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Zhou Q, Liu S, Chen J, Tuersun Y, Liang Z, Wang C, Sun J, Yuan L, Qian Y. The role of sleep quality and anxiety symptoms in the association between childhood trauma and self-harm attempt: A chain-mediated analysis in the UK Biobank. J Affect Disord 2024; 362:569-577. [PMID: 39019228 DOI: 10.1016/j.jad.2024.07.041] [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: 04/02/2024] [Revised: 06/19/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Childhood trauma is a risk factor for self-harm/suicidal behavior, but research on the potential association linking sleep quality and anxiety symptoms to childhood trauma and self-harm attempt is limited. The aim of this study was to describe the mediating role of sleep quality and anxiety symptoms between childhood trauma and self-harm attempt, and to provide a scientific basis for the prevention of self-harm behaviors. METHODS This study ultimately included 11,063 study participants who participated in the baseline survey of this large prospective cohort study of the UK Biobank. We used structural equation modeling (SEM) to analyze the chain mediating role of sleep quality and anxiety symptoms in childhood trauma and self-harm attempt while controlling for covariates. RESULTS A total of 19.58 % of study participants self-reported self-harm attempt. Sleep quality was negatively correlated with childhood trauma, anxiety symptoms, and self-harm attempt (p < 0.01). Childhood trauma, anxiety symptoms, and self-harm attempt were positively correlated (p < 0.01). In addition, after adjusting for confounders, anxiety symptoms were able to partially mediate the association between childhood trauma and self-harm attempt (effect value: 0.042, p < 0.01), and sleep quality and anxiety symptoms can chain mediate the association between childhood trauma and self-harm attempt (effect value:0.002, p < 0.01), with a total mediating effect of 65.67 % of the total effect. Subgroup analyses further showed that the mediating effects of sleep quality and anxiety symptoms on childhood trauma and self-harm attempt differed across age, gender, ethnicity, and smoking and drinking subgroups. CONCLUSIONS This study found a complex relationship between childhood trauma, sleep quality, anxiety symptoms, and self-harm attempt, with sleep quality and anxiety symptoms mediating the relationship between childhood trauma and self-harm attempt. Multiple avenues of intervention, such as the provision of professional psychological interventions and timely monitoring, should be used to improve the sleep quality and mental health of individuals with traumatic childhood experiences and to prevent the occurrence of emotionally harmful behaviors such as self-harm/suicide.
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Affiliation(s)
- Qingping Zhou
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Siyuan Liu
- School of Health Management, Southern Medical University, Guangzhou, China; School of Public Health, Southern Medical University, Guangzhou, China
| | - Jiangyun Chen
- School of Health Management, Southern Medical University, Guangzhou, China
| | | | - Zhenning Liang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Chenxi Wang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Jinhai Sun
- Department of Health Management, Naval Medical University, Shanghai, China
| | - Lei Yuan
- Department of Health Management, Naval Medical University, Shanghai, China.
| | - Yi Qian
- School of Health Management, Southern Medical University, Guangzhou, China.
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Liu X, Li C, Chen X, Tian F, Liu J, Liu Y, Liu X, Yin X, Wu X, Zuo C, He C. Social support and sleep quality in people with schizophrenia living in the community: the mediating roles of anxiety and depression symptoms. Front Public Health 2024; 12:1414868. [PMID: 39139661 PMCID: PMC11319290 DOI: 10.3389/fpubh.2024.1414868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/19/2024] [Indexed: 08/15/2024] Open
Abstract
Introduction Research has demonstrated that higher social support is associated with better psychological health, quality of life, cognition, activities of daily living, and social participation, but the relationship between social support and sleep quality remains unknown. This study aims to investigate the mediating effects of anxiety and depression in the relationship between social support and sleep among community-dwelling patients with schizophrenia. Method Purposive sampling was used to collect face-to-face data from 1,107 community-dwelling patients with schizophrenia in Chengdu, Sichuan Province, China, between April and July 2023. The Athens Insomnia Scale (AIS) was used to assess sleep quality; the Generalized Anxiety Disorder 7-item scale (GAD-7) was utilized to evaluate anxiety symptoms; and the Patient Health Questionnaire-9 (PHQ-9) was employed to assess depressive symptoms. The mediating effect of anxiety and depression symptoms was assessed using the bootstrap method via Model 6 (Serial multiple mediator model) of the SPSS PROCESS macro. Results Among the 1,107 participants, the proportions of people with schizophrenia experiencing anxiety, depressive symptoms, and poor sleep quality were 22.8, 37.7, and 42.1%, respectively. Mediation analyses indicated that although social support had no direct effect on sleep quality, anxiety and depressive symptoms fully mediated the relationship between social support and sleep quality. Conclusion Patients with schizophrenia experience low levels of social support and poor sleep quality. To enhance the sleep quality of individuals with schizophrenia, all levels of society (government, medical institutions, and communities) must pay more attention to mental health. Implementing diverse intervention measures to strengthen social support and improve symptoms of anxiety and depression should be considered. This approach may potentially lead to an improvement in sleep quality among individuals with schizophrenia.
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Affiliation(s)
- Xin Liu
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Chao Li
- The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Xushu Chen
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Fengxiang Tian
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Juan Liu
- Western Theater General Hospital, Chengdu, China
| | - Yuanyuan Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiang Liu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaolan Yin
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiangrui Wu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chuanlong Zuo
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Changjiu He
- The Fourth People’s Hospital of Chengdu, Chengdu, China
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3
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Hao Y, Peng P, Wang Q, Zhou Y, Chen S, Wu Q, Liu T, Zhang X. Association between childhood maltreatment and suicidal ideation among Chinese patients with chronic schizophrenia: the mediating role of insomnia. BJPsych Open 2024; 10:e98. [PMID: 38699889 PMCID: PMC11094451 DOI: 10.1192/bjo.2024.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Childhood maltreatment is a well-established transdiagnostic risk factor for suicidal ideation; however, previous studies on their association in schizophrenia have produced highly varied results. Moreover, the mechanism linking childhood maltreatment and suicide ideation remains unclear in schizophrenia. AIMS This cross-sectional study aimed to investigate the association between childhood maltreatment and suicide ideation in people with schizophrenia and tested whether insomnia mediated this relationship. METHOD Positive and Negative Syndrome Scale (PANSS), Insomnia Severity Index (ISI), Childhood Trauma Questionnaire - Short Form and Beck Suicidal Ideation Inventory were employed. Logistic regression and mediation analysis were performed. RESULTS (a) The prevalence of suicide ideation, insomnia, sexual abuse, emotional neglect, emotional abuse, physical abuse and physical neglect was 10% (n = 61), 18% (n = 111), 11% (n = 68), 25% (n = 153), 6.3% (n = 39), 17% (n = 106) and 39% (n = 239), respectively. In all, 52% (n = 320) reported childhood maltreatment; (b) patients with suicide ideation demonstrated higher insomnia and childhood maltreatment. PANSS depression factor, ISI, lifetime suicidal attempts and emotional abuse were independently associated with suicide ideation; (c) insomnia partially mediated the effects of emotional abuse and emotional neglect on suicide ideation, and insomnia completely mediated the effects of physical neglect and physical abuse on suicide ideation. CONCLUSION Our study calls for formal assessments for childhood maltreatment and insomnia in schizophrenia, which might help identify suicide ideation early. In addition, interventions targeting insomnia might help reduce suicide ideation among people with schizophrenia who experience childhood maltreatment.
