bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2025-4-2-1195bekhterev-1248Research ArticleИССЛЕДОВАНИЯINVESTIGATIONSОценка взаимосвязи ангедонии, качества сна и влечения к алкоголю у пациентов с алкогольной зависимостью и коморбидной депрессиейAssessment of the relationship between anhedonia, sleep quality and alcohol craving in patients with alcohol dependence and comorbid depressionhttps://orcid.org/0000-0003-1797-1121РыбаковаК. В.RybakovaK. V.

Рыбакова Ксения Валерьевна - д.м.н., зам. руководителя Института Аддиктологии

192019, Санкт-Петербург, ул. Бехтерева, 3

Kseniia V. Rybakova   

St. Petersburg

kvrybakova@yandex.ruВязоваА. И.VyazovaA. I.

Вязова Анастасия Игоревна - младший научный сотрудник Института Аддиктологии

192019, Санкт-Петербург, ул. Бехтерева, 3

Anastasiia I. Vyazova   

St. Petersburg

tni.spb@mail.ruhttps://orcid.org/0000-0003-2110-5525ГончаровО. В.GoncharovO. V.

Гончаров Олег Валерьевич - к.м.н., старший научный сотрудник Института Аддиктологии

192019, Санкт-Петербург, ул. Бехтерева, 3

Oleg V. Goncharov   

St. Petersburg

ovg2804@gmail.comhttps://orcid.org/0000-0002-8391-4953СкуратЕ. П.SkuratE. P.

Скурат Евгения Петровна - биостатистик

192019, Санкт-Петербург, ул. Бехтерева, 3

Evgeniia P. Skurat  

St. Petersburg

skuratevgenia@gmail.comhttps://orcid.org/0000-0002-5274-0137БерезинаА. А.BerezinaA. A.

Березина Анна Андреевна - младший научный сотрудник Института Аддиктологии

192019, Санкт-Петербург, ул. Бехтерева, 3

Anna A. Berezina   

St. Petersburg

aneta.berezina@gmail.comhttps://orcid.org/0000-0001-6162-1511КлимановаС. Г.KlimanovaS. G.

Климанова Светлана Георгиевна - научный сотрудник Института Аддиктологии

192019, Санкт-Петербург, ул. Бехтерева, 3

Svetlana G. Klimanova   

St. Petersburg

svetlanagk@mail.ruhttps://orcid.org/0000-0002-0529-4525КрупицкийЕ. М.KrupitskyE. M.

Крупицкий Евгений Михайлович - доктор медицинских наук, профессор, заместитель директора по научной работе и руководитель Института Аддиктологии; директор Института фармакологии им. А.В. Вальдмана

192019, Санкт-Петербург, ул. Бехтерева, 3

197022, Санкт-Петербург, ул. Льва Толстого, 6-8

Evgeny M. Krupitsky

St. Petersburg

kruenator@mail.ruНациональный медицинский исследовательский центр психиатрии и неврологии им. В.М. БехтереваРоссияV.M. Bekhterev National Medical Research Centre for Psychiatry and NeurologyRussian FederationНациональный медицинский исследовательский центр психиатрии и неврологии им. В.М. Бехтерева; Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаРоссияV.M. Bekhterev National Medical Research Centre for Psychiatry and Neurology; I.P. Pavlov First St. Petersburg State Medical UniversityRussian Federation202510012026594-2109119Copyright © Рыбакова К.В., Вязова А.И., Гончаров О.В., Скурат Е.П., Березина А.А., Климанова С.Г., Крупицкий Е.М., 20262026Рыбакова К.В., Вязова А.И., Гончаров О.В., Скурат Е.П., Березина А.А., Климанова С.Г., Крупицкий Е.М.Rybakova K.V., Vyazova A.I., Goncharov O.V., Skurat E.P., Berezina A.A., Klimanova S.G., Krupitsky E.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/1248Актуальность

