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Berardelli I, Amerio A, Bartoli F, Cuomo A, Deste G, Orsolini L, Sampogna G, Pompili M. Rethinking the role of trazodone in the different depressive dimensions. Expert Rev Neurother 2024; 24:619-632. [PMID: 38881379 DOI: 10.1080/14737175.2024.2363843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 05/31/2024] [Indexed: 06/18/2024]
Abstract
INTRODUCTION The efficacy of trazodone for several psychopathologic dimensions of depression has been shown in the literature. Trazodone has been widely used in some clinical contexts (e.g. for insomnia and depression in the elderly). However, the role of trazodone in several aspects of depression is not well known. AREA COVERED Eight experts from academic and medical centers across Italy met to identify the difficulties and barriers faced in daily clinical practice in the assessment and management of major depressive disorder and how the use of trazodone could address some unmet needs. The objective of the expert meetings and the present document was to increase knowledge of particular areas of treatment with trazodone. EXPERT OPINION Evidence of the role of trazodone in patients affected by major depressive disorder with anxiety symptoms, insomnia, agitation, cognitive deficits, alcohol use disorders, physical comorbidities, and suicide risk has been identified, showing the effectiveness of trazodone in different presentations of major depressive disorder. The main characteristics of patients with depression for whom trazodone seems to be most effective have been identified, providing clinicians with information on possible uses of this drug in such population of patients.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Bartoli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Alessandro Cuomo
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Giacomo Deste
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Valcamonica, Esine, Italy
| | - Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania 'L. Vanvitelli', Naples, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Meng J, Zheng C, Wang H, Välimäki M, Wang M. Non-pharmacological interventions for improving sleep in people living with HIV: a systematic narrative review. Front Neurol 2023; 14:1017896. [PMID: 38125837 PMCID: PMC10732507 DOI: 10.3389/fneur.2023.1017896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/27/2023] [Indexed: 12/23/2023] Open
Abstract
Background Sleep disturbances are common in people living with Human Immunodeficiency Virus (HIV) and may lead to poor adherence to antiretroviral therapy and worsen HIV symptom severity. Due to the side effects of pharmacotherapy for sleep disturbances, there is more room for non-pharmacological interventions, but knowledge of how these non-pharmacological interventions have been used to improve sleep in people living with HIV (PLWH) is still missing. Objective To investigate the content of non-pharmacological interventions, sleep measurements, and the impact of these interventions on improving sleep in PLWH. Methods Following PRISMA guidelines, we conducted a systematic search on PubMed, EMBASE, Cochrane Central Registry of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and China Biology Medicine disc. Non-pharmacological interventions for improving sleep in PLWH were included, and study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. We performed a narrative approach to synthesize the data to better understand the details and complexity of the interventions. Results Fifteen experimental studies in three categories for improving sleep in PLWH were included finally, including psychological interventions (components of cognitive-behavioral therapy for insomnia or mindfulness-based cognitive therapy, n = 6), physical interventions (auricular plaster therapy, acupuncture, and exercise, n = 8), and elemental interventions (speed of processing training with transcranial direct current stimulation, n = 1). Wrist actigraphy, sleep diary, and self-reported scales were used to measure sleep. Psychological interventions and physical interventions were found to have short-term effects on HIV-related sleep disturbances. Conclusions Psychological and physical interventions of non-pharmacological interventions can potentially improve sleep in PLWH, and the combination of patient-reported outcomes and actigraphy devices can help measure sleep comprehensively. Future non-pharmacological interventions need to follow protocols with evidence-based dosing, contents, and measures to ensure their sustainable and significant effects.