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Affiliation(s)
- Yuzhu Hao
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Pu Peng
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yanan Zhou
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital), Changsha, China
| | - Shubao Chen
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiuxia Wu
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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4
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Üçok A, Noyan H, Gülöksüz S, Saka MC, Alptekin K, Atbaşoğlu C, Akturan E, Karadayı G, Baran Tatar Z, Akdede B, Binbay T, Altınyazar V, Ulaş H, Yalınçetin B, Gümüş-Akay G, Cihan B, Soygür H, Şahin Cankurtaran E, Ulusoy Kaymak S, Rutten BPF, van Os J. The relationship between childhood trauma, psychotic symptoms, and cognitive schemas in patients with schizophrenia, their siblings, and healthy controls: results from the EU-GEI study. Psychol Med 2024:1-12. [PMID: 38606591 DOI: 10.1017/s0033291724000540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
BACKGROUND The relationship between childhood trauma (CT) and psychotic symptoms in patients with schizophrenia (SCZ), and subthreshold psychotic experiences in non-clinical populations is well-established. However, little is known about the relationship between subtypes of trauma and specific symptoms in patients, their siblings, and controls. It is also not clear which variables mediate the relationship between trauma and psychotic symptoms. METHODS Seven hundred and forty-two patients with SCZ, 718 of their unaffected siblings and 1039 controls from three EU-GEI sites were assessed for CT, symptom severity, and cognitive schemas about self/others. CT was assessed with the Childhood Trauma Questionnaire, and cognitive schemas were assessed by The Brief Core Schema Scale. RESULTS Patients with psychosis were affected by CT more than their siblings and controls in all domains. Childhood emotional abuse and neglect were more common in siblings than controls. CT was related to negative cognitive schemas toward self/others in patients, siblings, and controls. We found that negative schemas about self-mediated the relationship between emotional abuse and thought withdrawal and thought broadcasting. Approximately 33.9% of the variance in these symptoms was explained by the mediator. It also mediated the relationship between sexual abuse and persecutory delusions in SCZ. CONCLUSIONS Our findings suggest that childhood abuse and neglect are more common in patients with schizophrenia than their siblings and healthy controls, and have different impacts on clinical domains which we searched. The relationship between CT and positive symptoms seems to be mediated by negative cognitive schemas about self in schizophrenia.
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Affiliation(s)
- Alp Üçok
- Psychotic Disorders Research Program, Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Handan Noyan
- Psychotic Disorders Research Program, Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Department of Psychology, Faculty of Social Sciences, Beykoz University, Istanbul, Turkey
| | - Sinan Gülöksüz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Meram Can Saka
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
- Ankara University Brain Research Center, Ankara University, Ankara, Turkey
| | - Köksal Alptekin
- Department of Psychiatry, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Cem Atbaşoğlu
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
- Ankara University Brain Research Center, Ankara University, Ankara, Turkey
| | - Elçin Akturan
- Psychotic Disorders Research Program, Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gülşah Karadayı
- Psychotic Disorders Research Program, Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Zeynep Baran Tatar
- Department of Psychiatry, Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Berna Akdede
- Department of Psychiatry, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Tolga Binbay
- Department of Psychiatry, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Vesile Altınyazar
- Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Halis Ulaş
- Department of Psychiatry, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Berna Yalınçetin
- Department of Neuroscience, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Güvem Gümüş-Akay
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
- Ankara University Brain Research Center, Ankara University, Ankara, Turkey
| | - Burçin Cihan
- Department of Psychology, Middle East Technical University, Ankara, Turkey
| | - Haldun Soygür
- Turkish Federation of Schizophrenia Associations, Ankara, Turkey
- Department of Psychology, Faculty of Humanities and Social Sciences, Okan University, Istanbul, Turkey
| | | | | | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, the Netherlands
- King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
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Rogers E, Gresswell M, Durrant S. The relationship between sleep and suicidality in schizophrenia spectrum and other psychotic disorders: A systematic review. Schizophr Res 2023; 261:291-303. [PMID: 37879227 DOI: 10.1016/j.schres.2023.10.010] [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: 02/02/2023] [Revised: 09/06/2023] [Accepted: 10/14/2023] [Indexed: 10/27/2023]
Abstract
Individuals with Schizophrenia Spectrum Disorders (SSDs) have significantly higher rates of suicidal thoughts, attempts, and death by suicide in comparison to the general population. Sleep disturbances (reduced duration, timing and quality of sleep) are risk factors for suicidality in the general population, with research indicating the relationship is both immediate and accumulative. Sleep disturbances are also considered to be implicated in the onset and exacerbation of psychotic symptoms in SSDs. Reducing the risk of suicidality in SSDs remains an important public health priority, thus exploration of contributing risk factors is warranted. Sleep monitoring may also offer an adjunct risk monitoring method to suicidality assessments in SSDs, and a potential treatment target for psychotic symptoms. This review aimed to explore proximal and longitudinal relationships between self-reported and objectively measured sleep and suicidality in SSDs and other psychotic disorders. A comprehensive search of four databases was conducted. Eleven studies met the inclusion criteria (10 cross sectional and 1 longitudinal). Narrative synthesis indicated that self-reported sleep disturbances and sleep disorders (e.g. insomnia) were associated with increased risk of suicidal ideation and attempt. However, one study employing polysomnography did not find sleep to be associated with suicidality. Methodological limitations of the evidence base include: i) little experimental or longitudinal evidence, (ii) self-report and/or single item assessment of sleep disturbance, (iii) limited use of validated measures of suicidality, (iv) considerable research in long-term schizophrenia but sparse evidence in early psychosis. Future research should explore (i) cross-sectional and longitudinal relationships between specific aspects of suicidality and objective sleep parameters, (ii) use qualitative or mixed-methods designs to disentangle the nuances and bidirectionality in the sleep-suicide relationship, (iii) explore the psychological processes underpinning or mediating the sleep-suicide relationship in SSDs.
