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Jo H, Lim M, Jeon HJ, Ahn J, Jeon S, Kim JK, Chung S. Data-driven shortened Insomnia Severity Index (ISI): a machine learning approach. Sleep Breath 2024; 28:1819-1830. [PMID: 38684641 DOI: 10.1007/s11325-024-03037-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 03/21/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The Insomnia Severity Index (ISI) is a widely used questionnaire with seven items for identifying the risk of insomnia disorder. Although the ISI is still short, more shortened versions are emerging for repeated monitoring in routine clinical settings. In this study, we aimed to develop a data-driven shortened version of the ISI that accurately predicts the severity level of insomnia disorder. METHODS We collected a sample of 800 responses from the EMBRAIN survey system. Based on the responses, seven items were grouped based on the similarity of their response using exploratory factor analysis (EFA). The most representative item within each group was selected by using eXtreme Gradient Boosting (XGBoost). RESULTS Based on the selected three key items, maintenance of sleep, interference with daily function, and concerns about sleep problems, we developed a data-driven shortened questionnaire of ISI, ISI-3 m (machine learning). ISI-3 m achieved the highest coefficient of determination (R 2 = 0.910 ) for the ISI score prediction task and the accuracy of 0.965, precision of 0.841, and recall of 0.838 for the multiclass-classification task, outperforming four previous versions of the shortened ISI. CONCLUSION As ISI-3 m is a highly accurate shortened version of the ISI, it allows clinicians to efficiently screen for insomnia and observe variations in the condition throughout the treatment process. Furthermore, the framework based on the combination of EFA and XGBoost developed in this study can be utilized to develop data-driven shortened versions of the other questionnaires.
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Affiliation(s)
- Hyeontae Jo
- Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea
- Division of Applied Mathematical Sciences, Korea University, Sejong, 30019, Republic of Korea
| | - Myna Lim
- Department of Information Science, Cornell University, Ithaca, NY, 14850, USA
| | - Hong Jun Jeon
- Department of Psychiatry, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Junseok Ahn
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Saebom Jeon
- Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea
- Department of Marketing Bigdata, Mokwon University, Daejeon, Republic of Korea
| | - Jae Kyoung Kim
- Biomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic Science, Daejeon, 34126, Republic of Korea.
- Department of Mathematical Sciences, KAIST, 291 Daehak-Ro Yuseong-Gu, Daejeon, 34141, Republic of Korea.
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 86 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
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Lenderking WR, Savva Y, Atkinson MJ, Campbell R, Chabot I, Moline M, Meier G, Morin CM. Re-examining the factor structure of the Insomnia Severity Index (ISI) and defining the meaningful within-individual change (MWIC) for subjects with insomnia disorder in two phase III clinical trials of the efficacy of lemborexant. J Patient Rep Outcomes 2024; 8:65. [PMID: 38951287 PMCID: PMC11217251 DOI: 10.1186/s41687-024-00744-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 06/14/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND The Insomnia Severity Index (ISI) is a widely used measure of insomnia severity. Various ISI research findings suggest different factor solutions and meaningful within-individual change (MWIC) to detect treatment response in patients with insomnia. This study examined an ISI factor solution and psychometric indices to define MWIC in a robust patient sample from clinical trial settings. METHODS We endeavored to improve upon previous validation of ISI by examining structural components of confirmatory factor analysis (CFA) models using two large, placebo-controlled clinical trials of lemborexant for insomnia. Using the best-fitting two-factor solution, we evaluated anchor-based, distribution-based and receiver operating characteristic (ROC) curve methods to derive an estimate of the MWIC. RESULTS The model structure for the 7-item scale proposed in other research did not fit the observed data from our two lemborexant clinical trials (N = 1956) as well as a two-factor solution based on 6 items did. Using triangulation of anchor-based, distribution-based, and ROC methods, we determined that a 5-point reduction using 6 items best represented a clinically meaningful improvement in individuals with insomnia in our patient sample. CONCLUSIONS A 6-item two-factor scale had better psychometric properties than the 7-item scale in this patient sample. On the 6-item scale, a reduction of 5 points in the ISI total score represented the MWIC. Generalizability of the proposed MWIC may be limited to patient populations with similar demographic and clinical characteristics.
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Affiliation(s)
| | | | | | | | - Isabelle Chabot
- Faculty of Pharmacy, University of Montreal, Montreal, QC, Canada
| | | | | | - Charles M Morin
- School of Psychology and Brain Research Center, Laval University, Quebec City, Canada
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Krivosova M, Hutka P, Ondrejka I, Visnovcova Z, Funakova D, Hrtanek I, Ferencova N, Mlyncekova Z, Kovacova V, Macejova A, Kukucka T, Mokry J, Tonhajzerova I. Vortioxetine's impact on the autonomic nervous system in depressed children and adolescents: analysis of the heart rate variability. Sci Rep 2024; 14:14442. [PMID: 38910177 PMCID: PMC11194280 DOI: 10.1038/s41598-024-65278-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 06/18/2024] [Indexed: 06/25/2024] Open
Abstract
Relationship between depressive disorder and autonomic nervous system has been already discussed. Reduced emotional regulation is supposed to be associated with prefrontal hypofunction and subcortical hyperactivity. The aim of this study was to determine the effect of vortioxetine on heart rate variability (HRV), a parameter of cardiac autonomic regulation, in depressed hospitalized paediatric patients and assess the clinical effectiveness of the drug in this population. We performed repeated polysomnography analyses at admission and after a short treatment in hospital (15.2 days on average) and measured various HRV parameters (RRi, pNN50, RMSSD, LF-HRV, HF-HRV) during wakefulness, N3 and REM sleep stages. Out of 27 study subjects, 67% have improved depression symptoms as well as anxiety and subjective sleep quality after short vortioxetine treatment. We have found a significant decrease in parasympathetic parameters pNN50, RMSSD and HF-HRV during N3 sleep phase, though not exclusively among vortioxetine responders. The anticipated increase in cardiovagal regulation after vortioxetine treatment was not demonstrated in this pilot study, possibly due to the drug's multimodal mechanism and impact on the nucleus tractus solitarii, particularly its antagonism on 5HT-3 receptors. Application of selective drugs could further explain the effect of vortioxetine on HRV in depressed patients.
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Affiliation(s)
- Michaela Krivosova
- Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin, Comenius University Bratislava, Martin, Slovakia
| | - Peter Hutka
- Jessenius Faculty of Medicine in Martin, Psychiatric Clinic, Comenius University Bratislava, University Hospital Martin, Martin, Slovakia
| | - Igor Ondrejka
- Jessenius Faculty of Medicine in Martin, Psychiatric Clinic, Comenius University Bratislava, University Hospital Martin, Martin, Slovakia.
| | - Zuzana Visnovcova
- Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin, Comenius University Bratislava, Martin, Slovakia
| | - Dana Funakova
- Jessenius Faculty of Medicine in Martin, Psychiatric Clinic, Comenius University Bratislava, University Hospital Martin, Martin, Slovakia
| | - Igor Hrtanek
- Jessenius Faculty of Medicine in Martin, Psychiatric Clinic, Comenius University Bratislava, University Hospital Martin, Martin, Slovakia
| | - Nikola Ferencova
- Jessenius Faculty of Medicine in Martin, Biomedical Centre Martin, Comenius University Bratislava, Martin, Slovakia
| | - Zuzana Mlyncekova
- Jessenius Faculty of Medicine in Martin, Psychiatric Clinic, Comenius University Bratislava, University Hospital Martin, Martin, Slovakia
| | - Veronika Kovacova
- Jessenius Faculty of Medicine in Martin, Psychiatric Clinic, Comenius University Bratislava, University Hospital Martin, Martin, Slovakia
| | - Andrea Macejova
- Jessenius Faculty of Medicine in Martin, Psychiatric Clinic, Comenius University Bratislava, University Hospital Martin, Martin, Slovakia
| | - Tomas Kukucka
- Jessenius Faculty of Medicine in Martin, Psychiatric Clinic, Comenius University Bratislava, University Hospital Martin, Martin, Slovakia
| | - Juraj Mokry
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University Bratislava, Martin, Slovakia
| | - Ingrid Tonhajzerova
- Jessenius Faculty of Medicine in Martin, Psychiatric Clinic, Comenius University Bratislava, University Hospital Martin, Martin, Slovakia
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University Bratislava, Martin, Slovakia
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4
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Sancho-Domingo C, Carballo JL, Coloma-Carmona A, Buysse DJ. Psychometric adaptation of the Spanish version of the Brief Pittsburgh Sleep Quality Index in adolescents. J Pediatr Psychol 2024:jsae046. [PMID: 38894636 DOI: 10.1093/jpepsy/jsae046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/26/2024] [Accepted: 05/26/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE Good sleep quality is essential for adolescent health, yet sleep difficulties persist in this age group. The 6-item Brief Pittsburgh Sleep Quality Index (B-PSQI) was recently developed to improve sleep quality assessment, however, its validity in adolescents remains unexplored. This study examined the B-PSQI's psychometric properties in Spanish adolescents and adapted the scoring method to age-specific sleep recommendations. METHODS A cross-sectional study involving 1,065 adolescents (15-17 years; 56.8% female) was conducted in public high schools. Sleep quality was measured using the B-PSQI, the Insomnia Severity Index (ISI), the short Patient-Reported Outcomes Measurement Information System (PROMIS), and the Epworth Sleepiness Scale (ESS). Additionally, depression and anxiety were assessed using the Depression, Anxiety, and Stress Scales. Reliability, validity, and measurement invariance were analyzed. RESULTS The B-PSQI global scores were 4.5 (SD = 1.9) for the original scoring method and 5.4 (SD = 2.8) for the age-adjusted. The age-adjusted B-PSQI showed satisfactory reliability (ω = 0.84) and concurrent, convergent, and discriminant validity (ISI rS = 0.67; PROMIS rS = 0.71; anxiety rS = 0.40; depression rS = 0.42; ESS rS = 0.29). Adequacy for one-factor structure (χ2(4) = 53.9; CFI = 0.97; TLI = 0.92; RMSEA = 0.108; SRMR = 0.05) and invariance across sexes were supported. Both B-PSQI scoring methods showed similar psychometric properties, but the original yielded a higher percentage of poor sleepers (43.1%; cutoff ≥5) than the age-adjusted version (41.9%; cutoff ≥6). CONCLUSIONS Findings suggest that the B-PSQI is a valid and reliable measure to assess adolescent sleep quality. Its scoring can be adjusted to provide age-specific criteria for good sleep. The B-PSQI has potential utility for screening sleep problems and facilitating overall health promotion in adolescents.