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Affiliation(s)
- Jingjing Meng
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Chunyuan Zheng
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Honghong Wang
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
- Xiangya Center for Evidence-Based Practice & Healthcare Innovation: A Joanna Briggs Institute Affiliated Group, Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Maritta Välimäki
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
- Xiangya Center for Evidence-Based Practice & Healthcare Innovation: A Joanna Briggs Institute Affiliated Group, Xiangya Nursing School, Central South University, Changsha, Hunan, China
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Min Wang
- The Institute of HIV/AIDS, The First Hospital of Changsha, Hunan, China
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Zahr NM, Sullivan EV, Pfefferbaum A. Poor subjective sleep reported by people living with HIV is associated with impaired working memory. NEUROIMMUNE PHARMACOLOGY AND THERAPEUTICS 2023; 2:127-137. [PMID: 37946876 PMCID: PMC10635409 DOI: 10.1515/nipt-2023-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Poor sleep can undermine health and may be especially disruptive to those with chronic conditions including HIV infection. Here, clinically well-described people living with HIV [PLWH] (74 men, 35 women) and healthy control (38 men, 35 women) participants were administered the Pittsburgh Sleep Quality Index (PSQI), a validated measure of subjective sleep with a global score ≥5 able to distinguish good from poor sleepers. In addition, participants completed a battery of neuropsychological tests. PLWH (6.8 ± 3.7) had higher global PSQI scores than healthy controls (4.1 ± 2.8): 39.7 % of uninfected controls and 68.8 % of PLWH had a PSQI≥5 indicative of poor sleep. There were no relations between the global PSQI score and any evaluated variables among uninfected individuals or with demographic or HIV-related variables in PLWH. Instead, a higher global PSQI score among PLWH was associated with worse "Quality of Life" scores [Global Assessment of Functioning (GAF, p=0.0007), Medical Outcomes Study survey (21-item short form, SF-21, p<0.0001), and Activities of Daily Living-Instrumental (ADL-I, p=0.0041)] and higher Beck Depression Index (BDI, p<0.0001) depressive symptoms. Further, in PLWH, higher global PSQI scores were associated with poor performance on a working memory task, the digit backward span (p=0.0036). In PLWH, the 5 variables together explained 32.3 % of the global PSQI score variance; only 3 variables - the SF-21, BDI, and digit backward scores - explained 30.6 % of the variance. To the extent that poor subjective sleep contributes to impaired working memory in HIV, we speculate that this impairment may be ameliorated by improved sleep health.
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Affiliation(s)
- Natalie M. Zahr
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Neuroscience Program, SRI International, Menlo Park CA, USA
| | - Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Mazzitelli M, Trunfio M, Milinkovic A, Castelli E, Sasset L, Leoni D, Salvucci M, Cazzaro R, Calcinoni I, Balducci P, Ribeiro GCQ, Filagrana G, Scaglione V, Cattelan AM. Sleep disturbances and their correlation with cardiovascular risk, obesity, and mood disorders in people with HIV. AIDS 2023; 37:925-934. [PMID: 36723511 DOI: 10.1097/qad.0000000000003493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The relationship between sleep disorders (SDs), cardiovascular risk (CVR), and mood disorders (MDs) has been studied in detail in the general population, but far less in people with HIV (PWH). METHODS Cross-sectional analysis in single centre cohort of PWH. Sleep quality was assessed using by Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Berlin Questionnaire (BQ), Pittsburgh Sleep Quality Index (PSQI); anxiety and depression were evaluated by the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9. Demographic, clinical and HIV-related data were collected, and Framingham and Data collection on Adverse effects of anti-HIV Drugs (DAD)-10 scores were computed in modelling associations with each SDs scale. RESULTS Data were collected for 721 PWH on stable combination antiretroviral therapy (cART) (median age of 53 years, 71.8% males, 96% with undetectable HIV RNA, 50.3% on cART potentially affecting sleep, and 20.4% on hypno-inducing drugs), 76.9% had SDs 60.3, 31.3, 31.1, and 7.9% at PSQI, BQ, ISI, and ESS, respectively. Anxiety and depression were detected in 28.3 and 16.1% participants, respectively. BQ score was independently associated with high BMI ( P < 0.001), Framingham risk >10% ( P < 0.001), and both DAD-10R and -10F score >10% ( P < 0.001 and P = 0.031). PSQI and ISI scores were independently associated with depression and anxiety ( P < 0.001). No association between SDs and specific antiretroviral regimens, nor HIV-related parameters was detected. CONCLUSIONS In our cohort of PWH on stable ART, despite the alarmingly higher prevalence, SDs were associated with the same determinants (cardiovascular risk factors and MDs) observed in the general population.
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Affiliation(s)
- Maria Mazzitelli
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Mattia Trunfio
- Infectious Diseases Unit, Department of Medical Sciences, University of Turin at Amedeo di Savoia Hospital, Turin, Italy
- HIV Neurobehavioral Research Program and Departments of Neurosciences and Psychiatry, School of Medicine, University of California, San Diego, California, USA
| | - Ana Milinkovic
- Chelsea and Westminster Foundation Trust
- Imperial College London, London, UK
| | - Eleonora Castelli
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Lolita Sasset
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Davide Leoni
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | | | | | | | | | | | | | - Vincenzo Scaglione
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
| | - Anna M Cattelan
- Department of Molecular Medicine, Infectious and Tropical Diseases Unit, Department of Medical Sciences, Padua University Hospital, Padua
- Student at University of Padua, Padua University Hospital
- University of Padua, Padua, Italy
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Ramirez Garcia MP, Leclerc-Loiselle J, Côté J, Brouillette MJ, Thomas R. Effect of autogenic training on quality of life and symptoms in people living with HIV: A mixed method randomized controlled trial. Complement Ther Clin Pract 2023; 50:101716. [PMID: 36528982 DOI: 10.1016/j.ctcp.2022.101716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/16/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Quality of life of people living with HIV is strongly affected by sleep problems, fatigue, pain, anxiety, and depression symptoms. This study set out to evaluate the effects of autogenic training (AT) on quality of life and symptoms within this population. METHODS A mixed method randomized controlled trial was conducted. Participants were randomly assigned to either the AT group (n = 32) or the control group (CG) (n = 31). Quality of life and symptoms were measured in both groups three times: prior to intervention (T0), immediately after intervention (T3), and three months after intervention (T6). Fourteen individual interviews were conducted. RESULTS Results show a significant improvement in social and mental dimensions of quality of life for the two groups at T6. They also show a significant improvement in sleep for AT participants at T3. Qualitative results are consistent with quantitative ones. CONCLUSION AT seems to improve sleep quality and could improve some dimensions of quality of life and other symptoms among people living with HIV. Further studies are needed to confirm these results. TRIAL REGISTRATION NUMBER NCT01901016.