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Affiliation(s)
- Eva Rogers
- Xu Yafen Building, Jubilee Campus, University of Nottingham, NG8 1BB, United Kingdom; Nottinghamshire Healthcare NHS Foundation Trust, Duncan Macmillan House, Porchester Road, Nottingham, NG3 6AA, United Kingdom.
| | - Mark Gresswell
- Department of Clinical Psychology, Sarah Swift Building Brayford Wharf East, University of Lincoln, United Kingdom
| | - Simon Durrant
- School of Psychology, Sarah Swift Building Brayford Wharf East, University of Lincoln, United Kingdom
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Formica MJC, Fuller-Tyszkiewicz M, Hickie I, Olive L, Wood SJ, Purcell R, Yung AR, Phillips LJ, Nelson B, Pantelis C, McGorry PD, Hartmann JA. The relationship between subjective sleep disturbance and attenuated psychotic symptoms after accounting for anxiety and depressive symptoms. Schizophr Res 2023; 258:84-93. [PMID: 37536174 DOI: 10.1016/j.schres.2023.07.019] [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: 09/09/2022] [Revised: 05/10/2023] [Accepted: 07/23/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND AND HYPOTHESES Sleep disturbances are increasingly recognized as cooccurring with psychotic symptoms. The potential importance of this relationship is complicated when considering the effects of anxiety and depressive symptoms which commonly present in early-stage illness states. This study aimed to investigate the relationship between self-reported sleep disturbance on the development of attenuated psychotic symptoms (APS) cross-sectionally and longitudinally while adjusting for roles of anxiety and depressive symptoms. DESIGN Eight-hundred and two help-seeking young people aged 12 to 25 years who engaged with our Australian early intervention services were included in the study (the "Transitions" cohort). Cross sectional mediation and cross-lagged longitudinal (12-month) mediation models were developed with outcomes being different APS domains. RESULTS Only baseline excessive daytime sleepiness predicted later APS when accounting for previous APS, anxiety and depressive symptomatology. Cross sectionally, self-reported sleep disturbance showed both direct and indirect predictive relationships with all APS domains. Partial mediation through anxiety and depression was shown for unusual thought content, perceptual abnormalities, and disorganised speech, while full mediation through depression was shown for non-bizarre ideas. CONCLUSIONS The specificity of the relationship between self-reported sleep disturbance on APS highlights the potential for different roles in mechanistic models of psychotic symptom expression. This further indicates the need for further experimental research to illuminate potential causal pathways. Future research should continue to use continuous, symptom level approaches across a range of timeframes to more accurately model the complex dynamics present in the sleep-psychosis relationship.
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Affiliation(s)
- M J C Formica
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; School of Psychology, Deakin University, Burwood, Australia.
| | | | - I Hickie
- Brain and Mind Centre, University of Sydney, Camperdown, Australia
| | - L Olive
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; School of Psychology, Deakin University, Burwood, Australia
| | - S J Wood
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; School of Psychology, University of Birmingham, Birmingham, England
| | - R Purcell
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - A R Yung
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; School of Medicine, Deakin University, Burwood, Australia
| | - L J Phillips
- School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - B Nelson
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - P D McGorry
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - J A Hartmann
- Orygen, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; Department of Public Mental Health, Central Institute of Mental Health, Heidelberg Univeristy, Mannheim, Germany
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7
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Foiselle M, Lajnef M, Hamdani N, Boukouaci W, Wu CL, Naamoune S, Chami L, Mezoued E, Richard JR, Bouassida J, Sugunasabesan S, Le Corvoisier P, Barrau C, Yolken R, Leboyer M, Tamouza R. Immune cell subsets in patients with bipolar disorder or schizophrenia with history of childhood maltreatment. Brain Behav Immun 2023; 112:42-50. [PMID: 37263365 DOI: 10.1016/j.bbi.2023.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/06/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
A history of Childhood Maltreatment (CM) has been repeatedly associated with an increased risk of developing bipolar disorders (BD) or schizophrenia (SZ). The impact of severe stress induced by CM has been proposed to be mediated by elevated inflammation reflected by dysregulated inflammatory processes. Little is known about the potential impact of CM on lymphocyte subpopulations or the role of pre-existing infections on CM physiological consequences. This study therefore explored the role of CM and past infection exposure impact on lymphocyte subpopulations to give an indication of their relevance as stressors in the pathoetiology of major mood and psychotic disorders. 118 adult patients with SZ, and 152 with BD were included in the analysis. CM history was assessed by the Childhood Trauma Questionnaire (CTQ), with current and past psychiatric symptomatology also evaluated. Circulating immune cell subsets were analyzed using flow cytometry-based analysis. Past exposure to common infectious stigma including toxoplasma, cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were measured by solid phase-enzyme microplate and ELISA immunoassays. The relationship between CM, biological phenotypes (including immune cell subsets distribution and past infectious status) and clinical phenotypes were analyzed using univariate and multivariate analyses. BD patients with, versus without, CM had higher levels of CD3+CD8+ cytotoxic T cells and CMV antibodies along with decreased levels of CD45RA+CCR7+CD8+ naïve CD8+ T cells, and a more severe clinical profile. CMV antibody levels were inversely associated with the CD3 + CD8 + lymphocyte subset level. SZ patients with, versus without, CM, showed lower levels of CD14 + monocytes and no specific clinical characteristics. The accumulation of different types of maltreatment associated with increased body mass index and CMV autoantibodies as well as decreased levels of CD14 + monocytes. In both BD and SZ, further analysis according to the type and the number of CM subtypes showed association with specific changes in lymphocyte cell subsets, clinical profile, and infectious stigma. Adults with BD or SZ exposed to CM exhibit specific immune cell subset profiles, clinical features, and stigma of past infections. In BD, our data indicate an interplay between CM and CMV infections, which may possibly contribute to premature aging and cellular senescence, both of which have previously been shown to associate with mood disorders. Longitudinal studies of CM-exposed patients are required to clarify the interactions of CM and viral infections, including as to the pathophysiological processes driving patient symptomatology.
