Antidepressant response to partial sleep deprivation in unipolar depression is not related to state anxiety

The effect of sleep deprivation and restriction on mood, emotion, and emotion regulation: three meta-analyses in one

STUDY OBJECTIVES

New theory and measurement approaches have facilitated nuanced investigation of how sleep loss impacts dimensions of affective functioning. To provide a quantitative summary of this literature, three conceptually related meta-analyses examined the effect of sleep restriction and sleep deprivation on mood, emotion, and emotion regulation across the lifespan (i.e. from early childhood to late adulthood).

METHODS

A total of 241 effect sizes from 64 studies were selected for inclusion, and multilevel meta-analytic techniques were used when applicable.

RESULTS

There was a moderate, positive effect of sleep loss on negative mood (g = 0.45), which was stronger for studies with younger samples, as well as a large, negative effect of sleep loss on positive mood (g = -0.94). For negative mood only, studies that used total sleep deprivation had larger effect sizes than studies that restricted sleep. After correcting for publication bias, a modest but significant negative effect for sleep loss on emotion (g = -0.11) was found; the valence of emotional stimuli did not change the direction of this effect, and type of sleep manipulation was also not a significant moderator. Finally, sleep restriction had a small, negative effect on adaptive emotion regulation (g = -0.32), but no significant impact on maladaptive emotion regulation (g = 0.14); all studies on adaptive emotion regulation were conducted with youth samples.

CONCLUSIONS

Sleep loss compromises optimal affective functioning, though the magnitude of effects varies across components. Findings underscore the importance of sleep for healthy affective outcomes.

Evaluation of psychometric properties of the Chinese Mandarin version State-Trait Anxiety Inventory Y form in Taiwanese outpatients with anxiety disorders

This study was conducted to develop the Chinese Mandarin State-Trait Anxiety Inventory Y form and to evaluate its psychometric properties among Taiwanese outpatients with anxiety disorders. A three-phase survey questionnaire was used to gather cross-sectional data. Non-hospitalized adults (n= 306) with anxiety disorders were recruited from mental health clinics in central Taiwan. Cronbach's alpha reliabilities for the state and trait anxiety subscales were 0.91 and 0.92, respectively. The 2-week test-retest reliabilities for the state and trait anxiety subscales were 0.76 and 0.91, respectively. Criterion validity of the scale was supported by its high correlations with the interview version of the Chinese Hamilton Anxiety Rating Scale (r= 0.69 for state and 0.74 for trait anxiety). Construct validity of the scale was confirmed by a four-factor structure, showing slightly adequate representation of the data. The scale was shown to be reliable and may be valid for measuring anxiety in Taiwanese adults with anxiety disorders.

The influence of daytime napping versus controlled activity on the subjective well-being of patients with major depression

While the impact of sleep on cognitive functions such as memory is under extensive study, the role of sleep in modulating a persons' subjective well-being remains largely uncharacterized, especially in groups with psychiatric disorders. To gather more information on this topic a study was conducted with 20 patients suffering from Major Depression (MD) and 20 healthy controls, matched for age, gender and education. All subjects rated their subjective well-being at 10a.m. in the morning. Half of the subjects in each experimental group were given the opportunity to nap in the afternoon between 2p.m. and 3.30p.m., while the other half stayed awake accompanied by controlled activity. All subjects rated their subjective well-being again at 4p.m. Only the group of patients with MD who were given the opportunity to sleep during the day showed a significant improvement in subjective well-being from morning to afternoon. All the other subgroups showed no significant changes across the time interval. The results of this study suggest that depressive patients benefit from daytime naps with regard to their subjective well-being. Further research is needed to determine the exact mechanisms of this improvement.

[Affective disorders and biological rhythms]

Disruptions of circadian rhythms are described in affective disorders, including unipolar and bipolar disorder, but also seasonal affective disorder. Sleep-wake and hormone circadian rhythms are among the most quoted examples. Depression could be conceptualized as a desynchronization between the endogenous circadian pacemaker and the exogenous stimuli, such as sunlight and social rhythms. Accordingly, Clock genes have been studied and the literature suggests that variants in these genes confer a higher risk of relapse, more sleep disturbances associated with depression, as well as incomplete treatment response. Most of therapeutic interventions in depression have an impact on biological rhythms. Some of them exclusively act via a biological pathway, such as sleep deprivation or light therapy. Some psychosocial interventions are specifically focusing on social rhythms, particularly in bipolar disorder, in which the promotion of stabilization is emphasized. Finally, all antidepressant medications could improve biological rhythms, but some new agents are now totally focusing this novel approach for the treatment of depression.