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Affiliation(s)
- Maria Pilar Ramirez Garcia
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada; Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada; AIDS and Infectious Disease Network (SIDA-MI), Canada; Quebec Network on Nursing Intervention Research (RRISIQ), QC, Canada.
| | | | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada; Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada; AIDS and Infectious Disease Network (SIDA-MI), Canada; Quebec Network on Nursing Intervention Research (RRISIQ), QC, Canada.
| | - Marie-Josée Brouillette
- AIDS and Infectious Disease Network (SIDA-MI), Canada; Department of Psychiatry, McGill University, Montréal, QC, Canada; McGill University Health Centre, Canada.
| | - Réjean Thomas
- AIDS and Infectious Disease Network (SIDA-MI), Canada; Clinique Médicale l'Actuel, Montréal, QC, Canada.
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Han S, Zhang Y, Yang X, Li K, Zhang L, Shao Y, Ma J, Hu Y, Zhu Z, Zhang Y, Wang Z. Exploring core mental health symptoms among persons living with HIV: A network analysis. Front Psychiatry 2023; 14:1081867. [PMID: 36741117 PMCID: PMC9895861 DOI: 10.3389/fpsyt.2023.1081867] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
CONTEXT Persons living with HIV (PLWH) commonly experience mental health symptoms. However, little is known about the core mental health symptoms and their relationships. OBJECTIVE This study aimed to evaluate the prevalence of various mental health symptoms and to explore their relationships in symptom networks among PLWH. METHODS From April to July 2022, we recruited 518 participants through convenience sampling in Beijing, China, for this cross-sectional study. Forty mental health symptoms, including six dimensions (somatization symptoms, negative affect, cognitive function, interpersonal communication, cognitive processes, and social adaptation), were assessed through paper-based or online questionnaires. Network analysis was performed in Python 3.6.0 to explore the core mental health symptoms and describe the relationships among symptoms and clusters. RESULTS Of the 40 mental health symptoms, the most common symptoms were fatigue (71.2%), trouble remembering things (65.6%), and uncertainty about the future (64.0%). In the single symptom network, sadness was the most central symptom across the three centrality indices (rS = 0.59, rC = 0.61, rB = 0.06), followed by feeling discouraged about the future (rS = 0.51, rC = 0.57, rB = 0.04) and feelings of worthlessness (rS = 0.54, rC = 0.53, rB = 0.05). In the symptom cluster network, negative affect was the most central symptom cluster across the three centrality indices (rS = 1, rC = 1, rB = 0.43). CONCLUSION Our study provides a new perspective on the role of each mental health symptom among PLWH. To alleviate the mental health symptoms of PLWH to the greatest extent possible and comprehensively improve their mental health, we suggest that psychological professionals pay more attention to pessimistic mood and cognitive processes in PLWH. Interventions that apply positive psychology skills and cognitive behavioral therapy may be necessary components for the mental health care of PLWH.