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Affiliation(s)
- Clara Sancho-Domingo
- Center of Applied Psychology, Department of Health Psychology, Miguel Hernández University of Elche, Spain
| | - José Luis Carballo
- Center of Applied Psychology, Department of Health Psychology, Miguel Hernández University of Elche, Spain
| | - Ainhoa Coloma-Carmona
- Center of Applied Psychology, Department of Health Psychology, Miguel Hernández University of Elche, Spain
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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Nagy SM, Emert SE, Leete JJ, Taylor DJ, Dietch JR, Slavish DC, Ruggero CJ, Kelly K. Psychometric Evaluation of the Insomnia Severity Index in Nurses. Behav Sleep Med 2024:1-11. [PMID: 38872302 DOI: 10.1080/15402002.2024.2362370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Examine psychometric properties of the Insomnia Severity Index (ISI) in a sample of nurses. METHOD In a sample of day shift nurses (N = 289), a confirmatory factor analysis (CFA), convergent and discriminant validity analyses, and a test-retest reliability analysis were performed. RESULTS CFA showed that a two-factor model provided the best fit. The ISI had moderate to poor convergent validity with sleep diary parameters, and moderate convergent validity with the Sleep Condition Indicator (r = -.66), Pittsburgh Sleep Quality Index (r = .66), and PROMIS Sleep-Related Impairment measure (r = .67). The ISI demonstrated good discriminant validity with the measures Composite Scale of Morningness (r = -.27), Nightmares Disorder Index (r = .25), PTSD Checklist for DSM-5 (sleep items removed; r = .32), and Perceived Stress Scale (r = .43). The ISI had weaker discriminant validity with the PHQ-9 (r = .69) and Generalized Anxiety Disorder Screener (r = .51). The ISI demonstrated a good test-retest reliability (ICCs = .74-.88). CONCLUSIONS The ISI is a psychometrically strong measure for the assessment of insomnia severity in day shift nurses. Overlap with psychological symptoms, primarily anxiety and depression, suggests caution while interpreting these constructs.
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Affiliation(s)
- Samantha M Nagy
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Sarah E Emert
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | | | - Daniel J Taylor
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Jessica R Dietch
- Department of Psychology, University of North Texas, Denton, Texas, USA
- School of Psychological Science, Oregon State University, Corvallis, Oregon, USA
| | - Danica C Slavish
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Kimberly Kelly
- Department of Psychology, University of North Texas, Denton, Texas, USA
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Alruwaili A, Alanazy ARM. The Effect of Shift Work on Sleep Patterns of Paramedics in Saudi Arabia. J Multidiscip Healthc 2024; 17:2857-2869. [PMID: 38881751 PMCID: PMC11180460 DOI: 10.2147/jmdh.s458512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/22/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose Shift work poses significant sleep health challenges for paramedics, affecting their ability to respond effectively in emergencies. This study aimed to evaluate the impact of shift work on sleep parameters among paramedics in Saudi Arabia, identifying key factors influencing insomnia. Patients and Methods A cross-sectional, online survey was conducted, gathering data on sociodemographic characteristics, work-related factors, sleep duration, and insomnia among paramedics in Saudi Arabia. The Athens Insomnia Scale was used to define insomnia. The association between shift work and sleep parameters was examined. Predictors of insomnia were identified through logistic regression models by inspecting the adjusted odds ratio (aOR). Results 1076 Saudi paramedics were included, most of whom were 26-35 years old, males, married, had a Bachelor's degree, worked in hospital-based settings for private agencies in rural areas, and had 6-10 years of experience. Occupational stress was reported by 52.96% of paramedics. All shift work characteristics (working hours, number of shifts, work schedule, and off-work days) were significantly associated with insomnia (p=0.0001). The multivariate regression revealed that work setting (aOR=18.71, p=0.02), coffee consumption (aOR=36.83, p=0.01), work schedule (aOR=21.93, p=0.01), and time to bed (aOR=0.01, p=0.01), sleep duration (aOR=0.03, p=0.03), and occupation stress (aOR=9.31, p=0.001) were predictors for insomnia. Conclusion Our findings underscores the need for targeted interventions to mitigate the adverse effects of shift work on sleep health among paramedics.
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Affiliation(s)
- Abdullah Alruwaili
- Emergency Medical Services Program, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Al Ahsa, 31982, Saudi Arabia
- King Abdullah International Medical Research Center, Al Ahsa, 31982, Saudi Arabia
- Ministry of National Guard - Health Affairs, Al Ahsa, 31982, Saudi Arabia
| | - Ahmed Ramdan M Alanazy
- Emergency Medical Services Program, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Al Ahsa, 31982, Saudi Arabia
- King Abdullah International Medical Research Center, Al Ahsa, 31982, Saudi Arabia
- Ministry of National Guard - Health Affairs, Al Ahsa, 31982, Saudi Arabia
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Que J, Chen S, Chan NY, Wu S, Zhang L, Chen Y, Liu J, Chen M, Chen L, Li SX, Lin D, Liu F, Wing YK. Associations of evening-type and insomnia symptoms with depressive symptoms among youths. Sleep Med 2024; 118:81-87. [PMID: 38626648 DOI: 10.1016/j.sleep.2024.04.009] [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: 01/31/2024] [Revised: 03/23/2024] [Accepted: 04/06/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Evening-type and insomnia symptoms are significantly related to each other and independently associated with depressive symptoms, yet few studies have examined the potential interaction between these two conditions. Therefore, we aimed to examine the associations of evening-type and insomnia symptoms with depressive symptoms among Chinese youths, with a specific focus on the joint effects of the two conditions on depressive symptoms. METHODS Participants aged between 12 and 25 were invited to participate in an online survey from December 15, 2022, to May 26, 2023. Multivariate logistic regression models and additive interaction models were used to examine the independent and joint effects of chronotypes and insomnia symptoms on depressive symptoms, respectively. RESULTS Of the 6145 eligible youths, the prevalence of evening-type and insomnia symptoms were 24.9 % and 29.6 %, respectively. Both evening-type (adjusted OR, [AdjOR]: 3.21, 95 % CI: 2.80-3.67) and insomnia symptoms (AdjOR: 10.53, 95 % CI: 9.14-12.12) were associated with an increased risk of depressive symptoms. In addition, the additive interaction models showed that there is an enhanced risk of depression related to interaction between evening-type and insomnia symptoms (relative excess risk due to interaction, [RERI]: 11.66, 95 % CI: 7.21-16.11). CONCLUSIONS The present study provided additional evidence demonstrating the presence of interaction between evening-type and insomnia symptoms, which can lead to a higher risk of depressive symptoms. Our findings argue the need for addressing both sleep and circadian factors in the management of depressive symptoms in young people.
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Affiliation(s)
- Jianyu Que
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China
| | - Sijing Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China; Centre de Recherche CERVO/Brain Research Center, École de Psychologie, Université Laval, Quebec City, Quebec, Canada
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Suying Wu
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China
| | - Li Zhang
- Inner Mongolia Autonomous Region Mental Health Center, Hohhot, Inner Mongolia, China
| | - Yaoyi Chen
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China
| | - Jingrou Liu
- Xiamen University of Technology, Xiamen, Fujian, China
| | | | - Lixia Chen
- Inner Mongolia Autonomous Region Mental Health Center, Hohhot, Inner Mongolia, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region of China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Duoduo Lin
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China.
| | - Farong Liu
- Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Fujian, China.
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
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Chen SJ, Li SX, Zhang J, Lam SP, Chan JWY, Chan KCC, Li AM, Morin CM, Wing YK, Chan NY. Subtyping at-risk adolescents for predicting response toward insomnia prevention program. J Child Psychol Psychiatry 2024; 65:764-775. [PMID: 37803887 DOI: 10.1111/jcpp.13904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Previous study has shown that a brief cognitive-behavioral prevention insomnia program could reduce 71% risk of developing insomnia among at-risk adolescents. This study aimed to evaluate the differential response to insomnia prevention in subgroups of at-risk adolescents. METHODS Adolescents with a family history of insomnia and subthreshold insomnia symptoms were randomly assigned to a 4-week insomnia prevention program or nonactive control group. Assessments were conducted at baseline, 1 week, and 6- and 12-month after the intervention. Baseline sleep, daytime, and mood profiles were used to determine different subgroups by using latent class analysis (LCA). Analyses were conducted based on the intention-to-treat approach. RESULTS LCA identified three subgroups: (a) insomnia symptoms only, (b) insomnia symptoms with daytime sleepiness and mild anxiety, and (c) insomnia symptoms with daytime sleepiness, mild anxiety, and depression. The incidence rate of insomnia disorder over the 12-month follow-up was significantly reduced for adolescents receiving intervention in subgroup 3 compared with the controls (hazard ratio [HR] = 0.37; 95% confidence interval [CI]: 0.13-0.99; p = .049) and marginally for subgroup 2 (HR = 0.14; 95% CI: 0.02-1.08; p = .059). In addition, adolescents who received intervention in subgroups 2 and 3 had a reduced risk of excessive daytime sleepiness (subgroup 2: adjusted OR [AdjOR] = 0.45, 95% CI: 0.23-0.87; subgroup 3: AdjOR = 0.32, 95% CI: 0.13-0.76) and possible anxiety (subgroup 2: AdjOR = 0.47, 95% CI: 0.27-0.82; subgroup 3: AdjOR = 0.33, 95% CI: 0.14-0.78) compared with the controls over the 12-month follow-up. CONCLUSIONS Adolescents at risk for insomnia can be classified into different subgroups according to their psychological profiles, which were associated with differential responses to the insomnia prevention program. These findings indicate the need for further phenotyping and subgrouping at-risk adolescents to develop personalized insomnia prevention.
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Affiliation(s)
- Si-Jing Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong, SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, SAR, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Siu Ping Lam
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Kate Ching-Ching Chan
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Charles M Morin
- School of Psychology, Université Laval and Centre de recherche CERVO, Quebec City, QC, Canada
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
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Lindholm A, Jarbin H, Aili K, Nygren JM, Svedberg P, Larsson I. Sex Differences in Children with Uncomplicated Attention Deficit/Hyperactivity Disorder and Sleep Problems. CHILDREN (BASEL, SWITZERLAND) 2024; 11:636. [PMID: 38929216 PMCID: PMC11201524 DOI: 10.3390/children11060636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Approximately 7.6% of children are diagnosed with attention deficit/hyperactivity disorder (ADHD), and sleep impairments affect 25-85%. There is a noticeable lack of research on girls and sex differences. The aim of this study was to examine sex differences in children with uncomplicated ADHD and sleep problems. METHODS Cross-sectional baseline data were retrieved from a randomized controlled trial with weighted blankets (55 boys and 41 girls, 6-14 years) on a cohort recently diagnosed with uncomplicated ADHD and sleep problems. Differences between boys and girls in ADHD symptoms, objectively and subjectively measured sleep, anxiety, and functioning were examined via parent- or self-reported validated instruments. RESULTS Girls reported significantly lower (worse) satisfaction with well-being, life overall, and school, but not for family. Parents reported more sleep anxiety and night-time wakings among boys, but no sex differences in other measures and also not in self-reported measures or objective sleep measures. Children who reported worry, sadness, or unhappiness had more sleep problems. CONCLUSIONS Boys with ADHD and sleep problems may need support with sleep-related anxiety and night-time wakings, while girls may require support with overall functioning. Additionally, children who express feelings of worry, sadness, or unhappiness alongside their ADHD symptoms should have attention given to their sleep.
