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Piccin J, Viduani A, Buchweitz C, Pereira RB, Zimerman A, Amando GR, Cosenza V, Ferreira LZ, McMahon NA, Melo RF, Richter D, Reckziegel FD, Rohrsetzer F, Souza L, Tonon AC, Costa-Valle MT, Zajkowska Z, Araújo RM, Hauser TU, van Heerden A, Hidalgo MP, Kohrt BA, Mondelli V, Swartz JR, Fisher HL, Kieling C. Prospective Follow-Up of Adolescents With and at Risk for Depression: Protocol and Methods of the Identifying Depression Early in Adolescence Risk Stratified Cohort Longitudinal Assessments. JAACAP OPEN 2024; 2:145-159. [PMID: 38863682 PMCID: PMC11163476 DOI: 10.1016/j.jaacop.2023.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 06/13/2024]
Abstract
Objective To present the protocol and methods for the prospective longitudinal assessments-including clinical and digital phenotyping approaches-of the Identifying Depression Early in Adolescence Risk Stratified Cohort (IDEA-RiSCo) study, which comprises Brazilian adolescents stratified at baseline by risk of developing depression or presence of depression. Method Of 7,720 screened adolescents aged 14 to 16 years, we recruited 150 participants (75 boys, 75 girls) based on a composite risk score: 50 with low risk for developing depression (LR), 50 with high risk for developing depression (HR), and 50 with an active untreated major depressive episode (MDD). Three annual follow-up assessments were conducted, involving clinical measures (parent- and adolescent-reported questionnaires and psychiatrist assessments), active and passive data sensing via smartphones, and neurobiological measures (neuroimaging and biological material samples). Retention rates were 96% (Wave 1), 94% (Wave 2), and 88% (Wave 3), with no significant differences by sex or group (p > .05). Participants highlighted their familiarity with the research team and assessment process as a motivator for sustained engagement. Discussion This protocol relied on novel aspects, such as the use of a WhatsApp bot, which is particularly pertinent for low- to-middle-income countries, and the collection of information from diverse sources in a longitudinal design, encompassing clinical data, self-reports, parental reports, Global Positioning System (GPS) data, and ecological momentary assessments. The study engaged adolescents over an extensive period and demonstrated the feasibility of conducting a prospective follow-up study with a risk-enriched cohort of adolescents in a middle-income country, integrating mobile technology with traditional methodologies to enhance longitudinal data collection.
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Affiliation(s)
- Jader Piccin
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Anna Viduani
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Claudia Buchweitz
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Rivka B. Pereira
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Aline Zimerman
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Guilherme R. Amando
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Victor Cosenza
- Universidade Federal de Pelotas (UFPEL), Pelotas, Brazil
| | | | - Natália A.G. McMahon
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | | | - Danyella Richter
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Frederico D.S. Reckziegel
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Fernanda Rohrsetzer
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Laila Souza
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - André C. Tonon
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marina Tuerlinckx Costa-Valle
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Zuzanna Zajkowska
- King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
| | | | - Tobias U. Hauser
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, London, United Kingdom, Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom and with Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Alastair van Heerden
- Human and Social Development, Human Sciences Research Council, Pietermaritzburg, South Africa and Medical Research Council/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Maria Paz Hidalgo
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Valeria Mondelli
- King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
- National Institute for Health and Care Research Maudsley Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | | | - Helen L. Fisher
- King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, United Kingdom
- ESRC Centre for Society and Mental Health, King’s College London, London, United Kingdom
| | - Christian Kieling
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Prodia - Child & Adolescent Depression Program, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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Chan JW, Feng H, Zhang J, Chan NY, Li TMH, Chau SW, Liu Y, Li SX, Wing YK. Objective and subjective sleep in patients with non-seasonal major depressive disorder and eveningness - Results from a randomized controlled trial of bright light therapy. Sleep Med 2023; 112:132-140. [PMID: 37857115 DOI: 10.1016/j.sleep.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/06/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023]
Abstract
STUDY OBJECTIVES This study examines the (dis)agreement between objective and subjective sleep and their prospective changes in a randomized controlled trial of bright light therapy (BLT) in patients with major depressive disorder (MDD) and eveningness. METHODS A total of 93 adults were randomized to receive either 30-min daily of 10,000 lux BLT or 50lux placebo dim red light therapy (DRL group) for a total of 5 weeks. Actigraphic data were collected at the baseline and during the last week of treatment. (Dis)Concordance of diary and actigraphic sleep parameters were assessed by partial correlations and Bland-Altman plots, and the associations between these discrepancies to depression severity was assessed by linear regression models. Changes of sleep parameters were assessed by linear mixed models. RESULTS Significant correlations were found between subjective sleep timings and chronotype to actigraphic parameters. Discrepancies between diary- and actigraphic-measures were observed, and patients with more severe depressive symptoms were associated with a greater under-estimation of total sleep time (TST). A greater advance in the diary-based time to fall sleep and rise time were achieved in the BLT group as compared to the DRL group, while diary-based wake after sleep onset (WASO), TST and sleep efficiency (SE) comparably improved with time in both groups. There was no significant difference between the two groups in the actigraphic parameters after treatment. CONCLUSIONS In this study, we found that depression severity influenced subjective report of sleep. BLT led to a greater advance in subjective sleep timings when compared to the placebo group.