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Affiliation(s)
- Shuyu Han
- School of Nursing, Peking University, Beijing, China
| | - Yizhu Zhang
- School of Nursing, Peking University, Beijing, China
| | - Xianxia Yang
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Ke Li
- Department of Emergency, Peking University First Hospital, Beijing, China
| | - Lili Zhang
- Department of Nursing, Beijing Youan Hospital Affiliated with Capital Medical University, Beijing, China
| | - Ying Shao
- Department of Infection, Beijing Youan Hospital Affiliated With Capital Medical University, Beijing, China
| | - Jianhong Ma
- Department of Infection, Beijing Youan Hospital Affiliated With Capital Medical University, Beijing, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China
| | - Yukun Zhang
- School of Nursing, Fudan University, Shanghai, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China
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Chan ASW, Leung LM, Li JSF, Ho JMC, Tam HL, Hsu WL, Iu ANOS, Tang PMK, Yan E. Impacts of psychological wellbeing with HIV/AIDS and cancer among sexual and gender minorities: A systematic review and meta-analysis. Front Public Health 2022; 10:912980. [PMID: 36523575 PMCID: PMC9746694 DOI: 10.3389/fpubh.2022.912980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background The agony and economic strain of cancer and HIV/AIDS therapies severely impact patients' psychological wellbeing. Meanwhile, sexual minorities experience discrimination and mental illness. LGBT individuals with cancer and HIV/AIDS play two roles. It is important to understand and examine this groups mental wellbeing. Objective The purpose of this study is to synthesize current studies on the impact of HIV/AIDS and cancer on LGBT patients' psychological wellbeing. Methods This research uses a systematic literature review at first and later stage a meta-analysis was run on the same review. In this study, data from Google academic and Web of Science has been used to filter literature. PRISMA 2020 Flow Diagram seeks research on LGBT cancer and HIV/AIDS patients. The above sites yielded 370 related papers, some of which were removed due to age or inaccuracy. Finally, meta-analyses was done on 27 HIV/AIDS and 33 cancer patients's analyse. Results The research included 9,898 LGBT cancer sufferers with AIDS and 14,465 cancer sufferers with HIV/AIDS. Using meta-analysis, we discovered the gap in psychological wellbeing scores between HIV/AIDS LGBT and non-LGBT groups ranged from -10.86 to 15.63. The overall score disparity between the HIV/AIDS LGBT and non-LGBT groups was 1.270 (95% CI = 0.990-1.560, Z = 86.58, P < 0.1). The disparity in psychological wellbeing scores between cancer LGBT group and general group varies from -8.77 to 20.94 in the 34 papers examined in this study. Overall, the psychological wellbeing score disparity between the cancer LGBT subset and the general group was 12.48 (95% CI was 10.05-14.92, Test Z-value was 268.40, P-value was <0.1). Conclusion Inflammation and fibrosis in HIV/AIDS and cancer sufferers adversely affect their psychological wellbeing.
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Affiliation(s)
- Alex Siu Wing Chan
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China,*Correspondence: Alex Siu Wing Chan ;
| | - Lok Man Leung
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Jane Siu Fan Li
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Jacqueline Mei Chi Ho
- Faculty of Health and Social Sciences, School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Hon Lon Tam
- Faculty of Medicine, Nethersole School of Nursing, The Chinese University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Wing Leung Hsu
- Aceso Medical Centre, Hong Kong, Hong Kong SAR, China,Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, United Kingdom
| | - April Nicole On Sang Iu
- Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Patrick Ming Kuen Tang
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Elsie Yan
| | - Elsie Yan
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China,Patrick Ming Kuen Tang
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Pujasari H, Chung MH. Sleep Disturbance in the Context of HIV: A Concept Analysis. SAGE Open Nurs 2022; 8:23779608221094541. [PMID: 35493547 PMCID: PMC9039437 DOI: 10.1177/23779608221094541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/24/2022] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
Due to the differing definitions of the concept of sleep disturbance among people living with human immunodeficiency virus (HIV), reviewers in this area have not reached any firm conclusions. The study aimed to clarify and provide a stronger foundation for the definition of sleep disturbance in the context of HIV to enhance the concept’s development. Following Beth Rodgers’ concept analysis guidelines, two leading databases were searched, and 73 articles were used for this concept analysis. The attributes, surrogate terms, antecedents, and consequences of sleep disturbance have been identified using thematic analysis. In this analysis, two main attributes of sleep disturbance in the context of HIV were identified: a) subjective measures, including reduced total sleep time, difficulty falling asleep, nighttime and early morning awakenings, feeling sleepy and poorly rested after a night’s sleep, frequent arousals, and irritability, and b) objective measures, including changes in sleep architecture and sleep continuity. Five antecedents of sleep disturbance in the context of HIV were identified. Meanwhile, the consequences of sleep disturbance in HIV are listed based on the frequency the points occur within the reviewed articles. The list is as follows: fatigue and pain; reduced neurocognitive functions; reduced health outcome and quality of life; poor anti-retroviral (ARV) therapy adherence; daytime sleepiness; depression, anxiety, and maladaptive coping; increased disease progression and cardiovascular mortality; and social phobia, living arrangement and sexual dysfunction. An improved understanding of sleep disturbance in the context of HIV will be beneficial in directing analysts to develop research plans. At the same time, the knowledge gaps identified in the analysis provided a solid basis for further study intending to fill in these gaps.