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Affiliation(s)
- Annelie Lindholm
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
| | - Håkan Jarbin
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, SE-22184 Lund, Sweden;
- Child and Adolescent Psychiatry, Region Halland, SE-30185 Halmstad, Sweden
| | - Katarina Aili
- Department of Health and Sport, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden;
| | - Jens M. Nygren
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
| | - Petra Svedberg
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
| | - Ingrid Larsson
- Department of Health and Care, School of Health and Welfare, Halmstad University, SE-30118 Halmstad, Sweden; (A.L.); (J.M.N.); (P.S.)
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10
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Ding W, Wang MZ, Zeng XW, Liu ZH, Meng Y, Hu HT, Zhang Y, Guan YG, Meng FG, Zhang JG, Wang S. Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic: A multicenter cross-sectional study. World J Psychiatry 2024; 14:704-714. [PMID: 38808084 PMCID: PMC11129153 DOI: 10.5498/wjp.v14.i5.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/19/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Healthcare workers (HCWs) are at increased risk of contracting coronavirus disease 2019 (COVID-19) as well as worsening mental health problems and insomnia. These problems can persist for a long period, even after the pandemic. However, less is known about this topic. AIM To analyze mental health, insomnia problems, and their influencing factors in HCWs after the COVID-19 pandemic. METHODS This multicenter cross-sectional, hospital-based study was conducted from June 1, 2023 to June 30, 2023, which was a half-year after the end of the COVID-19 emergency. Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs. Symptoms such as anxiety, depression, and insomnia were evaluated by the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Insomnia Severity Index. Factors influencing the symptoms were identified by multivariable logistic regression. RESULTS A total of 2000 participants were invited, for a response rate of 70.6%. A total of 1412 HCWs [618 (43.8%) doctors, 583 (41.3%) nurses and 211 (14.9%) nonfrontline], 254 (18.0%), 231 (16.4%), and 289 (20.5%) had symptoms of anxiety, depression, and insomnia, respectively; severe symptoms were found in 58 (4.1%), 49 (3.5%), and 111 (7.9%) of the participants. Nurses, female sex, and hospitalization for COVID-19 were risk factors for anxiety, depression, and insomnia symptoms; moreover, death from family or friends was a risk factor for insomnia symptoms. During the COVID-19 outbreak, most [1086 (76.9%)] of the participating HCWs received psychological interventions, while nearly all [994 (70.4%)] of them had received public psychological education. Only 102 (7.2%) of the HCWs received individual counseling from COVID-19. CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic, they still faced challenges and greater risks than did the general population. Identifying risk factors would help in providing targeted interventions. In addition, although a major proportion of HCWs have received public psychological education, individual interventions are still insufficient.
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Affiliation(s)
- Wei Ding
- Department of Public Health, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
| | - Min-Zhong Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Xian-Wei Zeng
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
| | - Zhen-Hua Liu
- Sleep Medicine Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
| | - Yao Meng
- Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
| | - Hui-Ting Hu
- Department of Neurology, Heze Mudan People’s Hospital, Heze 274000, Shandong Province, China
| | - Yuan Zhang
- Neonatal Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Yu-Guang Guan
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Fan-Gang Meng
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Jian-Guo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Shu Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
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11
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Arnison T, Evans B, Schrooten MGS, Persson J, Palermo TM. Adolescent Girls' Musculoskeletal Pain is More Affected by Insomnia Than Boys, and Through Different Psychological Pathways. THE JOURNAL OF PAIN 2024:104571. [PMID: 38763259 DOI: 10.1016/j.jpain.2024.104571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
Prior research has established that insomnia is predictive of pain in adolescents and that psychological mechanisms have a crucial role in this relationship. Adolescent girls report more insomnia and pain than boys, yet little is known of gender differences in how insomnia influences pain. This study assessed gender differences in levels and trajectories of insomnia and pain during adolescence, and whether rumination and negative mood mediated the effect of insomnia on pain. Longitudinal survey data measured on 5 annual occasions (Nbaseline = 2,767) were analyzed in a multigroup longitudinal serial mediation model. A final model was generated with insomnia as the predictor, rumination and depressed mood as mediators, pain as the outcome, and gender as the grouping variable. The results showed that insomnia predicted pain in adolescents, with an effect 3.5 times larger in girls than boys. Depressed mood was the main mediator in boys. In girls, rumination was the only significant mediator. There were significant gender differences in the effects of insomnia on rumination and pain, and in the effects of rumination on depressed mood and pain, with stronger effects in girls. These results highlight that girls and boys should be considered separately when studying the relationship between insomnia and pain. PERSPECTIVE: Levels of insomnia and pain are progressively higher in adolescent girls than boys, across adolescence. The predictive strength of insomnia symptoms for future pain is 3.5 times greater in girls, with distinct gender-specific underlying pathways: rumination partially mediates this effect in girls, while depressed mood does so in boys.
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Affiliation(s)
- Tor Arnison
- Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Örebro County, Sweden; School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden.
| | - Brittany Evans
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Martien G S Schrooten
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden
| | - Jonas Persson
- School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Örebro County, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Stockholm County, Sweden
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology, Pediatrics & Psychiatry, University of Washington School of Medicine, Seattle, Washington
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12
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Rollinson R, Cole A, Gee B, Tofan I, Graham A, Hatton J, Lyons J, Reeve S, Wilson J, Beardsworth K, Clarke T. Delivering a sleep intervention across a youth mental health service using non-expert practitioners: A service evaluation. Early Interv Psychiatry 2024. [PMID: 38703076 DOI: 10.1111/eip.13534] [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] [Received: 01/10/2024] [Revised: 03/26/2024] [Accepted: 04/08/2024] [Indexed: 05/06/2024]
Abstract
AIMS Poor sleep is highly prevalent in young people and increases risk of mental health difficulties, yet access to sleep interventions remains limited. This paper evaluates the use of a sleep intervention delivered by non-expert practitioners in a secondary care youth mental health service. METHOD Assistant psychologists were trained to deliver a six-session 1:1 cognitive-behavioural sleep intervention adapted for use with young people with mental health difficulties. A within-subject design assessed clinical outcomes relating to sleep (Insomnia Severity Index), psychological distress and personal goals (Goal Based Outcome Measures) at four time points. RESULTS High referral, intervention take-up (82.82%) and completion (70%) rates were reported, together with high baseline levels of insomnia (Insomnia Severity Index mean 20.47, SD 3.68) and poor sleep efficiency (56.36%, SD 17.23). Fifty-six young people (average age 19.2 years, SD 3.25) were included in the outcome analysis. Statistically and clinically significant improvements were seen across all outcome measures, with 68% no longer meeting clinical threshold (ISI ≥15) for insomnia at endpoint. CONCLUSIONS This study demonstrates exceptionally high levels of clinical need and engagement with a sleep intervention adapted specifically for young people with mental health difficulties. Whilst limited by the uncontrolled design, large improvements in insomnia and psychological distress support its effectiveness and utility in clinical settings. More robust implementation and evaluation is warranted in broader youth mental health services to promote earlier access.
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Affiliation(s)
- Rebecca Rollinson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK
| | - Amber Cole
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Brioney Gee
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK
| | - Ioana Tofan
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Adam Graham
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Jude Hatton
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Jonathan Lyons
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Sarah Reeve
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK
- Cambridgeshire and Peterborough NHS FoundationTrust, Cambridge, Cambridgeshire, UK
| | - Jonathan Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK
| | | | - Tim Clarke
- Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
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13
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Chen CX, Zhang JH, Li SX, Chan KCC, Li AM, Kong APS, Chan JWY, Wing YK, Chan NY. Secular trends in sleep and circadian problems among adolescents in Hong Kong: From 2011-2012 to 2017-2019. Sleep Med 2024; 117:62-70. [PMID: 38513532 DOI: 10.1016/j.sleep.2024.03.003] [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: 01/07/2024] [Revised: 03/01/2024] [Accepted: 03/03/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE The study aimed to investigate secular trends in sleep and circadian problems in Hong Kong Chinese adolescents. METHODS This study analyzed cross-sectional data from two large-scale school-based sleep surveys conducted in 2011-2012 and 2017-2019. Sleep and circadian problems, including sleep-wake pattern, insomnia, chronotype, social jetlag, daytime sleepiness, and other sleep-related factors, were compared between two survey years. RESULTS A total of 8082 adolescents (5639 students in 2011-2012 [Mean age: 14.4 years, 50.9% boys] and 2443 students in 2017-2019 [Mean age: 14.7 years, 54.0% boys]) were included in this 7-year study. The average time in bed of Hong Kong adolescents decreased from 8.38 hours to 8.08 hours from 2011-2012 to 2017-2019. There was a 0.28-hour delay in weekday bedtime, 0.54-hour advance in weekend wake-up time, and a 0.36-hour decline in average time in bed, resulting in increased trends of sleep loss (Time in bed <8h: OR = 2.06, 95%CI: 1.44-2.93, p < 0.01; Time in bed <7h: OR = 2.73, 95%CI: 1.92-3.89, p < 0.01), daytime sleepiness (OR = 1.70, 95%CI: 1.34-2.16, p < 0.01), and evening chronotype (OR = 1.26, 95%CI: 1.08-1.48, p < 0.01). The increased trend in insomnia disorder, however, was insignificant when covariates were adjusted. CONCLUSION A secular trend of reduced time in bed, delay in weekday bedtime, advance in weekend wake-up time, increase in evening chronotype and daytime sleepiness from 2011-2012 to 2017-2019 were observed. There is a timely need for systematic intervention to promote sleep health in adolescents.
