Qualidade de sono na conversão diagnóstica do transtorno depressivo maior para o transtorno bipolar

Abstract

Studies that investigate the diagnostic conversion to bipolar disorder (TB) are important to define the appropriate treatment for young adults with major depressive disorder (MDD). There is sufficient data to suggest that individuals with bipolar disorder suffer more frequently from sleep disorders. Since sleep is a crucial process for affective stability, disturbed sleep can be a risk factor for the subsequent occurrence of bipolar disorder. Using data from the 2nd phase of a cohort of young adults, this study tests the hypothesis that sleep disturbs the risk factor for the occurrence of bipolar disorder. Thus, the objective was to investigate the risk factors associated with the conversion of MDD to TB in a clinical sample of patients. The diagnosis of MDD and BD was conducted through the Mini International Neuropsychiatric Interview-Plus and the sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI-BR). The conversion rate from MDD to BD was 12,4%. Demographic risk factors for a change from MDD to BD included female, non-caucasian ethnicity and low schooling level. After adjusting for possible confounding factors, the diagnostic conversion was significantly associated with short sleep duration (P= .045), disrupted sleep efficiency (P = .042) and sleep disturbances (P = .037) when compared with non-converted. The evidence shown in this study is consistent with the general hypothesis of sleep instability in TB subjects and suggests that conversion-associated sleep disorders are not limited to acute episodes.