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Affiliation(s)
- Marianne Foiselle
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Mohamed Lajnef
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Nora Hamdani
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Wahid Boukouaci
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Ching-Lien Wu
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Soumia Naamoune
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Leïla Chami
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Esma Mezoued
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Jean-Romain Richard
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Jihène Bouassida
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Sobika Sugunasabesan
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Philippe Le Corvoisier
- Inserm, Centre d'Investigation Clinique 1430 et AP-HP, Hôpitaux Universitaires Henri Mondor, Univ Paris Est Creteil, F-94010 Créteil, France
| | - Caroline Barrau
- Plateforme de Ressources Biologiques, HU Henri Mondor, AP-HP, Créteil F94010, France
| | - Robert Yolken
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Marion Leboyer
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
| | - Ryad Tamouza
- Université Paris-Est Créteil (UPEC), INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Hôpitaux Universitaires H. Mondor, DMU IMPACT, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Fondation FondaMental, F-94010 Créteil, France
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8
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Abstract
PURPOSE OF REVIEW Insomnia is common in schizophrenia. Insomnia has been associated with suicidal ideation and behavior, as well as greater severity of psychopathology, in schizophrenia. This review performs a meta-analysis of associations between insomnia, suicide, and psychopathology in patients with schizophrenia. RECENT FINDINGS We searched major electronic databases from inception until November 2022 for studies of insomnia, suicide, and psychopathology in patients with schizophrenia. Random effects meta-analysis calculating odds ratios (ORs, for suicide) and effect sizes (ESs, for psychopathology) and 95% confidence intervals (CIs) were performed. Ten studies met the inclusion criteria, comprising 3428 patients with schizophrenia. Insomnia was associated with a significant increased odds of suicidal ideation (OR = 1.84, 95% CI 1.28-2.65, P < 0.01) and suicide attempt or death (OR = 5.83, 95% CI 1.61-2.96, P < 0.01). Insomnia was also associated with total (ES = 0.16, 95% CI 0.09-0.23, P < 0.01), positive (ES = 0.14, 95% CI 0.08-0.20, P = 0.02), and general (ES = 0.17, 95% CI 0.08-0.27, P < 0.01) psychopathology. In meta-regression analyses, BMI was negatively associated with suicidal ideation. Otherwise, age, sex, and study year were all unrelated to the associations. SUMMARY Insomnia is associated with suicide and psychopathology in schizophrenia. Formal assessment and treatment of insomnia appears relevant to the clinical care of schizophrenia.
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Affiliation(s)
| | - William V McCall
- Medical College of Georgia, Augusta University
- Department of Psychiatry and Health Behavior, Augusta University, Augusta, Georgia, USA
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9
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Carruthers SP, Lee SJ, Sankaranarayanan A, Sumner PJ, Toh WL, Tan EJ, Neill E, Van Rheenen TE, Gurvich C, Rossell SL. Psychosis and Hopelessness Mediate the Relationship Between Reduced Sleep and Suicidal Ideation in Schizophrenia Spectrum Disorders. Arch Suicide Res 2022; 26:1862-1879. [PMID: 34225564 DOI: 10.1080/13811118.2021.1944412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Suicide is a major cause of death amongst individuals with schizophrenia spectrum disorders (SSD). Despite numerous risk factors being identified, accurate prediction of suicidality and provision of tailored and effective treatment is difficult. One factor that may warrant particular attention as a contributor to increased psychopathology and suicidality in SSD is disturbed sleep. Sleep disturbances have been reliably linked to greater levels of suicidal ideation and are highly prevalent amongst individuals with SSD. This study aimed to examine if reduced sleep duration and psychopathology are associated with increased suicidal ideation. METHOD One-hundred and eighteen adults with chronic SSD living within the community participated in this cross-sectional study. Psychosis symptoms were assessed using the Positive and Negative Syndrome Scale. Items 4 and 10 from the Montgomery-Asperg Depression Rating Scale and Item 2 from the Calgary Depression Scale for Schizophrenia were used to assess reduced sleep duration, current suicidal ideation, and hopelessness, respectively. All measures were rated concurrently. RESULTS A hierarchical logistic regression revealed that greater acute sleep disturbances were associated with increased suicidal ideation and this relationship was found to be uniquely mediated by both positive symptom severity and hopelessness. CONCLUSION These results suggest that individuals with SSD who exhibited disrupted or disordered sleep, positive symptoms and/or hopelessness should be routinely screened for suicidal thinking. Furthermore, interventions that effectively target sleep disruptions may provide much-needed action against suicidal ideation.HIGHLIGHTSReduced sleep found to be associated with increased suicidal ideationThis was uniquely mediated by both hopelessness and positive symptomsMore regular screening of sleep problems in schizophrenia is needed.
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10
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Diago M, Vila-Badia R, Serra-Arumí C, Butjosa A, Del Cacho N, Esteban Sanjusto M, Colomer-Salvans A, Sánchez L, Dolz M, Muñoz-Samons D, Profep G, Usall J. Emotional abuse and perceived stress: The most relevant factors in suicide behavior in first-episode psychosis patients. Psychiatry Res 2022; 315:114699. [PMID: 35785562 DOI: 10.1016/j.psychres.2022.114699] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 10/17/2022]
Abstract
People with a mental disorder have a higher risk of suicidal behavior. Little research has examined the role of childhood trauma in suicide behavior, and even fewer studies have assessed the specific relevance of subtypes of childhood trauma and suicidal behavior in first-episode psychosis (FEP). The aims of the present study were: 1) to compare suicide behavior between FEP and HC; 2) to study the relationship between the five types of ChT and suicide risk in FEP controlling for confounding sociodemographic, clinical, and psychosocial variables. 95 patients diagnosed with FEP and 92 healthy control (HC) were recruited as a part of the PROFEP study. ChT was evaluated using The Childhood Trauma Questionnaire-Short Form (CTQ) and suicide behavior through The Suicide Risk Scale of Plutchik (SRSP). Our results showed that patients with FEP presented more suicide behavior (ideation, attempt, and suicide risk) than HC. Emotional abuse was the most relevant type of ChT in suicide ideation and suicide risk. After controlling for other relevant variables, perceived stress seemed to play an important role in suicide ideations, suicide attempt, and suicide risk. The results highlight the importance of assessing and considering in the clinical practice ChT and the perceived stress.