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Affiliation(s)
- Chris Xie Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Ji-Hui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China; Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
| | - Kate Ching Ching Chan
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Alice Pik Shan Kong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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14
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Zhou SC, Zhou Z, Tang Q, Yu P, Zou H, Liu Q, Wang XQ, Jiang J, Zhou Y, Liu L, Yang BX, Luo D. Prediction of non-suicidal self-injury in adolescents at the family level using regression methods and machine learning. J Affect Disord 2024; 352:67-75. [PMID: 38360362 DOI: 10.1016/j.jad.2024.02.039] [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: 10/07/2022] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Adolescent non-suicidal self-injury (NSSI) is a major public health issue. Family factors are significantly associated with NSSI in adolescents, while studies on forecasting NSSI at the family level are still limited. In addition to regression methods, machine learning (ML) techniques have been recommended to improve the accuracy of family-level risk prediction for NSSI. METHODS Using a dataset of 7967 students and their primary caregivers from a cross-sectional study, logistic regression model and random forest model were used to test the forecasting accuracy of NSSI predictions at the family level. Cross-validation was used to assess model prediction performance, including the area under the receiver operator curve (AUC), precision, Brier score, accuracy, sensitivity, specificity, positive predictive value and negative predictive value. RESULTS The top three important family-related predictors within the random forest algorithm included family function (importance:42.66), family conflict (importance:42.18), and parental depression (importance:27.21). The most significant family-related risk predictors and protective predictors identified by the logistic regression model were family history of mental illness (OR:2.25) and help-seeking behaviors of mental distress from parents (OR:0.65), respectively. The AUCs of the two models, logistic regression and random forest, were 0.852 and 0.835, respectively. LIMITATIONS The key limitation is that this cross-sectional survey only enabled the authors to examine predictors that were considered to be proximal rather than distal. CONCLUSIONS These findings highlight the significance of family-related factors in forecasting NSSI in adolescents. Combining both conventional statistical methods and ML methods to improve risk assessment of NSSI at the family level deserves attention.
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Affiliation(s)
- Si Chen Zhou
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Zhaohe Zhou
- School of Basic Medical Sciences, Chengdu University, Chengdu, China
| | - Qi Tang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Ping Yu
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Huijing Zou
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Qian Liu
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Xiao Qin Wang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Jianmei Jiang
- The Central Hospital of Enshi Tujia Autonomous Prefecture, Enshi, China
| | - Yang Zhou
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Lianzhong Liu
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Bing Xiang Yang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Dan Luo
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
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15
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Yu BYM, Lam CS, Tam KYY, Cheung DST, Chen SC, Yeung WF. The Role of Insomnia and Exercise in COVID-19 Worries for Psychological Distress in Hong Kong Chinese: A Moderated Mediation Model. Behav Sleep Med 2024; 22:378-392. [PMID: 37842738 DOI: 10.1080/15402002.2023.2270095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
OBJECTIVE To examine the role of insomnia as a mediator between worrying and mental health and whether the association between worrying and insomnia is moderated by the levels of exercise frequency. METHODS A cross-sectional online survey was conducted during the fourth wave of the COVID-19 outbreak in Hong Kong (n = 988). Participants' insomnia, psychological distress, and exercise frequency were evaluated. A mediation analysis was performed to examine the direct effect of COVID-19 worries and their indirect effect through insomnia on psychological distress. RESULTS A significant indirect effect of COVID-19 worries through insomnia was found on psychological distress (beta = 0.18, SE = 0.02, 95% CI = 0.14-0.22, p < .001). The significant index of moderated mediation supported the moderating effect of exercise frequency on the indirect effect of COVID-19 worries on psychological distress (IMM = 0.06, SE = 0.02, 95% CI = 0.02-0.10, p = .006). The conditional indirect effects of insomnia on psychological distress were significant in individuals with mean and higher exercise frequency but not in those with lower exercise frequency. CONCLUSION COVID-19 worries increased psychological distress through the worsening of sleep, and such an array of COVID-19 worries on insomnia was moderated by exercise frequency. Engaging more frequent exercise could reduce insomnia in people with less COVID-19 worries.
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Affiliation(s)
- Branda Yee-Man Yu
- Department of Psychology, the University of Hong Kong, Hong Kong, SAR, China
| | - Chun Sing Lam
- School of Pharmacy, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Katy Yuen Yan Tam
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Shu Cheng Chen
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Wing Fai Yeung
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, China
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16
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Sun W, Cheung FTW, Chan NY, Zhang J, Chan JWY, Chan KCC, Wing YK, Li SX. The impacts of intra-individual daily sleep variability on daytime functioning and sleep architecture in healthy young adults: An experimental study. J Sleep Res 2024; 33:e13967. [PMID: 37366548 DOI: 10.1111/jsr.13967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 05/17/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Abstract
Sleep variability is commonly seen in the young populations. This study aimed to examine the impacts of experimentally induced sleep variability on sleepiness, mood, cognitive performance and sleep architectures among young adults. Thirty-six healthy individuals (aged 18-22 years) were randomly assigned to either variable sleep schedule (n = 20) or control (n = 16) groups. The protocol involved 1 week of regular sleep (time in bed = 7.5 hr) in the home setting, followed by one adaptation night (time in bed = 7.5 hr), one baseline night (time in bed = 7.5 hr), and 6 nights of sleep manipulation in the laboratory monitored by polysomnography (three cycles of variable sleep schedule by changing daily time in bed alternating between 6 hr and 9 hr for variable sleep schedule group versus fixed sleep schedule with daily time in bed for 7.5 hr for control group). Sleepiness, mood, sustained attention, processing speed, response inhibition and working memory were measured every morning and evening. The variable sleep schedule group reported a higher level of sleepiness, especially in the mornings, and increased negative mood in the evenings. There were no significant differences in positive mood, cognitive performance and sleep macro- and micro-structures. Our results showed the negative effects of sleep variability on daytime functioning especially sleepiness and negative mood, suggesting the need to address variable sleep schedules through sleep intervention.
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Affiliation(s)
- Wanqi Sun
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong, China
- Shanghai Mental Health Center, Shanghai, China
| | - Forrest Tin Wai Cheung
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kate Ching Ching Chan
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Shirley Xin Li
- Sleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
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17
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Mao B, Xie Z, Liu M, Gong Y, Wang H, Yang S, Liao M, Xiao T, Tang S, Wang Y, Yang YD. Associations of chronotype with anxiety, depression and insomnia among general adult population: A cross-sectional study in Hubei, China. J Affect Disord 2024; 351:250-258. [PMID: 38280566 DOI: 10.1016/j.jad.2024.01.188] [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: 05/15/2023] [Revised: 01/06/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND The relationship between chronotype and anxiety, depression, and insomnia was inconsistent. We aimed to assess the association between chronotype and mental health and the potential moderating effect of age and socioeconomic status (SES). METHODS A multi-stage sampling cross-sectional study with 12,544 adults was conducted. Chronotype, anxiety, depression, and insomnia were investigated by 5-item Morning and Evening, 7-item Generalized Anxiety Disorder, 9-item Patient Health, and the 7-item Insomnia Severity Index Questionnaires. Logistic regression was conducted. RESULTS The predominant chronotype was morning chronotype (69.2 %), followed by 27.6 % intermediate and 3.2 % evening chronotype. The prevalence of anxiety, depression, and insomnia was 0.7 %, 1.9 %, and 9.6 %, respectively. Compared with intermediate chronotype, morning chronotype participants had a lower risk of anxiety (OR = 0.28,95%CI:0.18-0.44), depression (OR = 0.54,95%CI:0.41-0.72) and insomnia (OR = 0.67,95%CI:0.58-0.77), while evening chronotype participants had a higher risk of depression (OR = 1.98,95%CI:1.06-3.71) but not anxiety or insomnia. Interactions between chronotype with age and SES on insomnia (Pinteraction < 0.05) were found. A more profound association between morning chronotype and insomnia was observed in <65 years participants (OR = 0.59,95%CI:0.50-0.71) and those with monthly household income ≥10,000yuan (OR = 0.21,95%CI:0.12-0.35), compared with their counterparts. LIMITATIONS The cross-sectional design limited causal conclusions. Only adults were included; the findings could not be generalized to children. CONCLUSIONS The morning chronotype might be protective for anxiety, depression, and insomnia, while the evening chronotype might be a risk factor for depression. Future studies are needed to assess the efficacy of chronotype-focused intervention for mental health. Insomnia prevention efforts should pay more attention to the elderly and those with lower incomes.
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Affiliation(s)
- Bin Mao
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Zhongliang Xie
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Mengjiao Liu
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang 330006, China; Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
| | - Yue Gong
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Huicai Wang
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Shuwang Yang
- Institute of Chronic Non-Communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Ming Liao
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Tianli Xiao
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Shiming Tang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Ying Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Yi-De Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China..
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18
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Li SX, Cheung FTW, Chan NY, Chan JWY, Zhang J, Li AM, Espie CA, Gradisar M, Wing YK. Effects of cognitive behavioural therapy and bright light therapy for insomnia in youths with eveningness: study protocol for a randomised controlled trial. Trials 2024; 25:246. [PMID: 38594725 PMCID: PMC11005158 DOI: 10.1186/s13063-024-08090-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/02/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Insomnia and eveningness are common and often comorbid conditions in youths. While cognitive behavioural therapy for insomnia (CBT-I) has been suggested as a promising intervention, it remains unclear whether it is sufficient to also address circadian issues in youths. In addition, despite that light has been shown to be effective in phase-shifting one's circadian rhythm, there has been limited data on the effects of bright light therapy and its combination with CBT-I on sleep and circadian outcomes in youths. The current protocol outlines a randomised controlled trial that examines the efficacy of CBT-I and CBT-I plus bright light therapy (BLT) in reducing insomnia severity, improving mood symptoms and daytime functioning (e.g. sleepiness, fatigue, cognitive function), and improving subjective and objective sleep and circadian measures compared to a waitlist control group. METHODS We will carry out a randomised controlled trial (RCT) with 150 youths aged 12-24 who meet the criteria of insomnia and eveningness. Participants will be randomised into one of three groups: CBT-I with bright light therapy, CBT-I with placebo light, and waitlist control. Six sessions of CBT-I will be delivered in a group format, while participants will be currently asked to use a portable light device for 30 min daily immediately after awakening throughout the intervention period for bright light therapy. The CBT-I with light therapy group will receive bright constant green light (506 lx) while the CBT-I with placebo light group will receive the modified light device with the LEDs emitting less than 10 lx. All participants will be assessed at baseline and post-treatment, while the two active treatment groups will be additionally followed up at 1 month and 6 months post-intervention. The primary outcome will be insomnia severity, as measured by the Insomnia Severity Index. Secondary outcomes include self-reported mood, circadian, daytime functioning, and quality of life measures, as well as sleep parameters derived from actigraphy and sleep diary and neurocognitive assessments. Objective measures of the circadian phase using dim-light melatonin onset assessment and sleep parameters using polysomnography will also be included as the secondary outcomes. DISCUSSION This study will be the first RCT to directly compare the effects of CBT-I and BLT in youths with insomnia and eveningness. Findings from the study will provide evidence to inform the clinical management of insomnia problems and eveningness in youths. TRIAL REGISTRATION ClinicalTrials.gov NCT04256915. Registered on 5 February 2020.