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Affiliation(s)
| | - Min-Huey Chung
- College of Nursing, Taipei Medical University, Taipei, Taiwan
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RODRIGUES T, SHIGAEFF N. Sleep disorders and attention: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:530-538. [DOI: 10.1590/0004-282x-anp-2021-0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/02/2021] [Indexed: 11/21/2022]
Abstract
ABSTRACT Background: Sleep is a special physiological state that occurs cyclically. The probable role of sleep in our organic functions remains to be explored to clarify the impact of sleep on brain functions. Sleep deprivation is known to affect all parts of the brain separately and independently, but further research is needed on the impact of sleep disorders on attention, particularly the specific types of attention that are most affected, and whether there is such a correlation. Objective: To conduct a systematic review of the possible correlation between sleep disorders and attentional performance. Methods: A systematic review and search at PubMed, SciELO, and Cochrane scientific databases for articles published in the last 10 years was carried out using the following keywords: sleep, attention, and attentional performance. Inclusion criteria were the use of attention tests and sleep disorders. Of the 1398 articles found, 15 were selected and included in this review. Results: The number of publications evaluating sleep and sleep disorders has increased, but is still limited. Of all the functions normally assessed, patients with sleep disorders perform worse on attention tasks, especially with sustained attention. However, these data require further investigation due to the complexity and diversity of the disorders, the small sample size of the included studies, and the fact that few studies used standardized tests. Conclusions: Our findings indicate that the correlation between sleep and attention is strong but limited. Few studies are devoted exclusively to the extent to which sleep disorders interferes with attention.
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Affiliation(s)
- Thiago RODRIGUES
- Universidade Federal de Juiz e Fora, Brazil; Universidade Federal de Juiz e Fora, Brazil
| | - Nadia SHIGAEFF
- Universidade Federal de Juiz e Fora, Brazil; Universidade Federal de Juiz e Fora, Brazil
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10
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Khazaie H, Khazaie S, Zakiei A, Dürsteler KM, Brühl AB, Brand S, Sadeghi-Bahmani D. When Non-Suicidal Self-Injury Predicts Non-Suicidal Self-Injury and Poor Sleep-Results from a Larger Cross-Sectional and Quasi-Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413011. [PMID: 34948620 PMCID: PMC8701371 DOI: 10.3390/ijerph182413011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 01/10/2023]
Abstract
Poor sleep is associated with a higher risk of non-suicidal self-injury (NSSI) as a proxy of unfavorable emotion regulation. In the present study, we tested the hypothesis that past non-suicidal self-injury was associated with current non-suicidal self-injury and with current subjective sleep patterns. To this end, a larger sample of young adults were assessed. A total of 2374 adults (mean age: 27.58 years; 39.6% females) completed a series of self-rating questionnaires covering sociodemographic information, past and current NSSIs, suicide attempts, and current sleep patterns, including experiencing nightmares. Past NSSIs predicted current NSSIs. Current sleep patterns had a modest impact on the association between past and current NSSIs. Compared to male participants, female participants did not report more sleep complaints or more current NSSIs, but more past NSSIs. Past NSSIs predicted the occurrences of nightmares and suicide attempts. The best predictor of current NSSI was the remembered past NSSI, while current poor sleep was only modestly associated with current NSSI. Further indicators of current NSSI and poor sleep were suicide attempts and nightmares within the last six months. Overall, it appears that poor emotion regulation should be considered as underlying factor to trigger and maintain non-suicidal self-injury-related behavior and poor sleep. Further, unlike previous studies, which focused on the possible influence of sleep patterns on NSSIs, the aim of the present study paradigm was to investigate NSSIs on sleep patterns.
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Affiliation(s)
- Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (H.K.); (A.Z.); (D.S.-B.)
| | - Sepideh Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (H.K.); (A.Z.); (D.S.-B.)
- Correspondence: (S.K.); (S.B.)
| | - Ali Zakiei
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (H.K.); (A.Z.); (D.S.-B.)
| | - Kenneth M. Dürsteler
- Psychiatric Clinics, Division of Substance Use Disorders Basel, University of Basel, 4002 Basel, Switzerland;
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8001 Zurich, Switzerland
| | - Annette Beatrix Brühl
- Center of Affective, Stress and Sleep Disorders, Psychiatric Hospital, University of Basel, 4002 Basel, Switzerland;
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (H.K.); (A.Z.); (D.S.-B.)
- Center of Affective, Stress and Sleep Disorders, Psychiatric Hospital, University of Basel, 4002 Basel, Switzerland;
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Tehran 1417466191, Iran
- Correspondence: (S.K.); (S.B.)
| | - Dena Sadeghi-Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851451, Iran; (H.K.); (A.Z.); (D.S.-B.)