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Affiliation(s)
- Marta Diago
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain
| | - Regina Vila-Badia
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Facultat de Medicina i Ciències de la Salut Barcelona, Barcelona, Spain
| | - Clara Serra-Arumí
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Facultat de Medicina i Ciències de la Salut Barcelona, Barcelona, Spain
| | - Anna Butjosa
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Hospital Infanto-juvenil Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, CIBERSAM, Esplugues de Llobregat, Spain
| | - Núria Del Cacho
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain; Universitat de Barcelona, Facultat de Medicina i Ciències de la Salut Barcelona, Barcelona, Spain
| | - Marina Esteban Sanjusto
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain
| | - Alicia Colomer-Salvans
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain
| | - Laura Sánchez
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain
| | - Montserrat Dolz
- Universitat de Barcelona, Facultat de Medicina i Ciències de la Salut Barcelona, Barcelona, Spain
| | - Daniel Muñoz-Samons
- Universitat de Barcelona, Facultat de Medicina i Ciències de la Salut Barcelona, Barcelona, Spain
| | - Group Profep
- PROFEP GROUP: Abella M, Alcalde R, Alvarez M, Bañuelos M, Batllori M, Bogas JL, Bonilla R, Butjosa A, Camprodon E, Casado A, Casali T, Chavarria V, Coromina M, Cuautle A, Cuevas- Esteban J, Cunill R, Cuñat O, Del Cacho N, del Hoyo B, Diago M, Dolz M, Esteban-Santjusto M, Estrada X, Iglesias-González M, Jane C, López- Ortiz C, Membrive P, Molano A, Morelló G, Muñoz-Samons D, Nuñez M, Ochoa S, Pardo M, Pelaez T, Pla MM, Rodriguez A, Rodriguez MJ, Romans C, Rubio-Abadal E, Sanchez L, Santos A, Serra-Arumí C, Sibelo S, Teba S, Tena MC, Usall J, Vallejo G, Via E, Vila-Badia R, Vives L, Spain
| | - Judith Usall
- Etiopatogènia i tractament dels trastorns mentals greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, CIBERSAM, Doctor Antoni Pujadas, Sant Boi de Llobregat, Spain.
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11
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Sex differences in prevalence and clinical correlates of insomnia in Chinese patients with chronic schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 273:601-611. [PMID: 35972555 DOI: 10.1007/s00406-022-01473-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 08/02/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE It is generally recognized that there are sex differences in many aspects of schizophrenia. The main purpose of this study was to investigate the sex differences in the prevalence and clinical correlates of insomnia in patients with chronic schizophrenia. METHODS A total of 957 patients who met the DSM-IV diagnostic criteria for schizophrenia were recruited in this cross-sectional study (male/female = 630/327). Demographic, clinical, and insomnia data were collected using self-reported questionnaires. Fasting blood samples were collected to evaluate the status of blood lipids. Psychopathological symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). RESULTS The prevalence rate of insomnia in female patients with schizophrenia was significantly higher than that in male patients (17.3% for males and 26.3% for females; χ2 = 10.74, p = 0.001). Regression analysis showed that in male patients, insomnia was independently associated with severe PANSS positive symptoms, severe PANSS depressive factor, and high levels of low-density lipoprotein levels, while in female patients, insomnia was associated with low education level, high PANSS depressive factor, and high levels of apolipoprotein B levels. CONCLUSION This study illustrates that insomnia is more frequent in female than male schizophrenia patients, and that there are differences in the clinical correlates of insomnia by sex, suggesting that sex differences should be considered in prevention and treatment strategies for coexisting insomnia in schizophrenia patients.
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12
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Wang L, Yin Y, Zhou Y, Huang J, Zhang P, Chen S, Fan H, Cui Y, Luo X, Tan S, Wang Z, Li CSR, Tian B, Tian L, Elliot Hong L, Tan Y. The mediating effect of brain-derived neurotrophic factor levels on childhood trauma and psychiatric symptoms in patients with first-episode schizophrenia. Aust N Z J Psychiatry 2022; 56:828-835. [PMID: 34263656 DOI: 10.1177/00048674211031478] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Previous studies have implicated childhood trauma and abnormal brain-derived neurotrophic factor in the pathogenesis of schizophrenia. Here, we explored whether brain-derived neurotrophic factor levels mediated the relationship between childhood trauma and psychopathological symptoms in patients with first-episode schizophrenia. METHODS Patients with first-episode schizophrenia (n = 192) and healthy controls (n = 136) were enrolled. Childhood traumatic experiences and psychopathology were assessed by Childhood Trauma Questionnaire and Positive and Negative Syndrome Scale, respectively. Enzyme-linked immunosorbent assay was used to quantify brain-derived neurotrophic factor levels. RESULTS The patients with first-episode schizophrenia experienced more severe childhood trauma and had lower serum brain-derived neurotrophic factor levels than healthy controls. Emotional abuse and Childhood Trauma Questionnaire total score showed positive correlation with Positive and Negative Syndrome Scale positive, general psychopathological subscore and total score. Emotional neglect showed positive correlation with Positive and Negative Syndrome Scale positive subscore. Physical neglect was positively associated with Positive and Negative Syndrome Scale negative subscore. Emotional neglect and Childhood Trauma Questionnaire total score were negatively correlated with serum brain-derived neurotrophic factor levels. The serum brain-derived neurotrophic factor levels mediated the relationship between both Childhood Trauma Questionnaire total score and Positive and Negative Syndrome Scale total score and negative symptoms in the patients. The brain-derived neurotrophic factor levels also mediated the relationship between emotional neglect and Positive and Negative Syndrome Scale total score in the patients. CONCLUSION Childhood trauma might contribute to the clinical symptoms of schizophrenia by affecting brain-derived neurotrophic factor levels. Perhaps we can prevent schizophrenia by reducing childhood traumatic experiences.
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Affiliation(s)
- Leilei Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Yi Yin
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Yanfang Zhou
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Junchao Huang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Ping Zhang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Song Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Hongzhen Fan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Yimin Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China
| | - Xingguang Luo
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Shuping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Zhiren Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Baopeng Tian
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
| | - Li Tian
- Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Yunlong Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P.R. China
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13
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Chae W, Jang J, Park EC, Jang SI. Changes in child abuse experience associated to sleep quality: results of the Korean Children & Youth Panel Survey. BMC Public Health 2021; 21:1210. [PMID: 34167507 PMCID: PMC8223356 DOI: 10.1186/s12889-021-11309-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 06/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background A victim of child abuse can often develop mental illness. The early detection of mental illness of children could be supported by observing sleep quality. Therefore, we examined the relationship between sleep quality and the changes in child abuse by the child’s own parents over the study period. Methods Data from the 2011–2013 Korean Children and Youth Panel Survey was used, and 2012 was set as the baseline. Adolescents who had poor sleep quality in 2011 were excluded from the analysis to obtain the final study population of 1276 adolescents aged 14 and 15 years. The generalized estimating equation model (GEE) was used for statistical analysis. Results Children who had experienced and/or were currently experiencing child abuse showed significantly poorer sleep quality (current year abuse only: odds ratio [OR] = 0.57, 95% confidence interval [CI] = 0.41, 0.79; prior year abuse only: OR = 0.72, 95% CI = 0.52, 0.99; continuous abuse: OR = 0.56, 95% CI = 0.39, 0.80) compared to children who had no experience of child abuse. Conclusion Child abuse remains a traumatic experience that influences the quality of sleep and hinders the child’s proper psychological development. We suggest approaching this issue at both the community and national levels to protect the victims. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11309-3.