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Affiliation(s)
- Shirley Xin Li
- Department of Psychology, Sleep Research Clinic and Laboratory, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
| | - Forrest Tin Wai Cheung
- Department of Psychology, Sleep Research Clinic and Laboratory, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Center for Sleep and Circadian Medicine, The Affiliated Brain Hospital of Guangzhou Medicine University, Guangzhou, Guangdong, China
| | - Albert Martin Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Colin A Espie
- Nuffield Department of Clinical Neurosciences and Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
| | - Michael Gradisar
- WINK Sleep Pty Ltd, Adelaide, Australia
- Sleep Cycle AB, Gothenburg, Sweden
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
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Jia Q, Peng Z, Huang A, Jiang S, Zhao W, Xie Z, Ma C. Is fracture management merely a physical process? Exploring the psychological effects of internal and external fixation. J Orthop Surg Res 2024; 19:231. [PMID: 38589910 PMCID: PMC11000308 DOI: 10.1186/s13018-024-04655-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/02/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Internal and external fixation are common surgical procedures for treating fractures. However, the impact of different surgical approaches (including internal and external fixations) on patients' psychological status and Quality of Life (QoL) is rarely examined. Herein, we aimed to investigate the effects of internal and external fixation on anxiety, depression, insomnia, and overall mental and physical health in Distal Radius Fractures (DRF) patients. METHODS We performed a retrospective study on 96 fracture patients who underwent internal fixation (57 patients) or external fixation (39 patients). The Visual Analog Scale (VAS), the Hospital Anxiety and Depression Scale (HADS), the Athens Insomnia Scale (AIS), and the Medical Outcomes Study Short Form 36 (SF-36) questionnaire were used to assess the patients' pain, anxiety, depression, sleep, and QoL before surgery and at seven days, one month, and three months post-surgery. RESULTS The VAS scores were significantly lower in the Internal Fixation Group (IFG) than in the External Fixation Group (EFG) on the seventh day and one month postoperatively (P < 0.05). Although both groups showed no significant anxiety, depression, or insomnia before surgery (P > 0.05), the EFG showed significantly higher HADS-A, HADS-D, and AIS scores than the IFG at seven days and one and three months postoperatively (P < 0.05). Additionally, changes in HADS-A, HADS-D, and AIS scores were most significant at day seven post-surgery in the EFG (P < 0.05). Furthermore, no significant difference was found between the two groups in the average Physical Component Summary (PCS) and Mental Component Summary (MCS) scores before surgery (P > 0.05). However, both groups showed positive changes in PCS and MCS scores at postoperative day seven and one and three months postoperatively, with the IFG having significantly higher average PCS and MCS scores compared to the EFG (P < 0.05). CONCLUSION Compared to external fixation, internal fixation did not significantly impact patients' emotions regarding anxiety and depression in the early postoperative period, and physical and mental health recovery was better during the postoperative rehabilitation period. Furthermore, when there are no absolute indications, the impact on patients' psychological well-being should be considered as one of the key factors in the treatment plan during surgical approach selection.
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Affiliation(s)
- Qiyu Jia
- Department of Trauma Orthopedics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zhenlei Peng
- Xinjiang Clinical Research Center for Mental Health, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Anqi Huang
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Child Mental Health Research Center, Nanjing University, Nanjing, China
| | - Shijie Jiang
- Xinjiang Clinical Research Center for Mental Health, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Wen Zhao
- Department of Orthopedics, Beijing Aerospace General Hospital, Beijing, China.
- Department of Orthopedics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
| | - Zengru Xie
- Department of Trauma Orthopedics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
| | - Chuang Ma
- Department of Trauma Orthopedics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
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20
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Zhang K, Wang C, Gou L, Li Y, Li C, Luo G, Zhang X. The Impact of Prolonged Duration of Untreated Illness on Clinical Correlates in Chronic Schizophrenia: Exploring the Relationship With Suicide Risk. Psychiatry Investig 2024; 21:422-432. [PMID: 38695050 PMCID: PMC11065522 DOI: 10.30773/pi.2023.0384] [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: 11/09/2023] [Revised: 01/12/2024] [Accepted: 02/14/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE Studies on duration of untreated psychosis are common in patients with schizophrenia, but few studies have investigated the relationship between duration of untreated illness (DUI) and suicide, especially in patients with chronic schizophrenia. Therefore, we intended to investigate the relationship between DUI and suicide and clinical correlates in patients with chronic schizophrenia. METHODS A total of 1,555 Chinese patients with chronic schizophrenia were enrolled in this study. DUI was measured in years, reflecting the prolonged untreated periods observed in this population. Clinical correlates were assessed, including symptoms, cognitive functioning, and body mass index. Suicidal ideation and attempts were also examined. Statistical analyses, including multivariate models, were employed to investigate the associations between DUI and clinical correlates while controlling for potential confounders. RESULTS The study revealed a significant proportion (23.3%) of patients with chronic schizophrenia in China received their first treatment after a 4-year delay, with the longest untreated duration reaching 39 years. Patients with longer DUI exhibited more severe negative symptoms, lower immediate memory scores, a higher likelihood of being overweight, and surprisingly, a reduced likelihood of suicidal ideation and attempts. Each additional year of untreated illness was associated with a 3% decrease in the risk of suicidal ideation and attempts. CONCLUSION The findings underscore the prevalence of extended untreated periods in Chinese patients with chronic schizophrenia and highlight the impact of DUI on negative symptoms, cognitive function, and body weight. Intriguingly, a longer DUI was associated with a lower risk of suicidal ideation and attempts.
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Affiliation(s)
- Ke Zhang
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Chenxi Wang
- Department of Respiratory and Critical Care Medicine, Tianjin Chest Hospital, Tianjin, China
| | - Lei Gou
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Yaxi Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cui Li
- Department of Civil Engineering, Nanjing Technical Vocational College, Nanjing, China
| | - Guoshuai Luo
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Xiangyang Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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21
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Li SH, Corkish B, Richardson C, Christensen H, Werner-Seidler A. The role of rumination in the relationship between symptoms of insomnia and depression in adolescents. J Sleep Res 2024; 33:e13932. [PMID: 37198139 DOI: 10.1111/jsr.13932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/30/2023] [Accepted: 04/27/2023] [Indexed: 05/19/2023]
Abstract
There is a strong relationship between the symptoms of insomnia and depression, however, little is understood about the factors that mediate this relationship. An understanding of these underlying mechanisms may inform the advancement of existing treatments to optimise reductions in insomnia and depression when they co-occur. This study examined rumination and unhelpful beliefs about sleep as mediators between symptoms of insomnia and depression. It also evaluated the effect of cognitive behavioural therapy for insomnia (CBT-I) on rumination and unhelpful beliefs about sleep, and whether these factors mediated the effect of CBT-I on depressive symptoms. A series of mediation analyses and linear mixed modelling were conducted on data from 264 adolescents (12-16 years) who participated in a two-arm (intervention vs. control) randomised controlled trial of Sleep Ninja®, a CBT-I smartphone app for adolescents. Rumination, but not unhelpful beliefs about sleep, was a significant mediator between symptoms of insomnia and depression at baseline. CBT-I led to reductions in unhelpful beliefs about sleep, but not in rumination. At the between-group level, neither rumination, nor unhelpful beliefs about sleep emerged as mechanisms underlying improvement in depression symptoms, however, rumination mediated within-subject improvements following CBT-I. The findings suggest rumination links symptoms of insomnia and depression and provide preliminary evidence that reductions in depression following CBT-I occurs via improvements in rumination. Targeting rumination may improve current therapeutic approaches.
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Affiliation(s)
- Sophie H Li
- Black Dog Institute, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Brittany Corkish
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Cele Richardson
- Centre for Sleep Science, School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Aliza Werner-Seidler
- Black Dog Institute, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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Lönn M, Svedberg P, Nygren J, Jarbin H, Aili K, Larsson I. The efficacy of weighted blankets for sleep in children with attention-deficit/hyperactivity disorder-A randomized controlled crossover trial. J Sleep Res 2024; 33:e13990. [PMID: 37452697 DOI: 10.1111/jsr.13990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
Weighted blankets are a non-pharmacological intervention for treating sleep and anxiety problems in children with attention-deficit/hyperactivity disorder. However, research on the efficacy of weighted blankets is sparse. The aim of this randomized controlled trial with a crossover design (4 + 4 weeks) was to evaluate the efficacy of weighted blankets on sleep among children with attention-deficit/hyperactivity disorder and sleeping problems. Children diagnosed with uncomplicated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition attention-deficit/hyperactivity disorder with verified sleep problems were randomized to start with either a weighted blanket or a lighter control blanket. Data collection was performed at weeks 0, 4 and 8 using actigraphy, questionnaires and a daily sleep diary. T-tests were used to evaluate efficacy. The study included 94 children with attention-deficit/hyperactivity disorder (mean age 9.0 [sd 2.2] years; 54 [57.4%] boys). Weighted blankets had a significant effect on total sleep time (mean diff. 7.72 min, p = 0.027, Cohen's d = 0.24), sleep efficiency (mean diff. 0.82%, p = 0.038, Cohen's d = 0.23) and wake after sleep onset (mean diff. -2.79 min, p = 0.015, Cohen's d = -0.27), but not on sleep-onset latency (p = 0.432). According to our exploratory subgroup analyses, weighted blankets may be especially beneficial for improving total sleep time in children aged 11-14 years (Cohen's d = 0.53, p = 0.009) and in children with the inattentive attention-deficit/hyperactivity disorder subtype (Cohen's d = 0.58, p = 0.016). Our results suggest that weighted blankets may improve children's sleep and could be used as an alternative to pharmacological sleep interventions.