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Affiliation(s)
- Joey Wy Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Hongliang Feng
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medicine University, Guangzhou, Guangdong, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medicine University, Guangzhou, Guangdong, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Tim Man Ho Li
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Steven Wh Chau
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Yaping Liu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medicine University, Guangzhou, Guangdong, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region of China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
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3
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Tonon AC, Constantino DB, Amando GR, Abreu AC, Francisco AP, de Oliveira MAB, Pilz LK, Xavier NB, Rohrsetzer F, Souza L, Piccin J, Caye A, Petresco S, Manfro PH, Pereira R, Martini T, Kohrt BA, Fisher HL, Mondelli V, Kieling C, Hidalgo MPL. Sleep disturbances, circadian activity, and nocturnal light exposure characterize high risk for and current depression in adolescence. Sleep 2022; 45:6582017. [DOI: 10.1093/sleep/zsac104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/21/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study Objectives
Major depressive disorder (MDD) in adolescence is associated with irregularities in circadian rhythms and sleep. The characterization of such impairment may be critical to design effective interventions to prevent development of depression among adolescents. This study aimed to examine self-reported and actimetry-based circadian rhythms and sleep–wake behavior associated with current MDD and high risk (HR) for MDD among adolescents.
Methods
Ninety-six adolescents who took part in the IDEA-RiSCo study were recruited using an empirically developed depression-risk stratification method: 26 classified as low risk (LR), 31 as HR, and 39 as a current depressive episode (MDD). We collected self-report data on insomnia, chronotype, sleep schedule, sleep hygiene as well as objective data on sleep, rest-activity, and light exposure rhythms using actimetry for 10 days.
Results
Adolescents with MDD exhibited more severe insomnia, shorter sleep duration, higher social jetlag (SJL), lower relative amplitude (RA) of activity, and higher exposure to artificial light at night (ALAN) compared with the other groups. They also presented poorer sleep hygiene compared with the LR group. The HR group also showed higher insomnia, lower RA, higher exposure to ALAN, and higher SJL compared with the LR group.
Conclusions
HR adolescents shared sleep and rhythm alterations with the MDD group, which may constitute early signs of depression, suggesting that preventive strategies targeting sleep should be examined in future studies. Furthermore, we highlight that actimetry-based parameters of motor activity (particularly RA) and light exposure are promising constructs to be explored as tools for assessment of depression in adolescence.
