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Yıl:2012; Cilt: 2; Sayı: 1>> Özet
TAM METİN
Journal of Mood Disorders; 2012;2(1):28-33
Uykusuzluk ve majör depresif bozukluk arasındaki bağlantı: Bir tavuk ve yumurta durumu mudur?
M Gulec, H Ozcan, E Oral, Y Selvi, A Aydin
Atatürk Üniversitesi Tıp Fakültesi, Erzurum
Majör depresif bozukluk (MDB) çok yaygın, şiddetle güçsüz düşürücü ve sıklıkla da yineleyicidir. MDB'li bireylerin önemli bir kısmı uyku düzensizliklerinden yakınırlar. MDB aynı zamanda çeşitli uyku bozukluklu kitleler arasında fazla miktarda temsil edilmektedir. Uyku düzensizlikleri MDB'nin tipik özelliklerinden olsa da, böyle belirtiler bazen bir MDB döneminden önce ortaya çıkarlar. Uyku düzensizliği, özellikle de uykusuzluk ile MDB arasındaki çift yönlü ilişkiler, aralarındaki neden-sonuç bağlantılarının kurulmasını güçleştirmektedir. Uzunlamasına çalışmalar uykusuzluğu sürekli olarak yeni başlangıçlı ya da yineleyici bir MDB gelişimi için bir risk etmeni olarak tanımlamışlar ve bu ilişki genç, orta yaşlı ve hatta yaşlı erişkinlerde gösterilmiştir. Araştırmalar uykusuzluk ve depresyon birlikteliğinin aynı zamanda dönem şiddeti ve süresi yanında alevlenme oranlarını da artırarak MDB'nin seyrini etkilediğini gözlemlemişlerdir. Ancak yakın tarihli çalışmalar uykusuzluk için gerek ilaçla gerekse de ilaç dışındaki müdahalelerin MDB'yi uygun bir şekilde azaltabileceği ve belki de önleyebileceğini göstermişlerdir. Bu bulguların tümü birden uyku ile ilişkili belirtilerin ister bir MDB dönemi öncesinde, isterse de sırasında ve/veya sonrasında olsunlar, düzelme halinin sağlanması ve sürdürülmesinde önemli bir rol oynayabilecek büyük olasılıkla da değiştirilebilir etmenler olduklarını ileri sürülmüştür.
The relationship between insomnia and major depressive disorder: a chicken and egg situation?
Major Depressive Disorder (MDD) is highly prevalent, severely debilitating, and often recurrent. The majority of individuals with MDD experience sleep disturbances. MDD is also over-represented in populations with a variety of sleep disorders. Although sleep disturbances are typical features of MDD, such symptoms sometimes appear prior to an episode of MDD. The bidirectional association between sleep disturbance, especially insomnia and MDD, increases the difficulty of differentiating cause-and-effect relationship between them. Longitudinal studies have consistently identified insomnia as a risk factor for the development of a new-onset or recurrent MDD, and this association has been identified in young, middle-aged, and even older adults. Researches have also observed that the combination of insomnia and depression influences the trajectory of MDD, increasing episode severity and duration, as well as relapse rates. Fortunately, recent studies have demonstrated that both pharmacological and non-pharmacological interventions for insomnia may favourably reduce and possibly prevent MDD. Together, these findings suggest that sleep-related symptoms that are present before, during, and/or after a major depressive episode are potentially modifiable factors that may play an important role in achieving and maintaining remission of depression.

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