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Affiliation(s)
- Maria Lönn
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Psychiatry Halland, Region Halland, Halmstad, Sweden
| | - Petra Svedberg
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Jens Nygren
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Håkan Jarbin
- Department of Child and Adolescent Psychiatry, Region Halland, Halmstad, Sweden
- Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
| | - Katarina Aili
- Department of Health and Sport, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Ingrid Larsson
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
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23
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Liu L, Yang X, Yang C, Tian Y, Li W, Xia L, Liu H. Associations between insomnia symptoms and inflammatory cytokines in adolescents with first-episode and recurrent major depressive disorder. J Affect Disord 2024; 350:110-117. [PMID: 38220096 DOI: 10.1016/j.jad.2024.01.031] [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: 08/15/2023] [Revised: 12/04/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Insomnia symptoms are often associated with increased levels of inflammatory biomarkers. However, such associations have not been adequately explored in adolescents with major depressive disorder (MDD). This study aimed to examine the associations between insomnia symptoms with inflammatory cytokines in adolescents with first-episode and recurrent MDD. METHODS From January to December 2021, this study included 164 adolescents with MDD and 76 healthy controls (HCs). The Center for Epidemiological Studies Depression Scale (CES-D) and the Insomnia Severity Index Scale (ISI) were used to assess depressive and insomnia symptoms, respectively. Also, plasma levels of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-17 A and tumor necrosis factor-α (TNF-α) were measured. RESULTS The prevalence of mild, moderate and severe insomnia in adolescents with MDD was 40.24 %, 36.59 % and 6.71 %, respectively. The patients had higher levels of IL-1β, IL-6 and TNF-α than HCs (all p < 0.05). ISI score was positively correlated with CES-D score and levels of IL-1β, IL-6 and TNF-α in first-episode patients but not in recurrent patients. A further multivariate stepwise linear regression analysis showed that ISI score was independently associated with CES-D score (beta = 0.523, t = 5.833, p < 0.001) and TNF-α levels (beta = 0.254, t = 2.832, p = 0.006). LIMITATIONS The cross-sectional design leads to failure to make causal inferences. CONCLUSION Insomnia symptoms are common in adolescents with MDD and associated with elevated levels of inflammatory cytokines in first-episode patients. The findings suggest that inflammatory cytokines may relate to the pathogenesis of insomnia symptoms in adolescents with MDD, but further longitudinal studies are needed to explore the causal association between insomnia symptoms and inflammatory cytokines in MDD.
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Affiliation(s)
- Lewei Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China
| | - Xiaoxue Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China
| | - Cheng Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China
| | - Yinghan Tian
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China
| | - Wenzheng Li
- Department of Psychiatry, Hefei Fourth People's Hospital, Hefei 230000, Anhui Province, China
| | - Lei Xia
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China.
| | - Huanzhong Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui Province, China; Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei 238000, Anhui Province, China; Anhui Psychiatric Center, Anhui Medical University, Hefei 238000, Anhui Province, China.
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24
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Rautio D, Andrén P, Bjureberg L, Silverberg-Mörse M, Mataix-Cols D, Fernández de la Cruz L. Body-Focused Repetitive Behavior Disorders in Children and Adolescents: Clinical Characteristics and Treatment Outcomes in a Naturalistic Setting. Behav Ther 2024; 55:376-390. [PMID: 38418047 DOI: 10.1016/j.beth.2023.07.010] [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: 01/24/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 03/01/2024]
Abstract
Body-focused repetitive behavior disorders, including trichotillomania (hair-pulling disorder) and excoriation (skin picking) disorder, typically emerge in early adolescence, but little is known about the clinical characteristics and treatment outcomes of these disorders in young people, particularly in real-world clinical settings. Participants were 63 children and adolescents (51 girls; age range 9-17) with a diagnosis of trichotillomania (n = 33) and/or skin-picking disorder (n = 33) attending a specialist outpatient clinic in Stockholm, Sweden. Demographic and clinical characteristics were gathered at the initial assessment. Of the 63 assessed youths, 56 received manual-based behavior therapy mainly focusing on habit reversal training, which was combined with medication when deemed appropriate. The mean clinician-reported trichotillomania and skin-picking disorder symptom severity at baseline (n = 63) was in the moderate range. We observed high rates of psychiatric comorbidity (63.5%) and use of psychiatric medication (54.8%). For the 56 individuals undertaking treatment at the clinic, mixed-effects regression models showed a significant decrease in symptom severity from baseline to posttreatment, with gains maintained up to the 12-month follow-up. Substantial and durable improvements were also seen on self-reported symptoms, self-reported depression, and global functioning. Specialist care should be made more widely available to improve the prognosis and quality of life of young people with trichotillomania and skin-picking disorder.
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Affiliation(s)
- Daniel Rautio
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm.
| | - Per Andrén
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, and Lund University
| | | | | | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, and Lund University
| | - Lorena Fernández de la Cruz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm
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25
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Chung HKS, Louie K, Chan WS. Development and evaluation of a Chinese short-form of the Sleep-related Behaviors Questionnaire in Hong Kong Chinese adults using item response theory. J Health Psychol 2024; 29:255-265. [PMID: 37688382 DOI: 10.1177/13591053231195518] [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] [Indexed: 09/10/2023] Open
Abstract
Insomnia-related safety behaviors are behaviors that aim to mitigate the negative consequences of insomnia but inadvertently perpetuate insomnia. This study aimed to develop and evaluate a Chinese short-form of the sleep-related behavior questionnaire (SRBQ-SF), a self-report measure of insomnia-related safety behaviors, using item response theory. The Chinese version of the original SRBQ was completed by 536 Chinese-speaking adults with clinically significant insomnia. The automatic item selection procedure of the Mokken scaling analysis was used to develop and evaluate the SRBQ-SF. A 23-item SRBQ-SF consisting of a 14-item reduced engagement and avoidance subscale (SRBQ-REA) and a 9-item preoccupation with sleep subscale (SRBQ-PS) was derived. Classical test theory-based estimates showed that the SRBQ-REA and SRBQ-PS had good internal consistency and acceptable convergent and discriminant validities, and they were only weakly correlated with each other. We recommend the use of the SRBQ-REA and SRBQ-PS separately to assess two dimensions of safety behaviors in the study and treatment of insomnia in Chinese-speaking adults.
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Shan W, Peng X, Tan W, Zhou Z, Xie H, Wang S. Prevalence of insomnia and associations with depression, anxiety among adults in guangdong, China: A large-scale cross-sectional study. Sleep Med 2024; 115:39-47. [PMID: 38330694 DOI: 10.1016/j.sleep.2024.01.023] [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: 11/30/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Insomnia is a common sleep disorder, often associated with some mental disorders or mental health concerns, especially when accompanied by depression or anxiety, but very limited research has been reported in China. The purpose of this study was to investigate the prevalence of insomnia and associations with depression, anxiety in Chinese adults. METHODS We conducted this large-sample cross-sectional study (51774 adults) in Guangdong province from October to December 2022. We used multistage stratified equal-volume random sampling under a complex sampling design to select the sample and standardized structured questionnaires to collect the necessary information. Descriptive analysis and logistic regression model were used for statistical analysis. RESULTS The weighted prevalence of insomnia was 24.8 %. Insomnia was significantly associated with depression (OR:11.29, 95 %CI: 9.58-13.29), and anxiety (OR:10.98, 95 %CI: 8.78-13.72). Risk factors as being associated with insomnia were female, higher years of education, suffering from chronic diseases, previous drinking and current drinking, while protective factors were living in a rural area, married or cohabited, divorce or separation and being older. Risk factors as being associated with depression in the insomnia group included 10-16 years of education and suffering from chronic diseases, while protective factors were being older, married or cohabited, and normal BMI. Risk factors associated with anxiety in the insomnia group included 7-12 years of education and suffering from chronic diseases, while protective factors were being older, married or cohabited, and having a normal BMI. CONCLUSIONS Insomnia is associated with the development of depression and anxiety. Women and unhealthy lifestyle were at high risk for insomnia, had chronic diseases is an important factor, and insomnia with depression or anxiety.
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Affiliation(s)
- Wei Shan
- Affiliated Mental Health Center, Southern University of Science and Technology, China; Department of Public Health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - Xiaodong Peng
- Department of Public Health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.
| | - Wenyan Tan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China School of Health, Zhuhai College of Science and Technology, Zhuhai, China
| | - Zhijian Zhou
- Affiliated Mental Health Center, Southern University of Science and Technology, China; Department of Public Health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - Haiyan Xie
- Affiliated Mental Health Center, Southern University of Science and Technology, China; Department of Public Health, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - ShiBin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China School of Health, Zhuhai College of Science and Technology, Zhuhai, China; School of Health, Zhuhai College of Science and Technology, Zhuhai, China.
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27
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Wang S, Jülich ST, Lei X. Latent profile of the insomnia severity index: A longitudinal study. Sleep Med 2024; 115:202-209. [PMID: 38368737 DOI: 10.1016/j.sleep.2024.02.027] [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: 12/15/2023] [Revised: 02/01/2024] [Accepted: 02/13/2024] [Indexed: 02/20/2024]
Abstract
STUDY OBJECTIVES To identify the distinct classification of insomnia symptoms and to explore their association with sleep problems and depression. METHODS Latent profile analysis was used to examine patterns of insomnia symptoms in two samples. Discovery and replication samples comprised 1043 (Mean age at baseline = 18.95 ± 0.93 years, 62.2% females) and 729 (Mean age at baseline = 18.71 ± 1.02 years, 66.4% females) college students, respectively. Participants completed measures of sleep problems (insomnia symptoms, sleep quality, susceptibility to insomnia, perceived consequences of insomnia, dream recall frequency, and percentage of recurring nightmares) and other psychological variables (rumination and depression). Binary logistic regression was used to analyze the effects of different types of insomnia symptoms at baseline on sleep problems and depression two years later. RESULTS Four classes of insomnia symptoms were identified, and classified as "non-insomnia" (class 1, 45.7%), "mild subjective symptoms but severe subjective feelings" (class 2, 23.9%), "severe subjective symptoms but mild subjective feelings" (class 3, 22.0%), and "high insomnia risk" (class 4, 8.4%), respectively. Compared with the group classified as non-insomnia group, other classifications significantly predicted insomnia two years later, only class 4 significantly predicted depression, and class 3 significantly predicted susceptibility to insomnia, after adjusting gender, insomnia, depression, and susceptibility to insomnia at baseline. CONCLUSIONS The findings highlighted the importance of identifying the patterns of insomnia symptoms, and the need for tailored intervention to improve sleep problems. Additionally, when screening for insomnia symptoms, simplified screening using Insomnia Severity Index (ISI) dimensions or items should be considered.
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Affiliation(s)
- Shuo Wang
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, 400715, China
| | - Simon Theodor Jülich
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, 400715, China
| | - Xu Lei
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, 400715, China; Key Laboratory of Cognition and Personality, Southwest University, Ministry of Education, Chongqing, 400715, China.