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Affiliation(s)
- Wonjeong Chae
- BK21 FOUR R&E Center for Precision Public Health, College of Health Science, Korea University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Jieun Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.,Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. .,Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea.
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14
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Thompson EC, Jay SY, Andorko ND, Millman ZB, Rouhakhtar PR, Sagun K, Han SC, Herman B, Schiffman J. Sleep quality moderates the association between psychotic-like experiences and suicidal ideation among help-seeking university students. Psychiatry Res 2021; 296:113668. [PMID: 33401091 PMCID: PMC8482876 DOI: 10.1016/j.psychres.2020.113668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/19/2020] [Indexed: 02/07/2023]
Abstract
Suicide is a leading cause of death for young adults, and college-enrolled students are at markedly high risk for suicide. Psychotic-like experiences (PLEs) and sleep difficulties are prevalent among college students and have been linked to increased suicidal ideation (SI). This cross-sectional study examined the relation between PLEs and SI, moderated by sleep quality, in a sample of 442 students at a university counseling center. The Behavioral Health Measure-43 (BHM-43) was used to evaluate mental health symptoms, including sleep quality and SI. The PRIME Screen-Revised was used to measure PLEs. Regression results indicated that higher PRIME scores statistically predicted greater SI. There was a significant interaction between PRIME and sleep quality in predicting SI. Among individuals with greater sleep difficulties, PLEs were positively, significantly associated with SI. The PRIME was not a significant predictor of SI at lower levels of sleep difficulties (i.e. better sleep quality). This interaction effect remained significant when controlling for age and the BHM-43 depression and bipolar subscales. Findings suggest that sleep difficulties may be linked to increased SI for individuals with PLEs, and better sleep may be protective. Further research is needed to explore treatment targeting PLEs and/or sleep to mitigate suicide risk among university students.
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Affiliation(s)
- Elizabeth C. Thompson
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Samantha Y. Jay
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Nicole D. Andorko
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Zachary B. Millman
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | | | - Kristin Sagun
- Counseling Center, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Susan C. Han
- Counseling Center, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Bruce Herman
- Counseling Center, University of Maryland, Baltimore County, Catonsville, MD, 21250
| | - Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, 21250
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15
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Taliercio J, Bonasera B, Portillo C, Ramjas E, Serper M. Physical Activity, Sleep-related Behaviors and Severity of Symptoms in Schizophrenia. Psychiatry Res 2020; 294:113489. [PMID: 33038793 DOI: 10.1016/j.psychres.2020.113489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/25/2020] [Indexed: 12/22/2022]
Abstract
The beneficial effects of a healthy sleep hygiene and regular physical activity have both been noted in improving psychopathology symptom severity. No study to date however, has evaluated the potential therapeutic effects of both sleep and exercise simultaneously in individuals diagnosed with schizophrenia. To examine the two variables concurrently, in the present report, patients with diagnoses of schizophrenia spectrum disorders (n = 64), were administered assessments that measured both their physical activity and sleep-related behaviors. Additionally, patients' symptom severity and cognitive and daily functioning abilities were also assessed. It was found sleep hygiene and physical activity were associated with patients' symptom severity and cognitive capacities, but not with their daily functioning abilities. Further, no interaction effects were found between sleep hygiene and physical activity. These results suggest that physical activity and sleep hygiene should be considered, independently, in their contribution to psychopathology.
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Affiliation(s)
| | | | | | | | - Mark Serper
- Department of Psychology, Hofstra University, Hempstead, NY; Department of Psychiatry, Icahn Mount Sinai School of Medicine.
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16
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Kiwan N, Mahfoud Z, Ghuloum S, Chamali R, Yehya A, Hammoudeh S, Hani Y, Amro I, Al-Amin H. Self-Reported Sleep and Exercise Patterns in Patients with Schizophrenia: a Cross-Sectional Comparative Study. Int J Behav Med 2020; 27:366-377. [PMID: 31848893 PMCID: PMC7359133 DOI: 10.1007/s12529-019-09830-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Adequate sleep and physical activity have been linked to the overall well-being of both medical and psychiatric patients. Patients with schizophrenia have shown abnormal sleep patterns and decreased physical activity that were linked to their psychopathology and physical health. These phenomena are not studied yet in Arab patients with schizophrenia. The purpose of this study is to study the sleep and exercise patterns in Arab patients with schizophrenia compared with those of healthy controls. METHOD A total of 99 patients with schizophrenia and 101 controls were recruited. Arabic versions of sleep, exercise, socio-demographic, and clinical questionnaires were administered as well as the validated scales to measure psychopathology, depression, and suicidality in these participants. RESULTS The majority of patients with schizophrenia slept more than 8 h per day and exercised less when compared with controls. Sleep quality was worse in those with higher depression score and higher suicidality scores were seen in patients with lower sleep duration. Multinomial regression showed that patients with schizophrenia have higher odds of sleeping more than 8 h even after controlling for the intake of antipsychotics, age, gender, smoking status, and other confounding factors. CONCLUSION Our results showed that Arab patients with schizophrenia are at increased risk of having longer sleep duration with inadequate physical activity, which are correlating with worsening of depressive symptoms and suicidality. Thus, more attention should be paid to the changes in sleep patterns and level of exercise when treating Arab patients with schizophrenia.
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Affiliation(s)
- Nancy Kiwan
- Department of Research, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Ziyad Mahfoud
- Department of Health Policy and Research, Weill Cornell Medicine-Qatar, Doha, Qatar
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | | | - Rifka Chamali
- Department of Research, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Arij Yehya
- Department of Research, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Samer Hammoudeh
- Department of Research, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Yahya Hani
- Psychiatry Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Iman Amro
- Department of Research, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Hassen Al-Amin
- Department of Psychiatry, Weill Cornell Medicine-Qatar, Education City, P.O. Box 24144, Doha, Qatar.