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Affiliation(s)
- André Comiran Tonon
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
| | - Débora Barroggi Constantino
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
| | - Guilherme Rodriguez Amando
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
| | - Ana Carolina Abreu
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
| | - Ana Paula Francisco
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
| | - Melissa Alves Braga de Oliveira
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
| | - Luísa K Pilz
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
| | - Nicóli Bertuol Xavier
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
| | - Fernanda Rohrsetzer
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- Division of Child & Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil
| | - Laila Souza
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- Division of Child & Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil
| | - Jader Piccin
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- Division of Child & Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil
| | - Arthur Caye
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- Division of Child & Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil
| | - Sandra Petresco
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- Division of Child & Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil
| | - Pedro H Manfro
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Rivka Pereira
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- Division of Child & Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil
| | - Thaís Martini
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- Division of Child & Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil
| | - Brandon A Kohrt
- Division of Global Mental Health, Department of Psychiatry, School of Medicine and Health Sciences, The George Washington University , Washington, DC , USA
| | - Helen L Fisher
- King’s College London, Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience , London , UK
- ESRC Centre for Society and Mental Health, King’s College London , London , UK
| | - Valeria Mondelli
- King’s College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience , London , UK
- National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London , London , UK
| | - Christian Kieling
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Departament of Psychiatry, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- Division of Child & Adolescent Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA) , Porto Alegre , Brazil
| | - Maria Paz Loayza Hidalgo
- Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre/RS , Brazil
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Cederlöf E, Holm M, Lähteenvuo M, Haaki W, Hietala J, Häkkinen K, Isometsä E, Jukuri T, Kajanne R, Kampman O, Kieseppä T, Lahdensuo K, Lönnqvist J, Männynsalo T, Niemi-Pynttäri J, Suokas K, Suvisaari J, Tiihonen J, Turunen H, Wegelius A, Veijola J, Palotie A, Paunio T. Sleep in Psychotic Disorders: Results From Nationwide SUPER Finland Study. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac011. [PMID: 39144769 PMCID: PMC11206061 DOI: 10.1093/schizbullopen/sgac011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Objective Characterizing sleep in patients with schizophrenia, schizoaffective disorder, bipolar disorder, and psychotic depression. Methods This cross-sectional questionnaire study is based on the SUPER study sample, which is part of the Stanley Global Neuropsychiatric Genomics Initiative. The study is a multicentre, nationwide Finnish study consisting of patients (N = 8 623) both in primary and specialized health care. The main measurements were sleep duration, difficulties initiating sleep, early morning awakenings, and fatigue. These results were compared with a nationally representative sample of the Finnish population from the Health 2000 survey (N = 7 167) with frequency and logistic regression analyses. Results Patients had more sleep problems compared with the general population, especially young and middle-aged patients (Difficulties initiating sleep in young patients odds ratio = 12.3, 95% CI 9.8-15.4). Long sleep duration was the most deviating property of the sleep characteristics, being particularly common among young patients with schizophrenia (odds ratio = 27.9, 95% CI 22.1-35.2, 47.4% vs 3.3% prevalence). All sleep problems were associated with worse subjective health. We also conducted a latent class analysis, resulting in a cluster relatively free of sleep problems (58% of patients), an insomnia symptom cluster (26%), and a hypersomnia symptom cluster (15%). Conclusions In our sample, patients with psychotic disorders have more sleep problems-especially long sleep duration but also insomnia symptoms-compared with the general population. The patients can in a latent class analysis of their sleep symptoms be divided into groups with differing sleep profiles.
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Affiliation(s)
- Erik Cederlöf
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Minna Holm
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Markku Lähteenvuo
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
- Niuvanniemi Hospital, University of Eastern Finland, Finland
| | - Willehard Haaki
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Katja Häkkinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Erkki Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuomas Jukuri
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Risto Kajanne
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Olli Kampman
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Department of Psychiatry, University of Tampere, Tampere, Finland
| | - Tuula Kieseppä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kaisla Lahdensuo
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jouko Lönnqvist
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Männynsalo
- Social Services and Health Care Sector; City of Helsinki, Helsinki, Finland
| | | | - Kimmo Suokas
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Social Services and Health Care Sector; City of Helsinki, Helsinki, Finland
| | - Jaana Suvisaari
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jari Tiihonen
- Niuvanniemi Hospital, University of Eastern Finland, Finland
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, Stockholm, Sweden
| | - Hannu Turunen
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Asko Wegelius
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha Veijola
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Tiina Paunio
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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5
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Huang M, Bliwise DL, Hall MH, Johnson DA, Sloan RP, Shah A, Goldberg J, Ko YA, Murrah N, Levantsevych OM, Shallenberger L, Abdulbagki R, Bremner JD, Vaccarino V. Association of Depressive Symptoms with Sleep Disturbance: A Co-twin Control Study. Ann Behav Med 2021; 56:245-256. [PMID: 33991086 PMCID: PMC8887572 DOI: 10.1093/abm/kaab040] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Few studies have comprehensively evaluated the association of depression with sleep disturbance using a controlled twin study design. PURPOSE To cross-sectionally evaluate the association of depression with both objective and subjective sleep disturbance. METHODS We studied 246 members of the Vietnam Era Twin Registry. We measured depressive symptoms using the Beck Depression Inventory-II (BDI) and assessed major depression using structured clinical interviews. Twins underwent one-night polysomnography and 7-day actigraphy to derive measures of objective sleep and completed the Pittsburgh Sleep Quality Index for subjective sleep. Multivariable mixed-effects models were used to examine the association. RESULTS Twins were all male, mostly white (97%), with a mean (SD) age of 68 (2). The mean (SD) BDI was 5.9 (6.3), and 49 (20%) met the criteria for major depression. For polysomnography, each 5-unit higher BDI, within-pair, was significantly associated with 19.7 min longer rapid eye movement (REM) sleep latency, and 1.1% shorter REM sleep after multivariable adjustment. BDI was not associated with sleep architecture or sleep-disordered breathing. For actigraphy, a higher BDI, within-pair, was significantly associated with lower sleep efficiency, more fragmentation and higher variability in sleep duration. BDI was associated with almost all dimensions of self-reported sleep disturbance. Results did not differ by zygosity, and remained consistent using major depression instead of BDI and were independent of the presence of comorbid posttraumatic stress disorder and antidepressant use. CONCLUSIONS Depression is associated with REM sleep disruption in lab and sleep fragmentation and sleep variability at home, but not with sleep architecture or sleep-disordered breathing.