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Rong R, Xu Q, Jordan KP, Chen Y. Perceived Epidemic Impacts and Mental Symptom Trajectories in Adolescents Back to School After COVID-19 Restriction: A Longitudinal Latent Class Analysis. J Adolesc Health 2024; 74:487-495. [PMID: 37966411 DOI: 10.1016/j.jadohealth.2023.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE This study aimed to assess the impacts of COVID-19 epidemic on various life aspects and identify the trajectories of common mental symptoms among adolescents back to school after COVID-19 restriction. Furthermore, potential predictors associated with those trajectories were investigated. METHODS This longitudinal study, with five data collection points and a total follow-up of 68.4 days, was conducted among 1,393 junior high school students (mean age: 13.8 years; male, 53.3%) shortly after school reopened during the first COVID-19 outbreak in China. Questions on sociodemographics and perceived COVID-19 epidemic impacts were completed at the baseline while the Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Insomnia Severity Index were measured throughout the study for depression, anxiety, and insomnia symptoms, respectively. Trajectories of mental symptoms were classified by longitudinal latent class analysis, and the associated predictive factors were identified with multinomial regression modelling. RESULTS Our study revealed high but steadily declining prevalence of depression, anxiety, and insomnia symptoms (p trend < .001). Five distinctive trajectories were identified for both depression and anxiety ("resistance," "low symptom," "recovery," "chronic dysfunction," and "delayed dysfunction") and three for insomnia ("resistance," "low symptom," and "chronic dysfunction"). Besides the significant association between the mental symptom trajectories and students' perceived COVID-19 impacts on study practice, family income, and family relationship, female gender, lower school grade, and higher body mass index were found to be predictive of high severity trajectories. DISCUSSION Our findings may help locate the most psychologically vulnerable adolescents during the epidemic and foster better implementation of targeted intervention.
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Affiliation(s)
- Rong Rong
- Wisdom Lake Academy of Pharmacy, Xi'an Jiaotong-Liverpool University, Suzhou, China; Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Qiaochu Xu
- Wisdom Lake Academy of Pharmacy, Xi'an Jiaotong-Liverpool University, Suzhou, China
| | | | - Ying Chen
- Wisdom Lake Academy of Pharmacy, Xi'an Jiaotong-Liverpool University, Suzhou, China; School of Medicine, Keele University, Keele, United Kingdom.
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Wang J, Huang Y, Wang S, Zhang Z, He Y, Wang X, Guo H. The impact of workplace violence on job burnout among Chinese correctional officers: the chain mediating effects of stress and insomnia. BMC Public Health 2024; 24:566. [PMID: 38388879 PMCID: PMC10885376 DOI: 10.1186/s12889-024-18048-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The risk of workplace violence and job burnout among Chinese correctional officers is high. Stress and insomnia may influence the relationship between workplace violence and job burnout; however, this influence has been rarely studied. This study aimed to explore the effect of workplace violence on job burnout among Chinese correctional officers and to assess the contribution of stress and insomnia to this effect. METHODS In this study, the workplace violence scale, the Assens insomnia scale, the 21-item Depression Anxiety Stress Scale, and the Maslach Burnout Inventory-General Survey scale were used to assess the workplace violence, insomnia, stress, and job burnout experienced by the 472 correctional officers, respectively. RESULTS The results showed that (1) workplace violence was significantly and positively predictive of job burnout, (2) workplace violence affected job burnout through the mediation of stress, (3) workplace violence affected job burnout through the mediation of insomnia, and (4) stress and insomnia played fully interlocking mediating roles in the effect of workplace violence on job burnout. CONCLUSION Stress and insomnia may play a full mediating role in the relationship between workplace violence and job burnout. This suggested that correctional officers may take measures to reduce stress and improve insomnia, thereby reducing their job burnout. Further research may focus on the development of effective interventions to reduce stress and improve insomnia among correctional officers.
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Affiliation(s)
- Jizhi Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, The Second Xiangya Hospital of Central South University, National Technology Institute on Mental Disorders, Changsha, China
| | - Ying Huang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, The Second Xiangya Hospital of Central South University, National Technology Institute on Mental Disorders, Changsha, China
| | - Siyuan Wang
- Pingtang Compulsory Isolation Detoxification Institute in Hunan Province, Changsha, China
| | - Zheng Zhang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, The Second Xiangya Hospital of Central South University, National Technology Institute on Mental Disorders, Changsha, China
| | - Yuqiong He
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, The Second Xiangya Hospital of Central South University, National Technology Institute on Mental Disorders, Changsha, China
| | - Xiaoping Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, The Second Xiangya Hospital of Central South University, National Technology Institute on Mental Disorders, Changsha, China.
| | - Huijuan Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, The Second Xiangya Hospital of Central South University, National Technology Institute on Mental Disorders, Changsha, China.
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Yang X, Liu L, Tian Y, Yang C, Ling C, Liu H. Insomnia and Alexithymia in Chinese Adolescents with Major Depressive Disorder: A Cross-Sectional Study of Sex Differences and Associations. Psychol Res Behav Manag 2024; 17:615-625. [PMID: 38404923 PMCID: PMC10893783 DOI: 10.2147/prbm.s446788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/29/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose Insomnia is related to alexithymia in adults, but the relationship between insomnia and alexithymia in adolescents with major depressive disorder remains unclear. This study aimed to investigate the sex differences and the association between insomnia and alexithymia in adolescents with major depressive disorder. Patients and Methods From October 2020 to April 2022, adolescent patients with major depressive disorder were recruited from psychiatric departments of seven hospitals in Anhui Province, China. Their general demographic and clinical information were collected. The 20-item Toronto Alexithymia Scale, the Center for Epidemiologic Studies of Depression Scale, and the Insomnia Severity Index Scale were used to assess their alexithymia, depression, and insomnia symptoms, respectively. The analysis of variance (ANOVA), Student's t-test and Mann-Whitney U-test were used for continuous variables and chi-square tests for categorical variables. Pearson's correlation analysis and Spearman correlation analysis were used to examine the correlation between ISI and demographic and clinical variables. Multiple binary logistic regression analyses with the "Enter" method were carried out to explore the correlations of insomnia. Results The prevalence of insomnia in female adolescent patients was similar to that of male patients (χ2=1.84, p = 0.175). Compared with those without insomnia, patients with insomnia had worse family relationships (F = 7.71, p = 0.021), perceived heavier academic stress (F = 6.32, p = 0.012), more likely to take sedative-hypnotics (F = 5.51, p = 0.019), had higher levels of depression (F = 81.57, p < 0.001) and alexithymia (F = 28.57, p < 0.001). Correlation analysis showed that alexithymia was significantly associated with insomnia in adolescent patients (r = 0.360, p < 0.01). Binary logistic regression analyses showed that, alexithymia was significantly associated with insomnia in female patients (OR = 1.050, p < 0.05) but not male patients. Conclusion In female adolescent patients, alexithymia is a risk factor of insomnia, which is of great importance in the understanding of the psychopathological mechanisms, treatments and psychological interventions of insomnia in adolescents with major depressive disorder.
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Affiliation(s)
- Xiaoxue Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Lewei Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Yinghan Tian
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Cheng Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Chen Ling
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui Province, People's Republic of China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
- Anhui Psychiatric Center, Anhui Medical University, Hefei, Anhui Province, People’s Republic of China
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Zhao J, Li Y, Guo M, Zhang G, Chen P. Current Situation and Mental Health of Pregnant Women During the Prevention and Control of Novel Coronavirus Infection: A Cross-Sectional Study on the Investigation of Influencing Factors. Int J Womens Health 2024; 16:193-202. [PMID: 38328512 PMCID: PMC10848820 DOI: 10.2147/ijwh.s445473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
Background COVID-19 is a highly contagious respiratory infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which became a global public health crisis. In the past 3 years, the COVID-19 pandemic has resulted in a dramatic increase in the occurrence of psychological symptoms such as depression, anxiety, and stress in global populations. Therefore, it is important to help pregnant women cope with major public emergencies and improve their physical and mental health. Objective To investigate the status and influencing factors of anxiety, insomnia, and psychological stress disorder in pregnant women with COVID-19 to provide a theoretical basis for psychological intervention in pregnant women in the case of public health emergency events. Patients and methods A cross-sectional survey was conducted with 435 pregnant women from multiple tertiary hospitals in Zhengzhou from November 6 to December 6, 2022. The questionnaire contents included the general information of pregnant women, insomnia scale, generalized anxiety scale, and the revised version of the Accident Impact Scale. Results There are 251 pregnant women with anxiety (57.7%, 95% CI: (53.0%-62.4%).There are 166 pregnant women with insomnia.(38.2%, 95% CI: 33.6%-42.7%), There are 314 pregnant women with stress disorder.(72.2%, 95% CI: 68.0%-76.4%). During the epidemic prevention and control period, whether pregnant women had a history of adverse pregnancy had a statistically significant difference in anxiety, insomnia and stress disorders. Conclusion and Recommendation During the COVID-19 pandemic, pregnant women appeared to generally have anxiety, insomnia, and stress disorders. Poor pregnancy history is a protective factor for pregnant women with anxiety, insomnia, and post-traumatic stress disorder. In the case of similar public health emergencies, attention bias modification (ABM) may be a potential intervention measure to provide potentially new ideas for alleviating the psychological disorders of pregnant women during this special period.
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Affiliation(s)
- Jing Zhao
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Yan Li
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Miao Guo
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
| | - Guijuan Zhang
- Department of Gynaecology and Obstetrics, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
| | - Ping Chen
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China
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Chung KF, Lee CT, Au CH, Kam KY, Lee CK, Yeung WF, Lau EYY, Ho FYY, Ho LM. Cognitive behavioural therapy for insomnia as an early intervention of mood disorders with comorbid insomnia: A randomized controlled trial. Early Interv Psychiatry 2024; 18:82-93. [PMID: 37192756 DOI: 10.1111/eip.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 03/30/2023] [Accepted: 05/05/2023] [Indexed: 05/18/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of small-group nurse-administered cognitive behavioural therapy for insomnia (CBTI) as an early intervention of mood disorders with comorbid insomnia. METHODS A total of 200 patients with first-episode depressive or bipolar disorders and comorbid insomnia were randomized in a ratio of 1:1 to receiving 4-session CBTI or not in a routine psychiatric care setting. Primary outcome was Insomnia Severity Index. Secondary outcomes included response and remission status; daytime symptomatology and quality of life; medication burden; sleep-related cognitions and behaviours; and the credibility, satisfaction, adherence and adverse events of CBTI. Assessments were conducted at baseline, 3, 6, and 12-month. RESULTS Only a significant time-effect but no group-by-time interaction was found in the primary outcome. Several secondary outcomes had significantly greater improvements in CBTI group, including higher depression remission at 12-month (59.7% vs. 37.9%, χ2 = 6.57, p = .01), lower anxiolytic use at 3-month (18.1% vs. 33.3%, χ2 = 4.72, p = .03) and 12-month (12.5% vs. 25.8%, χ2 = 3.26, p = .047), and lesser sleep-related dysfunctional cognitions at 3 and 6-month (mixed-effects model, F = 5.12, p = .001 and .03, respectively). Depression remission rate was 28.6%, 40.3%, and 59.7% at 3, 6, and 12-month, respectively in CBTI group and 28.4%, 31.1%, and 37.9%, respectively in no CBTI group. CONCLUSION CBTI may be a useful early intervention to enhance depression remission and reduce medication burden in patients with first-episode depressive disorder and comorbid insomnia.