Актуальность: Коморбидность алкогольной зависимости (АЗ) и психических расстройств является широко распространенным явлением. Депрессивные расстройства, расстройства сна и ангедония повышают риск рецидива у пациентов с зависимостями. Цель исследования: Оценить взаимосвязь между ангедонией, качеством сна и влечением к алкоголю у пациентов с АЗ и коморбидной депрессией, являющихся плацебо нонреспондерами, на визите рандомизицации в исследование эффективности и безопасности применения антидепрессанта агомелатин для стабилизации ремиссии у больных с алкогольной зависимостью с коморбидными депрессивными расстройствами. Дизайн исследования. Проведено кроссекционное исследование 100 больных алкогольной зависимостью (F10.2). Оценивались уровень влечения к алкоголю, нарушения сна, уровень социального функционирования, депрессии и тревоги, клинико-анамнестические сведения. Результаты. Выявлено, что уровень депрессии по шкале Монтгомери-Асберг обратно коррелировал со шкалой социального функционирования (ρ-Спирмена = - 0,416; p = 0,000). Индекс качества сна прямо коррелировал с уровнем влечения к алкоголю (ρ-Спирмена = 0,371; = 0,366; =0,356; p=0,000). Дисфункциональные убеждения относительно сна прямо коррелировали с подшкалой «удовольстие от жизни» шкалы ангедонии Фергюсона (УЖФ) (ρ-Спирмена = 0,366; p = 0,000). Уровень влечения к алкоголю прямо коррелировал с выраженностью ангедонии по обеим подшкалам шкалы ангедонии Фергюсона (ШАФ): «интерес к жизни» (ИЖФ) и «удовольствие от жизни» (УЖФ): для Пенсильванской шкалы влечения к алкоголю (ПШВА) ρ-Спирмена = 0,287, p = 0,004 (ИЖФ); ρ-Спирмена = 0,368, p = 0,000 (УЖФ), для обсессивно-компульсивной шкалы влечения к алкоголю (ОКШВА) ρ- Спирмена = 0,276, p = 0,006 (ИЖФ); ρ-Спирмена = 0,254, p = 0,011 (УЖФ), для визуально-аналоговой шкалы влечения к алкоголю (ВАШВА) ρ-Спирмена = 0,266, p = 0,023 (ИЖФ); ρ- Спирмена = 0,227, p = 0,023 (УЖФ).

Выводы

Выводы. У пациентов с зависимостью от алкоголя нарушения сна были прямо связаны с влечением к алкоголю, которое в свою очередь коррелировало с уровнем ангедонии, что, учитывая влияние уровня ангедонии на рецидив аддиктивной патологии, подчеркивает необходимость их своевременной фармакологической коррекции для профилактики рецидивов зависимости.

Relevance

Relevance: Comorbidity of alcohol dependence (AUD) and mental disorders is a widespread phenomenon. Depressive disorders, sleep disorders, and anhedonia significantly increase the risk of relapse in patients with various addictions. Research Objective: To assess the relationship between anhedonia, sleep quality, and pathological alcohol craving in patients with AUD and comorbid depression who did not respond to placebo therapy at the randomization stage of a clinical trial. Research Design: A cross-sectional study was conducted involving 100 patients diagnosed with alcohol dependence (F10.2). The study evaluated several parameters, including the level of alcohol craving, sleep disturbances, social functioning levels, depression, anxiety, and clinical and anamnestic data. Results: The study revealed several significant correlations. The level of depression, as measured by the Montgomery-Asberg scale, showed an inverse correlation with the social functioning scale (Spearman’s ρ = -0.416; p = 0.000). The sleep quality index demonstrated a direct correlation with the level of alcohol craving (Spearman’s ρ = 0.371; 0.366; 0.356; p = 0.000). Dysfunctional beliefs about sleep showed a direct correlation with the “enjoyment of life” subscale of the Ferguson anhedonia scale (ρ-Spearman = 0.366; p = 0.000). The level of alcohol craving also showed a direct correlation with the severity of anhedonia on both subscales of the Ferguson anhedonia scale. Specifically: for PSVA: Spearman’s ρ = 0.287, p = 0.004 (ILF); ρ = 0.368, p = 0.000 (ELF), for OCSVA: Spearman’s ρ = 0.276, p = 0.006 (ILF); ρ = 0.254, p = 0.011 (ELF), for VASVA: Spearman’s ρ = 0.266, p = 0.023 (ILF); ρ = 0.227, p = 0.023 (ELF).

Conclusions

Conclusions: The findings indicate that in patients with alcohol dependence, sleep disorders were directly associated with alcohol craving, which in turn correlated with the level of anhedonia. Considering the significant impact of anhedonia levels on the relapse of addictive pathology, these results emphasize the critical need for timely pharmacological intervention to prevent relapse and maintain dependence remission.

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