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Affiliation(s)
- Minxuan Huang
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Donald L Bliwise
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Martica H Hall
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Richard P Sloan
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Amit Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine (Cardiology), School of Medicine, Emory University, Atlanta, GA, USA.,Atlanta Veteran Affairs Medical Center, Decatur, GA, USA
| | - Jack Goldberg
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA.,Vietnam Era Twin Registry, Seattle Epidemiologic Research and Information Center, US Department of Veterans Affairs, Seattle, WA, USA
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nancy Murrah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Oleksiy M Levantsevych
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lucy Shallenberger
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rami Abdulbagki
- Department of Pathology, Georgia Washington University Hospital, Washington, DC, USA
| | - J Douglas Bremner
- Atlanta Veteran Affairs Medical Center, Decatur, GA, USA.,Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine (Cardiology), School of Medicine, Emory University, Atlanta, GA, USA
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Gökce F, Ehring T, Werner GG, Takano K. Misperception of sleep is associated with intrinsic motivation toward thinking about sleep. J Behav Ther Exp Psychiatry 2020; 69:101591. [PMID: 32553998 DOI: 10.1016/j.jbtep.2020.101591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/31/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Misperception of sleep, the underestimation of total sleep time and overestimation of sleep onset latency (SOL) relative to objective measures, is often found in people with sleep disturbances. Theories of insomnia have proposed that perceived sleeplessness triggers excessive intention and effort to sleep, ironically disturbing the normal initiation of sleep. The current study tested this specific association between (mis)perception of sleep and intrinsic motivation to think about sleep. METHODS The sample (n = 74) covered students and community living in Munich and surrounds with ages between 18 and 30 years. We assessed the subjective and objective sleep of participants using a sleep diary and actigraphy. Participants also completed a decision-making task (the pay-per-view task), where they had to decide between thinking about sleep vs. eating. As these options were associated with a variable monetary reward, participants typically experienced a conflict between their preferred topic and the reward for their choice. RESULTS Multilevel logistic regression analyses showed that participants with greater SOL misperception (i.e., longer subjective relative to objective SOL) forgo a greater reward for the opportunity to think about sleep. LIMITATIONS The non-clinical nature of our sample may limit the implication of the findings for clinical levels of insomnia. CONCLUSIONS Results support the cognitive model of insomnia, suggesting that perception of sleeplessness is associated with higher intrinsic motivation to engage in sleep-related thinking.
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Affiliation(s)
- Feyza Gökce
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, LMU Munich, Leopoldstrasse 13, 80802, Munich, Germany
| | - Thomas Ehring
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, LMU Munich, Leopoldstrasse 13, 80802, Munich, Germany
| | - Gabriela G Werner
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, LMU Munich, Leopoldstrasse 13, 80802, Munich, Germany
| | - Keisuke Takano
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, LMU Munich, Leopoldstrasse 13, 80802, Munich, Germany.