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17
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Waite F, Sheaves B, Isham L, Reeve S, Freeman D. Sleep and schizophrenia: From epiphenomenon to treatable causal target. Schizophr Res 2020; 221:44-56. [PMID: 31831262 PMCID: PMC7327507 DOI: 10.1016/j.schres.2019.11.014] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Sleep disturbance is a common clinical issue for patients with psychosis. It has been identified as a putative causal factor in the onset and persistence of psychotic experiences (paranoia and hallucinations). Hence sleep disruption may be a potential treatment target to prevent the onset of psychosis and reduce persistent psychotic experiences. The aim of this review is to describe developments in understanding the nature, causal role, and treatment of sleep disruption in psychosis. METHOD A systematic literature search was conducted to identify studies, published in the last five years, investigating subjective sleep disruption and psychotic experiences. RESULTS Fifty-eight papers were identified: 37 clinical and 21 non-clinical studies. The studies were correlational (n = 38; 20 clinical, 18 non-clinical), treatment (n = 7; 1 non-clinical), qualitative accounts (n = 6 clinical), prevalence estimates (n = 5 clinical), and experimental tests (n = 2 non-clinical). Insomnia (50%) and nightmare disorder (48%) are the most prevalent sleep problems found in patients. Sleep disruption predicts the onset and persistence of psychotic experiences such as paranoia and hallucinations, with negative affect identified as a partial mediator of this relationship. Patients recognise the detrimental effects of disrupted sleep and are keen for treatment. All psychological intervention studies reported large effect size improvements in sleep and there may be modest resultant improvements in psychotic experiences. CONCLUSIONS Sleep disruption is a treatable clinical problem in patients with psychosis. It is important to treat in its own right but may also lessen psychotic experiences. Research is required on how this knowledge can be implemented in clinical services.
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Affiliation(s)
- Felicity Waite
- Department of Psychiatry, University of Oxford, UK; Oxford Health NHS Foundation Trust, UK; Sleep and Circadian Neuroscience Institute, University of Oxford, UK.
| | - Bryony Sheaves
- Department of Psychiatry, University of Oxford, UK,Oxford Health NHS Foundation Trust, UK,Sleep and Circadian Neuroscience Institute, University of Oxford, UK
| | - Louise Isham
- Department of Psychiatry, University of Oxford, UK,Oxford Health NHS Foundation Trust, UK
| | | | - Daniel Freeman
- Department of Psychiatry, University of Oxford, UK,Oxford Health NHS Foundation Trust, UK,Sleep and Circadian Neuroscience Institute, University of Oxford, UK
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18
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Sleep disturbance and quality of life in clinically stable inpatients with schizophrenia in rural China. Qual Life Res 2020; 29:2759-2768. [DOI: 10.1007/s11136-020-02541-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2020] [Indexed: 01/20/2023]
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Zhuo C, Xu X, Lin X, Chen M, Ji F, Jiang D, Xu Y, Wang L, Li Y, Tian H, Wang W, Zhou C. Depressive symptoms combined with auditory hallucinations are accompanied with severe gray matter brain impairments in patients with first-episode untreated schizophrenia - A pilot study in China. Neurosci Lett 2020; 730:135033. [PMID: 32417389 DOI: 10.1016/j.neulet.2020.135033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/07/2020] [Accepted: 05/03/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Depressive symptoms and auditory hallucinations (AHs) are often accompanied by gray matter volume (GMV) alterations in schizophrenia. However, little is known about the effects of concurrent depressive symptoms and AHs on the GMV of patients with schizophrenia. AIM To investigate the pathological features of gray brain matter in patients with first-episode untreated schizophrenia (FUSCH) who have concurrent moderate-to-severe depressive symptoms and AHs (FUSCH-DAH). METHODS The Calgary Depression Scale for Schizophrenia (CDSS) and Auditory Hallucinations Rating Scale (AHRS) were adopted. Voxel-based morphometry (VBM)-based GMV analyses were used to measure cortical alterations. FUSCH-DAH patients were compared to FUSCH patients with depressive symptoms but without AHs, denoted as FUSCH-D, along with healthy controls. RESULTS GMV reductions were more substantial in the FUSCH-DAH patients than FUSCH-D patients or healthy controls. Both FUSCH-DAH and FUSCH-D groups showed GMV reductions of the parietal, frontal, and temporal lobes, which were not apparent in the healthy controls. Compared to FUSCH-D patients, FUSCH-DAH patients demonstrated more substantial GMV reductions in the Broca area, Wernicke region, insular lobe, and prefrontal lobe. The GMV reductions were 1.06% and 0.58% in FUSCH-DAH and FUSCH-D patients, respectively, as compared with the healthy controls. CONCLUSIONS This is the first report showing that concurrent depressive symptoms and AHs leads to severe GMV deterioration in FUSCH-DAH patients. Hence, there is a reciprocal relationship between AHs and depressive symptoms in FUSCH-DAH patients. However, the potential additive effects of concurrent AHs and depressive symptoms require further investigation in order to identify future targeted therapies for schizophrenia.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining 272191, Shandong Province, China; Department of Psychiatry and Neuroimaging Center, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China; Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China.
| | - Xuexin Xu
- Department of Radiology, MRI Center, Tianjin Children Hospital, Tianjin Medical University Affiliated Tianjin Children Hospital, Tianjin 300444, China
| | - Xiaodong Lin
- Department of Psychiatry and Neuroimaging Center, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China
| | - Min Chen
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining 272191, Shandong Province, China
| | - Feng Ji
- Department of Biological Psychiatry, School of Mental Health, Jining Medical University, Jining 272191, Shandong Province, China
| | - Deguo Jiang
- Department of Psychiatry and Neuroimaging Center, Wenzhou Seventh People's Hospital, Wenzhou, 325000, Zhejiang Province, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Lina Wang
- Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China
| | - Yancheng Li
- Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China
| | - Hongjun Tian
- Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC_Lab), Tianjin Anding Hospital, 300300 Tianjin, China
| | - Wenqiang Wang
- Canada and China Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen 361000, Fujian Province, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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Trauma and Suicide: A Pilot Study Assessing Risk in Adults Diagnosed With Schizophrenia Spectrum Disorders. J Nerv Ment Dis 2020; 208:431-434. [PMID: 32282551 DOI: 10.1097/nmd.0000000000001144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This pilot study explored suicide risk in patients suffering from trauma and psychosis. Forty-seven participants diagnosed with schizophrenia spectrum disorders participated in the study. An archival design was used to identify the severity of suicide risk in participants with trauma and psychosis. Data included a chart review of documented trauma and responses to the Childhood Experience of Care and Abuse Questionnaire, Columbia-Suicide Severity Rating Scale, Beck Depression Inventory-II, and the Positive and Negative Syndrome Scale. Results of a linear regression indicated that chart-documented trauma and heightened depression scores were predictive of increased suicidality. Results suggest that, for patients with schizophrenia, depression severity and chart-documented trauma may be strong predictors of suicidality. Interestingly, data also revealed that, although depression and trauma were predictors of suicidality, psychosis was not. The implications of these results are discussed, in addition to suggestions for future research.