- Center of Affective, Stress and Sleep Disorders, Psychiatric Hospital, University of Basel, 4002 Basel, Switzerland;
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
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11
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The effects of trazodone on human cognition: a systematic review. Eur J Clin Pharmacol 2021; 77:1623-1637. [PMID: 34097124 PMCID: PMC8182348 DOI: 10.1007/s00228-021-03161-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/13/2021] [Indexed: 12/15/2022]
Abstract
Trazodone is a widely used antidepressant that is also useful in the control of agitation and insomnia in Alzheimer's disease. This drug is now recognized as having a new mechanism of action, an effect on the unfolded protein response (UPR) pathway, restoring protein translation and slowing neurodegenerative progression in mice. This mechanism may have a role in dementia-modifying treatment. To explore the effects of trazodone on human cognition and to search for clinical evidence of its putative benefits in human neurodegenerative diseases, a systematic review was conducted for studies that evaluated the effect of a minimum dose of 25 mg of trazodone daily, for at least 1 week, on cognition in adult humans. The search was run in MEDLINE, Web of Science, and CENTRAL from the Cochrane databases, yielding a total of 16 studies after selection. Overall, seven studies showed no effect of trazodone on cognition, five showed a beneficial effect by improving or reducing cognitive decline, and four evidenced impaired cognitive function. Our analysis highlights the possibility of a dose-independent dual effect of trazodone on human cognition, with acute utilization associated with impaired cognitive function and long-term use with preventing cognitive deterioration. There was no clinical evidence that trazodone could be used as a specific treatment of neurodegenerative diseases. Future studies should explore the role of trazodone in the UPR pathway and the implications in neurodegenerative diseases in humans.
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12
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Nakimuli‐Mpungu E, Musisi S, Smith CM, Von Isenburg M, Akimana B, Shakarishvili A, Nachega JB, Mills EJ, Chibanda D, Ribeiro M, V Williams A, Joska JA. Mental health interventions for persons living with HIV in low- and middle-income countries: a systematic review. J Int AIDS Soc 2021; 24 Suppl 2:e25722. [PMID: 34164926 PMCID: PMC8222847 DOI: 10.1002/jia2.25722] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Addressing the intersection between mental health and HIV is critical for the wellbeing of persons living with HIV (PLWH). This systematic review synthesized the literature on mental health interventions for PLWH in low- and middle-income countries (LMICs) to determine intervention components and explore their relationship with intervention effectiveness. METHODS We included only controlled clinical trials of interventions aiming to improve the mental health of PLWH. We conducted a search in the following databases: PubMed, CINAHL, PsycINFO and EMBASE for eligible studies describing the evaluation of interventions for mental health problems among PLWH in LMICs published through August 2020. Two reviewers independently screened references in two successive stages of title/abstract screening and then full-text screening for references meeting title/abstract criteria. RESULTS We identified a total of 30 eligible articles representing 6477 PLWH who were assigned to either the intervention arm (n = 3182) or control arm (n = 3346). The mental health interventions evaluated were psychological (n = 17, 56.67%), pharmacological (n = 6, 20.00%), combined psychological and pharmacological (n = 1, 3.33%) and complementary/alternative treatments (n = 6, 20.00%). The mental health problems targeted were depression (n = 22, 73.33 %), multiple psychological symptoms (n = 1, 3.33%), alcohol and substance use problems (n = 4, 13.33%), post-traumatic stress disorder (n = 1, 3.33%) and HIV-related neuro-cognitive impairment (n = 2, 6.67%). Studies of interventions with significant effects had significantly a higher number of active ingredients than those without significant effects [3.41 (2.24) vs. 1.84 (1.46) Mean (SD)] [Mean difference = -1.56, 95% CI = -3.03 to -0.09, p = 0.037]. CONCLUSIONS There continue to be advances in mental health interventions for PLWH with mental illness in LMICs. However, more research is needed to elucidate how intervention components lead to intervention effectiveness. We recommend scale up of culturally appropriate interventions that have been successfully evaluated in low- and middle-income countries.