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7
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Ratcliff CG, Zepeda SG, Hall MH, Tullos EA, Fowler S, Chaoul A, Spelman A, Arun B, Cohen L. Patient characteristics associated with sleep disturbance in breast cancer survivors. Support Care Cancer 2020; 29:2601-2611. [PMID: 32964261 DOI: 10.1007/s00520-020-05777-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 09/11/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Disturbed sleep is common among breast cancer survivors. Identifying patients at risk for disturbed sleep and its sequelae will aid in improving screening and intervention strategies to improve sleep and cancer-related quality of life (QOL). METHODS Women with stages I-III breast cancer undergoing neoadjuvant or adjuvant chemotherapy (N = 415) reported subjectively assessed sleep quality (PSQI) and actigraphy-assessed wake after sleep onset (AAS-WASO), total sleep time (AAS-TST), and sleep efficiency (AAS-SE), sociodemographic, and clinical characteristics and completed questionnaires assessing physical and mental health QOL at study entry and 3, 6, 12, and 15 months later. RESULTS Being from a racially/ethnically underserved population was associated with poorer sleep in all indices (p's < .04). Lower income was associated with poorer subjective sleep and greater AAS-WASO (p's < .02). BMI was associated with lower AAS-SE (p < .001). Baseline subjective sleep complaints were positively associated with depression, fatigue, and health-related QOL and cancer-related symptoms across follow-up (p's < 0.05). Baseline AAS-WASO was positively associated with anxiety and negatively associated with physical health-related QOL at the 3-month follow-up (p's < .001). Baseline AAS-WASO and AAS-SE were associated with mental health-related QOL at the 6-month follow-up (p's < .05). CONCLUSIONS In keeping with previous health disparity research, racially/ethnically underserved populations, lower household income, and higher BMI were associated with increased risk for disturbed sleep. Sleep disturbance may have long-term effects on multiple aspects of QOL for women undergoing treatment for breast cancer. Results may inform strategies to identify patients at greatest risk for disturbed sleep and its sequelae.
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Affiliation(s)
- Chelsea G Ratcliff
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA. .,Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Stephanie G Zepeda
- Departmnet of Psychology, Our Lady of the Lake University, The Woodlands, TX, USA
| | - Martica H Hall
- Department of Psychology, The University of Pittsburgh, Pittsburgh, PA, USA
| | - Emily A Tullos
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA
| | - Shaelyn Fowler
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA
| | | | - Amy Spelman
- Office of Protocol Research, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Banu Arun
- Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
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8
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Manual acupuncture for patients with major depressive disorder and comorbid insomnia: Evidence from polysomnography and serum biomarkers. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2020. [DOI: 10.1016/j.wjam.2020.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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9
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Yan T, Sun Y, Xiao F, Wu B, Bi K, He B, Jia Y. Schisandrae Chinensis Fructus inhibits behavioral deficits induced by sleep deprivation and chronic unpredictable mild stress via increased signaling of brain‐derived neurotrophic factor. Phytother Res 2019; 33:3177-3190. [DOI: 10.1002/ptr.6489] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/04/2019] [Accepted: 08/12/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Tingxu Yan
- School of Functional Food and WineShenyang Pharmaceutical University Shenyang China
| | - Yingying Sun
- School of Traditional Chinese Materia MedicaShenyang Pharmaceutical University Shenyang China
| | - Feng Xiao
- School of Functional Food and WineShenyang Pharmaceutical University Shenyang China
| | - Bo Wu
- School of Functional Food and WineShenyang Pharmaceutical University Shenyang China
| | - Kaishun Bi
- School of PharmacyShenyang Pharmaceutical University Shenyang China
| | - Bosai He
- School of Functional Food and WineShenyang Pharmaceutical University Shenyang China
| | - Ying Jia
- School of Functional Food and WineShenyang Pharmaceutical University Shenyang China
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10
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Tanaka T, Kokubo K, Iwasa K, Sawa K, Yamada N, Komori M. Intraday Activity Levels May Better Reflect the Differences Between Major Depressive Disorder and Bipolar Disorder Than Average Daily Activity Levels. Front Psychol 2018; 9:2314. [PMID: 30581399 PMCID: PMC6292921 DOI: 10.3389/fpsyg.2018.02314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 11/05/2018] [Indexed: 11/13/2022] Open
Abstract
It is important to establish an objective index to differentiate mood disorders (i.e., bipolar disorder; BD and major depressive disorder; MDD). The present study focused on the pattern of changes of physical activity in the amount of activity intraday, and examined the relationship between activity patterns and mood disorders. One hundred and eighteen inpatients with MDD or BD in a depressive state provided the activity data by using wearable activity trackers for 3 weeks. In order to illuminate the characteristic patterns of intraday activities, Principal Component Analysis (PCA) was adopted to extract the main components of intraday activity changes. We found that some of the PCs reflected the differences between the types of mood disorder. BD participants showed high activity pattern in the morning and low activity pattern in evenings. However, MDD showed the opposite. Our results suggest that activity tracking focused on daytime activity patterns may provide objective auxiliary diagnostic information.
