【摘要】 目的 了解安徽省育龄夫妇日间嗜睡与抑郁症状现况，并探讨两者之间的关系。方法 依托育龄夫妇生殖健康-安徽队列（RHCC-AC）子队列新婚夫妇队列开展，在安徽省南部、中部和北部地区共15个区县妇幼保健计划生育服务中心招募夫妇共33 483对，其中夫妇双方问卷均收集的共32 301对。本研究排除纳入时已怀孕的7 541对夫妇，重要信息缺失的517对夫妇，将未怀孕的24 232对夫妇纳入分析，描述夫妇双方一般情况、日间嗜睡状况和抑郁症状检出情况。通过主客体互倚模型，分析夫妇双方日间嗜睡和抑郁症状之间的关联。结果 安徽省育龄夫妇中男性轻度及中度日间嗜睡、重度日间嗜睡的检出率分别为24.4%、3.8%，女性的检出率分别为28.7%、5.5%。男性轻度及中度抑郁症状、重度抑郁症状的检出率分别为16.1%、2.9%，女性分别为19.8%、4.7%。Pearson相关分析显示，女方的日间嗜睡评分与自身及男方的抑郁症状评分均成正相关，与男方的日间嗜睡评分也呈正相关，男方的嗜睡程度与本身及女方的抑郁程度也均成正相关；此外，女方的抑郁程度与男方的抑郁程度呈正相关。广义线性回归模型分析显示男女双方抑郁症状变化程度均与日间嗜睡程度呈正向关联，男性中OR值（95%CI）分别为1.49(1.41～1.58)、3.15(2.96～3.34)，女性中OR值（95%CI）分别为1.66(1.57～1.75)、3.51(3.33～3.68)。主客体互倚模型显示妻子和丈夫的日间嗜睡均能够预测自身的抑郁症状程度[β(95%CI)=0.437(0.317～0.557),P<0.01]，即主体效应明显；在客体效应方面，妻子和丈夫的日间嗜睡均能够预测对方的抑郁症状程度[β(95%CI)=0.067(0.031～0.102)、0.087(0.051～0,122),P均<0.01]。结论安徽省育龄夫妇日间嗜睡程度与抑郁症状严重程度呈正向关联，且夫妇双方相互影响。该结果提示在进行治疗干预时，不能仅限于关注某一个体，更应该从系统的角度评估夫妻双方，及时解决夫妇的需求，从而降低双方抑郁的发生率，减轻抑郁症状。更多还原

【Abstract】 Objective To explore the relationship between daytime sleepiness and depressive symptoms in couples of childbearing age in Anhui Province using the actor-partner interdependence model. Methods Based on Reproductive Health of Childbearing age Couples-Anhui Cohort(RHCC-AC) sub-cohort of newlyweds’ cohort, a total of 33 483 couples were recruited from 15 districts and counties in southern, central, and northern Anhui Province, of which 32 301 couples were both surveyed. The study excluded 7 541 couples who were already pregnant, 517 with missing vital information, and 24 232 eligible couples who were not pregnant were included. The general situation, daytime sleepiness, and depressive symptoms of the couples were collected. The interaction between daytime sleepiness and depressive symptoms in couples was analyzed us-ing the actor-partner interdependence model. Results The detection rates of mild and moderate, severe daytime sleepiness were 24.4% and 3.8% in males and 28.7% and 5.5% in females, respectively. The detection rates of mild and moderate, se-vere symptoms of PHQ-9 screening were 16.1% and 2.9% in males and 19.8% and 4.7% in females, respectively. Pearson correlation analysis showed that the woman’s daytime sleepiness score was positively correlated with her own and the man ’s depression symptom score, and it was also positively correlated with the man ’s daytime sleepiness score. The man’s sleepiness level was also positively correlated with his own and the woman’s depression degree. In addition, women’s depression levels were positively correlated with men/s depression levels. The results of generalized linear regression analysis showed a positive linear correlation between changes in depression and daytime sleepiness. The OR values(95%CI) were 1.49(1.41-1.58) and 3.15(2.96-3.34) in males and 1.66(1.57-1.75) and 3.51(3.33-3.68) in females, respectively. Based on actor-partner interdependence model, it was found that both wife and husband’s daytime sleepiness could significantly predict depression symptoms [β(95%CI)=0.437(0.317-0.557), P<0.01], with the actor effect being significant. In terms of partner effect,both wife and husband’s daytime sleepiness could predict each other’s depressive symptoms [β(95%CI)=0.067(0.031-0.102), 0.087(0.051-0.122), all P<0.01]. Conclusion Daytime sleepiness is positively correlated with the severity of depressive symptoms, and the couples influence each other mutually. The results suggest that the therapeutic intervention should not only focus on one individual but also evaluate the needs of both spouses from a systematic point of view, so as to reduce the incidence of depression in both spouses and relieve symptoms of depression.更多还原