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Affiliation(s)
| | - Seggane Musisi
- Department of PsychiatryCollege of Health SciencesMakerere UniversityKampalaUganda
| | - Colin M Smith
- Department of Psychiatry and Behavioral SciencesDuke University Medical CenterDurhamNCUSA
- Department of MedicineDuke University Medical CenterDurhamNCUSA
| | - Megan Von Isenburg
- Duke University Medical Center LibraryDuke University Medical CenterDurhamNCUSA
| | - Benedict Akimana
- The Butabika National Referral HospitalMinistry of HealthKampalaUganda
| | | | - Jean B Nachega
- Department of International Health, Bloomberg's School of Public HealthJohns Hopkins UniversityBaltimoreMDUSA
- Department of EpidemiologyPittsburgh Graduate School of Public HealthUniversity of PittsburghPittsburghPAUSA
- Stellenbosch Center for Infectious DiseaseDepartment of MedicineStellenbosch UniversityStellenboschSouth Africa
| | - Edward J Mills
- Department of Clinical Epidemiology & BiostatisticsMcMaster UniversityHamiltonONCanada
| | - Dixon Chibanda
- Zimbabwe AIDS Prevention ProjectDepartment of Community MedicineUniversity of ZimbabweHarareZimbabwe
| | - Marcelo Ribeiro
- Reference Center for Alcohol, Tobacco and Other Drugs (CRATOD)São Paulo State Secretary of HealthSão PauloBrazil
| | - Anna V Williams
- National Addiction CentreInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonUK
| | - John A Joska
- HIV Mental Health Research UnitDepartment of PsychiatryNeuroscience InstituteUniversity of Cape TownCape TownSouth Africa
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Rezaie L, Maazinezhad S, Fogelberg DJ, Khazaie H, Sadeghi-Bahmani D, Brand S. Compared to Individuals with Mild to Moderate Obstructive Sleep Apnea (OSA), Individuals with Severe OSA Had Higher BMI and Respiratory-Disturbance Scores. Life (Basel) 2021; 11:life11050368. [PMID: 33919250 PMCID: PMC8143081 DOI: 10.3390/life11050368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 12/25/2022] Open
Abstract
Objective: Individuals with obstructive sleep apnea (OSA) are at increased risk to suffer from further somatic and sleep-related complaints. To assess OSA, demographic, anthropometric, and subjective/objective sleep parameters are taken into consideration, but often separately. Here, we entered demographic, anthropometric, subjective, and objective sleep- and breathing-related dimensions in one model. Methods: We reviewed the demographic, anthropometric, subjective and objective sleep- and breathing-related data, and polysomnographic records of 251 individuals with diagnosed OSA. OSA was considered as a continuous and as categorical variable (mild, moderate, and severe OSA). A series of correlational computations, X2-tests, F-tests, and a multiple regression model were performed to investigate which demographic, anthropometric, and subjective and objective sleep dimensions were associated with and predicted dimensions of OSA. Results: Higher apnea/hypopnea index (AHI) scores were associated with higher BMI, higher daytime sleepiness, a higher respiratory disturbance index, and higher snoring. Compared to individuals with mild to moderate OSA, individuals with severe OSA had a higher BMI, a higher respiratory disturbance index (RDI) and a higher snoring index, while subjective sleep quality and daytime sleepiness did not differ. Results from the multiple regression analysis showed that an objectively shorter sleep duration, more N2 sleep, and a higher RDI predicted AHI scores. Conclusion: The pattern of results suggests that blending demographic, anthropometric, and subjective/objective sleep- and breathing-related data enabled more effective discrimination of individuals at higher risk for OSA. The results are of practical and clinical importance: demographic, anthropometric, and breathing-related issues derived from self-rating scales provide a quick and reliable identification of individuals at risk of OSA; objective assessments provide further certainty and reliability.
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Affiliation(s)
- Leeba Rezaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran; (L.R.); (S.M.); (D.S.-B.)
| | - Soroush Maazinezhad
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran; (L.R.); (S.M.); (D.S.-B.)
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
| | - Donald J. Fogelberg
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA;
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran; (L.R.); (S.M.); (D.S.-B.)
- Correspondence: (H.K.); or (S.B.)
| | - Dena Sadeghi-Bahmani
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran; (L.R.); (S.M.); (D.S.-B.)
- Departments of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35209, USA
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Department of Clinical Research, University of Basel, 4031 Basel, Switzerland
| | - Serge Brand
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran; (L.R.); (S.M.); (D.S.-B.)
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran 25529, Iran
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland
- Correspondence: (H.K.); or (S.B.)
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Borran M, Dashti-Khavidaki S, Khalili H. The need for an integrated pharmacological response to the treatment of HIV/AIDS and depression. Expert Opin Pharmacother 2021; 22:1179-1192. [PMID: 33586560 DOI: 10.1080/14656566.2021.1882419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: The coexistence of depression and HIV infection affects more than 9 million people worldwide. A literature review revealed a large gap regarding the pharmacotherapy of depression among patients dually diagnosed with HIV and depression.Areas covered:In this review, the authors covered the various dimensions of deploying integrated pharmacological treatment of HIV/AIDS and depression. This topic was addressed in two ways; first, the direct results of integrated pharmacotherapy in syndemic patients; second, the indirect effects of the integrated model on other outcomes of HIV care.Expert opinion: An integrated pharmacological response to the treatment of HIV and depression can bring substantial benefits to HIV outcomes and reduce the burden of both diseases. The direct advantages regarding pharmacological response to the treatment of depression along with HIV care are improving adherence to antiretroviral therapy, optimizing pharmacotherapy, minimizing drug interaction, and prevention of additive adverse drug reactions. Furthermore, in some cases, medication can target both depression and other neuropsychiatric or somatic comorbidities among people living with HIV/AIDS. The integrated pharmacotherapy also has some potential indirect advantages on HIV care outcomes like minimizing loss of care, reducing ongoing HIV transmission, and improving the outcomes of both diseases.