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Affiliation(s)
- Tsunehiko Tanaka
- Educational Psychology Course, Faculty of Education, Niigata University, Niigata, Japan.,Department of Psychiatry, Shiga University of Medical Science, Ōtsu, Japan
| | - Kumiko Kokubo
- Graduate School of Engineering, Osaka Electro-Communication University, Neyagawa, Japan
| | - Kazunori Iwasa
- Department of Educational Psychology, Shujitsu University, Okayama, Japan
| | - Kosuke Sawa
- Faculty of Human Sciences, Department of Psychology, Senshu University, Kawasaki, Japan
| | - Naoto Yamada
- Department of Psychiatry, Shiga University of Medical Science, Ōtsu, Japan.,Kamibayashi Memorial Hospital, Ichinomiya, Japan
| | - Masashi Komori
- Faculty of Information and Communication Engineering, Osaka Electro-Communication University, Neyagawa, Japan
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11
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Lippman S, Gardener H, Rundek T, Seixas A, Elkind MSV, Sacco RL, Wright CB, Ramos AR. Short sleep is associated with more depressive symptoms in a multi-ethnic cohort of older adults. Sleep Med 2017; 40:58-62. [PMID: 29221780 PMCID: PMC5726583 DOI: 10.1016/j.sleep.2017.09.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/26/2017] [Accepted: 09/08/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To evaluate cross-sectional and prospective associations between short and long sleep duration and depressive symptoms in older adults (aged >65 years). METHODS The data from a subsample of the racially/ethnically diverse Northern Manhattan Study were analyzed. Depressive symptoms were assessed twice with the Center for Epidemiologic Studies Depression Scale (CES-D), approximately 5 years apart. The presence of depressive symptoms was defined as a CES-D score ≥16 or use of antidepressants. Self-reports of short (<6 h), intermediate (6-8 h) and long (≥9 h) sleep were assessed prior to the initial CES-D. Logistic regression was used to evaluate the cross-sectional associations between short and long sleep durations with depressive symptoms, using intermediate sleep as the reference. The prospective association between sleep duration and depression in a sample of participants without depressive symptoms at first CES-D was also analyzed. All models were adjusted for demographic, behavioral, and vascular risk factors. RESULTS The initial sample consisted of 1110 participants: 62% women, 69% Hispanic, 17% black, 14% white. Short sleep was reported by 25%, intermediate sleep by 65%, and long sleep by 9%. Depressive symptoms were described in 25% of the initial sample. Short sleep, but not long sleep, was associated with depressive symptoms at baseline (adjusted OR 1.8, 95% CI 1.3-2.6), and at follow-up (adjusted OR 1.9, 95% CI 1.1-3.5; median follow-up = 5.1 years). CONCLUSION Short sleep duration had a cross-sectional and prospective association with depressive symptoms in an urban multi-ethnic cohort of older adults.
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Affiliation(s)
- Suzanne Lippman
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hannah Gardener
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Azizi Seixas
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Mitchell S V Elkind
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ralph L Sacco
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Clinton B Wright
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Alberto R Ramos
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
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Abstract
BACKGROUND The sleep and cognitive dysfunction are common in major depressive disorders (MDDs). Recently, the 2-pore domain potassium channel twik-related K(+) channel 1 (TREK-1) has been identified to be closely related to the etiology of MDD. However, whether TREK-1 is involved in the regulation of sleep and cognition is still unknown. METHODS The present study tried to dissect the role of outwardly rectifying K+ channel-1 (ORK1) (TREK-1 homolog in Drosophila) in sleep and cognition in Drosophila. The mutant and over-expressed lines of ork1 were generated using Drosophila genetics. Sleep analysis and short-term memory experiments were used to test sleep time and short-term memory of the mutant and over-expressed ORK1 lines, respectively. RESULTS Our results showed that the learning index of ork1 mutant lines was increased compared with the wild type. However, ork1 mutant could obviously decrease sleep time in Drosophila. Contrary to the ork1 mutant lines, we also found that ORK1 over-expression could increase sleep time and decreased learning index in Drosophila. CONCLUSION Results from this study suggest that ORK1 might play an important role in the regulation of sleep time and short-term memory in Drosophila.
