적 : 본 연구의 목적은 불면증과 정신병적 증상이 지속되는 조현병 환자의 수면 장애와 연관된 요인과 수면의 특징을 평가하는 것이다. 방 법 : 지역사회 정신보건 시설에 거주 중이며 불면증과 정신병적 증상이 동반된 조현병 환자들이 참여하였다(n = 63). The Korean version of Insomnia Severity Index (ISIK)와 the Korean Version of Pittsburgh Sleep Quality Index (PSQI-K)와 같은 수면 척도가 평가되었고, ISI-K 점수가 15점 이상인 대상자들이 연구에 참여하였다. 정신병적, 불안, 우울 증상은 각각 Brief Psychotic Rating Scale (BPRS), the Korean Version of Anxiety Sensitivity Index (K-ASI) 그리고 the Korean Version of Beck Depression Inventory-I(K-BDI)로 평가하였다. 사회인구학적 자료와 ISI-K 그리고 PSQI-K 사이의 상관관계를 확인하기 위해 Pearson correlation analysis를 시행하였다. ISI-K와 PSQI-K에 영향을 미치는 각각의 요인을 확인하기 위하여 다중회귀분석으로 분석하였다. 결 과 : ISI-K와 PSQI-K의 평균 점수는 각각 $18.1{\pm}2.6$점과 $12.0{\pm}2.2$점이었다. Pearson correlation analysis 결과에서 발병 연령과 ISI-K사이의 음의 상관관계와 BPRS와 PSQI-K 사이, K-ASI와 모든 수면 척도 사이의 양의 상관관계를 확인하였다. ISI-K와 PSQI-K에 대해 K-ASI와 발병연령, K-ASI와 BPRS를 각각 단계적으로 입력한 모든 다중회귀분석에서 K-ASI만이 유의한 요인으로 남았다. 결 론 : 본 연구는 조현병 환자의 불면 증상이 우울 또는 정신병적 증상과 무관한 반면, 불안 증상과 관련이 있다는 점을 제안한다.

Keywords

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