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Affiliation(s)
- Mina Borran
- Department of Internal Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Simin Dashti-Khavidaki
- Professor of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Khalili
- Professor of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study. Life (Basel) 2021; 11:life11020133. [PMID: 33572330 PMCID: PMC7916154 DOI: 10.3390/life11020133] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 01/08/2023] Open
Abstract
Insomnia is a common problem in the general population. To treat insomnia, medication therapies and insomnia-related cognitive-behavioral interventions are often applied. The aim of the present study was to investigate the influence of acceptance and commitment therapy (ACT) on sleep quality, dysfunctional sleep beliefs and attitudes, experiential avoidance, and acceptance of sleep problems in individuals with insomnia, compared to a control condition. A total of 35 participants with diagnosed insomnia (mean age: 41.46 years old; 62.9% females) were randomly assigned to the ACT intervention (weekly group therapy for 60-70 min) or to the active control condition (weekly group meetings for 60-70 min without interventional and psychotherapeutic character). At baseline and after eight weeks (end of the study), and again 12 weeks later at follow-up, participants completed self-rating questionnaires on sleep quality, dysfunctional beliefs and attitudes about sleep, emotion regulation, and experiential avoidance. Furthermore, participants in the intervention condition kept a weekly sleep log for eight consecutive weeks (micro-analysis). Every morning, participants completed the daily sleep log, which consisted of items regarding subjective sleep duration, sleep quality, and the feeling of being restored. Sleep quality, dysfunctional beliefs and attitudes towards sleep, emotion regulation, and experiential avoidance improved over time, but only in the ACT condition compared to the control condition. Improvements remained stable until follow-up. Improvements in experiential avoidance were related to a favorable change in sleep and cognitive-emotional processing. Micro-analyses showed that improvements occurred within the first three weeks of treatment. The pattern of results suggests that ACT appeared to have improved experiential avoidance, which in turn improved both sleep quality and sleep-related cognitive-emotional processes at longer-term in adults with insomnia.
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Mojtahedi D, Dagnall N, Denovan A, Clough P, Hull S, Canning D, Lilley C, Papageorgiou KA. The Relationship Between Mental Toughness, Job Loss, and Mental Health Issues During the COVID-19 Pandemic. Front Psychiatry 2020; 11:607246. [PMID: 33613333 PMCID: PMC7886783 DOI: 10.3389/fpsyt.2020.607246] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/31/2020] [Indexed: 11/13/2022] Open
Abstract
Concerns toward public well-being and mental health are increasing considering the COVID-19 pandemic's global societal and individual impact. The present study builds on the current body of COVID-19 literature by examining the role of mental toughness (MT) in predicting negative affective states (depression, anxiety and stress) during the pandemic. The study also examined the effects of changes in employment on mental health and MT. Participants (N = 723) completed a battery of questionnaires including the Mental Toughness Questionnaire 48-item, The State-Trait Anxiety Inventory, and the Depression, Anxiety and Stress Scale - 21 items. Participants reported relatively higher levels of depression, stress and anxiety in comparison to pre-COVID-19 samples from previous research, with respondents who had lost their jobs during the pandemic reporting higher levels of negative affective states. Despite this, mentally tough individuals appeared to report lower levels of depression, anxiety and stress. Moreover, moderation analyses identified some interaction between MT and employment status when predicting depression, anxiety and stress. Our findings suggest that MT may have some utility in reducing the adverse mental health effects of the pandemic on individuals, however, further longitudinal research is needed to support these implications.
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Affiliation(s)
- Dara Mojtahedi
- Department of Psychology, Centre for Cognition and Neuroscience, University of Huddersfield, Huddersfield, United Kingdom
| | - Neil Dagnall
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Andrew Denovan
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Peter Clough
- Department of Psychology, Centre for Cognition and Neuroscience, University of Huddersfield, Huddersfield, United Kingdom
| | - Sophie Hull
- Department of Psychology, Centre for Cognition and Neuroscience, University of Huddersfield, Huddersfield, United Kingdom
| | - Derry Canning
- Department of Psychology, Centre for Cognition and Neuroscience, University of Huddersfield, Huddersfield, United Kingdom
| | - Caroline Lilley
- Department of Psychology, Centre for Cognition and Neuroscience, University of Huddersfield, Huddersfield, United Kingdom
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