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13
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Zhou Y, Cao Z, Yang M, Xi X, Guo Y, Fang M, Cheng L, Du Y. Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder. Sci Rep 2017; 7:40511. [PMID: 28098176 PMCID: PMC5241829 DOI: 10.1038/srep40511] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/06/2016] [Indexed: 01/23/2023] Open
Abstract
The comorbidity of major depressive disorder (MDD) and generalized anxiety disorder (GAD) is common and often predicts poorer outcomes than either disorder alone. This study aimed to examine the prevalence of comorbid GAD and its association with quality of life (QOL) among MDD patients. A total of 1225 psychiatric outpatients were screened using the Hospital Anxiety and Depression Scale (HADS). Those who scored ≥8 on the HADS were interviewed using DSM-IV criteria by two senior psychiatrists. Patients diagnosed with MDD were further assessed using the 9-item Patient Health Questionnaire, Social Support Rating Scale, Pittsburgh Sleep Quality Index, and World Health Organization QOL Scale, brief version (WHOQOL-BREF). Ultimately, 667 patients were diagnosed with MDD, of 71.7% of whom had GAD. Compared to those with MDD alone, comorbid patients had lower scores on the physical (38.64 ± 10.35 vs.36.54 ± 12.32, P = 0.026) and psychological (35.54 ± 12.98 vs. 30.61 ± 14.66, P < 0.001) domains of the WHOQOL-BREF. The association between comorbid GAD and poor QOL on the two domains remained statistically significant in the multiple linear regression (unstandardized coefficients: −1.97 and −4.65, P < 0.001). In conclusion, the prevalence of comorbid GAD in MDD patients is high, and co-occurring GAD may exacerbate impaired physical and psychological QOL in Chinese MDD patients.
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Affiliation(s)
- Yongjie Zhou
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China.,Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science &Technology, GongNongBin Road 125#, Wuhan, 430012, China
| | - Zhongqiang Cao
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China
| | - Mei Yang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China
| | - Xiaoyan Xi
- Affiliated Liyuan hospital, Tongji Medical College of Huazhong University of Science &Technology, YuanHu Road 39#, Wuhan, 430060, China
| | - Yiyang Guo
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China
| | - Maosheng Fang
- Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science &Technology, GongNongBin Road 125#, Wuhan, 430012, China
| | - Lijuan Cheng
- Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science &Technology, GongNongBin Road 125#, Wuhan, 430012, China
| | - Yukai Du
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China
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14
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Pyrke RJL, McKinnon MC, McNeely HE, Ahern C, Langstaff KL, Bieling PJ. Evidence-Based Design Features Improve Sleep Quality Among Psychiatric Inpatients. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2017; 10:52-63. [DOI: 10.1177/1937586716684758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: The primary aim of the present study was to compare sleep characteristics pre- and post-move into a state-of-the-art mental health facility, which offered private sleeping quarters. Background: Significant evidence points toward sleep disruption among psychiatric inpatients. It is unclear, however, how environmental factors (e.g., dorm-style rooms) impact sleep quality in this population. Methods: To assess sleep quality, a novel objective technology, actigraphy, was used before and after a facility move. Subjective daily interviews were also administered, along with the Horne–Ostberg Morningness–Eveningness Questionnaire and the Pittsburgh Sleep Quality Index. Results: Actigraphy revealed significant improvements in objective sleep quality following the facility move. Interestingly, subjective report of sleep quality did not correlate with the objective measures. Circadian sleep type appeared to play a role in influencing subjective attitudes toward sleep quality. Conclusions: Built environment has a significant effect on the sleep quality of psychiatric inpatients. Given well-documented disruptions in sleep quality present among psychiatric patients undergoing hospitalization, design elements like single patient bedrooms are highly desirable.