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Adverse childhood experiences and clinical severity in bipolar disorder and schizophrenia: A transdiagnostic two-step cluster analysis. J Affect Disord 2019; 259:104-111. [PMID: 31445335 DOI: 10.1016/j.jad.2019.08.049] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 07/03/2019] [Accepted: 08/17/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are risk factors for psychiatric disorders, but evidence about their relationship with clinical severity is limited. We aimed to classify patients according to ACEs and to compare these clusters with regards to the clinical severity. METHODS Seventy-four patients with Bipolar Disorder (BD) and 91 patients with a diagnosis within the Schizophrenia Spectrum Disorders (SSDs) were interviewed. The Childhood Experience of Care and Abuse scale (CECA) and the Positive and Negative Symptoms Scale (PANSS) were administered. A two-step cluster analysis was run to identify clusters according to ACEs. PANSS average scores were compared between clusters. RESULTS Three clusters emerged; significant differences in ACEs distribution were evident. Cluster 1 was characterized by very low frequency of ACEs. ACEs related to lack of support/isolation were more frequent within Cluster 2, instead ACEs related to abuse/neglect were over represented in Cluster 3. The comparison of PANSS through ANOVA demonstrated that Cluster 3 not only had significantly higher scores in all dimensions than Cluster 1 and 2 but also a higher average number of ACEs. LIMITATIONS CECA is a self-report scale and is subject to recall bias. CONCLUSIONS Specific ACEs are related to clinical severity among BD and SSD patients. Early life adversities related to abuse and neglect are associated to greater symptomatic severity than those related to lack of support/isolation. Our findings suggest that a history of ACEs could be used to identify patients at higher risk of unfavorable clinical features.
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Azadi S, Khosravani V, Naragon-Gainey K, Bastan FS, Mohammadzadeh A, Ghorbani F. Early Maladaptive Schemas Are Associated with Increased Suicidal Risk among Individuals with Schizophrenia. Int J Cogn Ther 2019. [DOI: 10.1007/s41811-019-00046-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Hsu CW, Lee SY, Wang LJ. Gender differences in the prevalence, comorbidities and antipsychotic prescription of early-onset schizophrenia: a nationwide population-based study in Taiwan. Eur Child Adolesc Psychiatry 2019; 28:759-767. [PMID: 30382356 DOI: 10.1007/s00787-018-1242-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 10/20/2018] [Indexed: 01/13/2023]
Abstract
Early-onset schizophrenia (EOS) is defined as patients diagnosed with schizophrenia before the age of 18. Whether the EOS population has gender differences is currently a matter of considerable debate. This study used a representative nationwide sample to examine potential gender differences in the prevalence, comorbidities, and prescription of antipsychotics among the EOS population. We identified a total of 401 patients with EOS (200 males and 201 females) from Taiwan's National Health Insurance Database between 2000 and 2012. The annual prevalence rate of overall patients with EOS increased significantly from 17.1 to 41.8 per 100,000 persons among the youth population (≤ 18 years). Sulpiride, Risperidone, and Aripiprazole were the most common antipsychotics of first choice for treating EOS. Compared to female patients, male patients were more likely to experience the following comorbidities: attention deficit hyperactivity disorder (15.5% vs. 5.5%), autism spectrum disorder (10.0% vs. 3.0%), intellectual disability (19.0% vs. 10.4%), developmental disorder (8.0% vs. 3.0%), and history of physical injury (65.5% vs. 48.8%), prior to being diagnosed with schizophrenia. We observed no significant gender differences with regard to incidence, prevalence, age of onset, and categories and doses of patients' first antipsychotic prescription. Our findings did not support the empirical opinion that males with EOS experience the onset earlier or are more prevalent than EOS female patients. However, male patients were more likely to have neurodevelopmental comorbidities and a history of physical injury. These results can function as an important reference for planning services that target real-world patient treatment.
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Affiliation(s)
- Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, College of Medicine, Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Liang-Jen Wang
- Chang Gung University College of Medicine, Kaohsiung, Taiwan.
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital, No. 123, Ta-Pei Road, Kaohsiung, Taiwan.
- Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Boysan M. An integration of quadripartite and helplessness-hopelessness models of depression using the Turkish version of the Learned Helplessness Scale (LHS). BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2019. [DOI: 10.1080/03069885.2019.1612033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Murat Boysan
- Department of Psychology, Faculty of Social Sciences, Van Yuzuncu Yil University, Van, Turkey
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Del Rio João KA, de Jesus SN, Carmo C, Pinto P. Sleep quality components and mental health: Study with a non-clinical population. Psychiatry Res 2018; 269:244-250. [PMID: 30153603 DOI: 10.1016/j.psychres.2018.08.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/02/2018] [Accepted: 08/10/2018] [Indexed: 12/21/2022]
Abstract
The deconstruction of sleep quality into its particular components may help to specify how each one of them influences mental health. Thus, to detail the understanding of the relationship between sleep quality and mental health, our study aims to assess the relationship between each component of the Pittsburgh Sleep Quality Index (PSQI) and depression, anxiety and stress. Also, we intend to analyse the moderating effects of gender, age and country on these relationships. The instruments PSQI and Depression Anxiety Stress Scale (DASS-21) were applied to a non-clinical population of 1552 participants from three different countries (Portugal, Spain and Brazil), aged over 18 years old. We estimated a multivariate regression model with AMOS Graphic 21.0 to test the seven proposed research hypotheses. The adjusted model explains 14.0%, 21.0% and 19.3% of the variances of depression, anxiety and stress, respectively. The conclusion of this study demonstrates that, with the exception of subjective sleep quality, all the other six components of the PSQI individually relate to mental health in non-clinical populations and that country is a significant moderator of these relationships.
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Affiliation(s)
| | - Saul Neves de Jesus
- Research Center for Spatial and Organizational Dynamics, University of Algarve, Portugal.
| | - Cláudia Carmo
- Research Center for Spatial and Organizational Dynamics, University of Algarve, Portugal
| | - Patrícia Pinto
- Research Center for Spatial and Organizational Dynamics, University of Algarve, Portugal
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