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Affiliation(s)
- Ryan J. L. Pyrke
- McMaster Integrative Neuroscience Discovery and Study Program, Hamilton, Ontario, Canada
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Margaret C. McKinnon
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Hamilton, Ontario, Canada
| | - Heather E. McNeely
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Neuropsychology Program, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
- Redevelopment, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Catherine Ahern
- Redevelopment, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Karen L. Langstaff
- Redevelopment, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Peter J. Bieling
- Mood Disorders Program, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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15
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Hsu HM, Chou KR, Lin KC, Chen KY, Su SF, Chung MH. Effects of cognitive behavioral therapy in patients with depressive disorder and comorbid insomnia: A propensity score-matched outcome study. Behav Res Ther 2015; 73:143-50. [PMID: 26313621 DOI: 10.1016/j.brat.2015.07.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/29/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We evaluated the effects of cognitive behavioral therapy for insomnia (CBT-I) in inpatients with a diagnosis of depression and comorbid insomnia. METHOD This study used a prospective, parallel-group design. The experimental group received CBT-I for no more than 90 min once weekly for 6 weeks and the control group only have health education manuals for insomnia. The following questionnaires were administered at baseline: the Hamilton Rating Scale for Depression (HAM-D), Dysfunctional Beliefs and Attitudes about Sleep (DBAS), Presleep Arousal Scale (PSAS), Sleep Hygiene Practice (SHP), and Pittsburgh Sleep Quality Index. The questionnaires were readministered after the completion of the 6-wk CBT-I intervention and 1 month following the completion of CBT-I, to determine the effects of the CBT-I intervention over time. The analysis of Generalized Estimation Equations was identified the difference between the experimental group and the control group by controlling for the variables in BZD dose and propensity score of gender, age, and the scores for the DBAS-16, PSAS, SHPS, and HAM-D. RESULTS Consequently, the significant difference in the PSQI scores was observed at the 1-month follow-up assessment however, no significant intergroup difference in the PSQI scores was found at the completion of the CBT-I intervention between two groups. CONCLUSIONS As a conclusion, we found that overall sleep quality significantly improved in patients who received CBT-I after we controlled for the BZD dose and propensity score, which suggests that CBT-I may represent a useful clinical strategy for improving sleep quality in patients with depression and comorbid insomnia.
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Affiliation(s)
- Hui-Min Hsu
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan; Graduate Institutes of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Chia Lin
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Kuan-Yu Chen
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Shu-Fang Su
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Institution of Nursing and Health Science, National Taipei University, Taipei, Taiwan
| | - Min-Huey Chung
- Graduate Institutes of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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16
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Du X, Pang TY. Is Dysregulation of the HPA-Axis a Core Pathophysiology Mediating Co-Morbid Depression in Neurodegenerative Diseases? Front Psychiatry 2015; 6:32. [PMID: 25806005 PMCID: PMC4353372 DOI: 10.3389/fpsyt.2015.00032] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/16/2015] [Indexed: 01/19/2023] Open
Abstract
There is increasing evidence of prodromal manifestation of neuropsychiatric symptoms in a variety of neurodegenerative diseases such as Parkinson's disease (PD) and Huntington's disease (HD). These affective symptoms may be observed many years before the core diagnostic symptoms of the neurological condition. It is becoming more apparent that depression is a significant modifying factor of the trajectory of disease progression and even treatment outcomes. It is therefore crucial that we understand the potential pathophysiologies related to the primary condition, which could contribute to the development of depression. The hypothalamic-pituitary-adrenal (HPA)-axis is a key neuroendocrine signaling system involved in physiological homeostasis and stress response. Disturbances of this system lead to severe hormonal imbalances, and the majority of such patients also present with behavioral deficits and/or mood disorders. Dysregulation of the HPA-axis is also strongly implicated in the pathology of major depressive disorder. Consistent with this, antidepressant drugs, such as the selective serotonin reuptake inhibitors have been shown to alter HPA-axis activity. In this review, we will summarize the current state of knowledge regarding HPA-axis pathology in Alzheimer's, PD and HD, differentiating between prodromal and later stages of disease progression when evidence is available. Both clinical and preclinical evidence will be examined, but we highlight animal model studies as being particularly useful for uncovering novel mechanisms of pathology related to co-morbid mood disorders. Finally, we purpose utilizing the preclinical evidence to better inform prospective, intervention studies.
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Affiliation(s)
- Xin Du
- Mental Health Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne , Melbourne, VIC , Australia
| | - Terence Y Pang
- Behavioural Neurosciences Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne , Melbourne, VIC , Australia
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