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Affiliation(s)
- Ka-Fai Chung
- Department of Psychiatry, The University of Hong Kong, Hong Kong, China
| | - Chit-Tat Lee
- Department of Psychiatry, Queen Mary Hospital, Hong Kong, China
| | - Chi-Hung Au
- Department of Psychiatry, Queen Mary Hospital, Hong Kong, China
| | - Ka-Yee Kam
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Che-Kin Lee
- Department of Psychiatry, Kowloon Hospital, Hong Kong, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Esther Yuet Ying Lau
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Lai-Ming Ho
- School of Public Health, The University of Hong Kong, Hong Kong, China
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Yan X, Li Y, Li S, Liang C, Wang L, Kong J, Zhao Y, Chen Q, Xu H. Validation of the Chinese version of the Sleep Regularity Questionnaire (SRQ) and analysis of influencing factors. Sleep Med 2024; 114:73-81. [PMID: 38157623 DOI: 10.1016/j.sleep.2023.12.008] [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: 11/05/2023] [Revised: 12/03/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Currently, there is no instrument to measure sleep regularity in China. In this study, the Sleep Regularity Questionnaire(SRQ) was translated into Chinese, tested for reliability and validity, and analyzed for factors affecting sleep regularity. METHODS The English version of the SRQ was translated into Chinese, and a total of 3642 individuals were included in this research. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the underlying factor structure of the Chinese version of the SRQ and to measure its reliability and validity. In addition, the correlations between sleep regularity and general information, personal habits, self-control, stress, anxiety, and depression were explored. RESULTS The Cronbach's α of the Chinese SRQ was 0.858, supporting the two-factor structure. Sleep regularity was statistically different between gender and ethnicity (p < 0.05), and personal habits (exercise, continued eating after dinner, smoking and drinking) had an effect on sleep regularity. Sleep regularity was positively associated with individual self-control and negatively associated with stress, anxiety, and depression. CONCLUSIONS The Chinese version of the SRQ has excellent reliability and validity. There are two dimensions, namely circadian regularity and sleep continuity regularity, which can be used to assess the sleep regularity of Chinese adults. The results of this study showed that males and Han Chinese having better sleep regularity. And people with good lifestyle habits and greater self-control sleep more regularly, while stress, anxiety and depression can affect individuals' sleep regularity.
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Affiliation(s)
- Xiangru Yan
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China; Jining No.1 People's Hospital, 272000, Jining, China.
| | - Yanhui Li
- Department of Stomatology, Shandong Medical College, 276000, Linyi, China.
| | - Sisi Li
- Department of Nursing, Panjin Vocational and Technical College, 124000, Panjin, China.
| | - Chunguang Liang
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Liying Wang
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Jie Kong
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Ying Zhao
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Qing Chen
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Huameng Xu
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
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Liu J, Ji X, Rovit E, Pitt S, Lipman T. Childhood sleep: assessments, risk factors, and potential mechanisms. World J Pediatr 2024; 20:105-121. [PMID: 36441394 PMCID: PMC9702880 DOI: 10.1007/s12519-022-00628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 09/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep problem is a highly prevalent health issue among pediatric populations across the world. In this review, we aimed to identify risk factors contributing to sleep deficiency and poor sleep hygiene in children. Potential biological, psychosocial, and environmental mechanisms as well as research gaps in the literature are also discussed. DATA SOURCES A comprehensive search for relevant English language full-text, peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed, SCOPUS, and Psych Info. Both relevant data based and systematic reviews are included. RESULTS This paper summarizes many risk factors for childhood sleep problems, including biological (e.g., genetics, gender, age and puberty, prenatal factors, postnatal factors); nutritional (e.g., macronutrients, micronutrients, omega-3 fatty acids, obesity); environmental (e.g., heavy metals, noise, light, air pollution); interpersonal (e.g., family, exposure to violence, screen media use, physical injury); and community/socioeconomic variables (e.g., racial/ethnicity and cultural factors, neighborhood conditions and socioeconomic status, school factors, public health disasters/emergencies), to better understand the development of sleep problems in children. CONCLUSIONS Poor childhood sleep is a multifactorial issue affected by a wide range of prenatal and early-life biological, environmental, and psychosocial risk factors and contributors. A better understanding of these risk factors and their mechanisms is an important first step to develop future research and prevention programs focusing on pediatric sleep problems.
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Affiliation(s)
- Jianghong Liu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA.
| | - Xiaopeng Ji
- School of Nursing, College of Health Sciences, University of Delaware, Newark, DE, 19716, USA
| | - Elizabeth Rovit
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
| | - Susannah Pitt
- Geisinger Commonwealth School of Medicine, Scranton, PA, 18510, USA
| | - Terri Lipman
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Room 426, Claire M. Fagin Hall, Philadelphia, PA, 19104, USA
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Menicucci D, Bastiani L, Malloggi E, Denoth F, Gemignani A, Molinaro S. Impaired Well-Being and Insomnia as Residuals of Resolved Medical Conditions: Survey in the Italian Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:129. [PMID: 38397620 PMCID: PMC10888320 DOI: 10.3390/ijerph21020129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/12/2024] [Accepted: 01/17/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Well-being encompasses physical, mental, social, and cultural aspects. Sleep quality and pathologies are among the objective conditions jeopardising it. Chronic insomnia, inflammatory-based diseases, and mood disorders often occur in a single cluster, and inflammation can negatively impact sleep, potentially harming well-being. Some evidence from specific clinical populations suggests that also some resolved past diseases could still have an impact on present sleep quality and well-being. The aim of the present study is to investigate, in the general population, whether and to what degree well-being and insomnia are associated with resolved pathologies. METHODS A cross-sectional survey (IPSAD®) was carried out using anonymous postal questionnaires that investigated past and present general health, well-being, and insomnia. A total of 10,467 subjects answered the questionnaire. RESULTS Several classes of both current and resolved pathologies resulted in increased odds ratios for current insomnia (odds ratios = 1.90; 1.43, respectively) and impaired well-being (odds ratios = 1.75; 1.33, respectively), proportional to the number of the displayed pathologies. Notably, both current and resolved past psychiatric disorders were strongly associated with both current impaired well-being (odds ratios = 5.38; 1.70, respectively) and insomnia (odds ratios = 4.99; 2.15, respectively). CONCLUSIONS To explain these associations, we suggest that systemic inflammation conveyed by several medical conditions disrupts homeostatic processes, with final effects on sleep quality and behaviour.
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Affiliation(s)
- Danilo Menicucci
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (D.M.); (E.M.); (A.G.)
| | - Luca Bastiani
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (L.B.); (F.D.)
| | - Eleonora Malloggi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (D.M.); (E.M.); (A.G.)
| | - Francesca Denoth
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (L.B.); (F.D.)
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (D.M.); (E.M.); (A.G.)
- Clinical Psychology Branch, Azienda Ospedaliero-Universitaria Pisana, 56100 Pisa, Italy
| | - Sabrina Molinaro
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy; (L.B.); (F.D.)
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Wong VWH, Tong JTY, Shi NK, Ng CH, Sarris J, Ho FYY. Smartphone-delivered multicomponent lifestyle medicine intervention for improving mental health in a nonclinical population: a randomized controlled trial. Front Public Health 2024; 11:1231981. [PMID: 38292386 PMCID: PMC10824847 DOI: 10.3389/fpubh.2023.1231981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/18/2023] [Indexed: 02/01/2024] Open
Abstract
Objective To prevent the exacerbation of mental health burdens, a growing body of research has recommended a balanced approach that emphasizes both the delivery of mental health treatments to individuals with common mental disorders (CMDs) and the strengthening of protective factors for CMDs among nonclinical populations. This randomized controlled trial (RCT) evaluated the efficacy of a smartphone-delivered multicomponent lifestyle medicine (LM) intervention, Lifestyle Hub, for improving mental health among a nonclinical population of Chinese adults. Methods A total of 106 participants with Patient Health Questionnaire-9 total score < 10 and Generalized Anxiety Disorder 7-Item Scale <8 were randomly assigned to either the Lifestyle Hub intervention group (LH, n = 53) or the waitlist control group (WL, n = 53). Lifestyle Hub is an 8-week smartphone-delivered multicomponent LM intervention developed based on the transtheoretical model. The intervention components included lifestyle psychoeducation, physical activity, diet and nutrition, stress management, sleep management, and motivation and goal-setting techniques. Assessments were conducted at baseline, immediate post-intervention, and 1-month follow-up (LH only). Results The linear mixed effect model based on the intention-to-treat principle indicated that Lifestyle Hub significantly improved overall mental health, depressive symptoms, anxiety symptoms, stress, insomnia severity, overall health-promoting behaviors, dietary quality, and stress management compared to the WL group at immediate post-intervention (d = 0.13-0.56). No significant between-group differences were observed in terms of functional impairment, health-related quality of life, health responsibility, physical activity level, spiritual growth, and interpersonal relations. The intervention gains in the LH group were maintained at 1-month follow-up. The LH participants indicated that Lifestyle Hub was an acceptable intervention for improving mental health, although a significantly higher level of study attrition was observed in the LH group (20.8%) relative to the WL group (5.7%). Conclusion Lifestyle Hub may serve as an efficacious and acceptable intervention for improving mental health in nonclinical adult populations. To extend the benefits of LM interventions at the population level, future studies are warranted to examine a stepped-care approach to delivering LM interventions.Trial registration: This randomized controlled trial was pre-registered with ClinicalTrials.gov (NCT04295369).
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Affiliation(s)
- Vincent Wing-Hei Wong
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Jessica Tsz-Yan Tong
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Nga-Kwan Shi
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Chee H. Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent’s Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Jerome Sarris
- Department of Psychiatry, Professorial Unit, The Melbourne Clinic, The University of Melbourne, Melbourne, VIC, Australia
- Western Sydney University, NICM Health Research Institute, Westmead, NSW, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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Lv R, Cai M, Tang N, Shi Y, Zhang Y, Liu N, Han T, Zhang Y, Wang H. Active versus sham DLPFC-NAc rTMS for depressed adolescents with anhedonia using resting-state functional magnetic resonance imaging (fMRI): a study protocol for a randomized placebo-controlled trial. Trials 2024; 25:44. [PMID: 38218932 PMCID: PMC10787505 DOI: 10.1186/s13063-023-07814-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/21/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Anhedonia, which is defined as the inability to feel pleasure, is considered a core symptom of major depressive disorder (MDD). It can lead to several adverse outcomes in adolescents, including heightened disease severity, resistance to antidepressants, recurrence of MDD, and even suicide. Specifically, patients who suffer from anhedonia may exhibit a limited response to selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT). Previous researches have revealed a link between anhedonia and abnormalities within the reward circuitry, making the nucleus accumbens (NAc) a potential target for treatment. However, since the NAc is deep within the brain, repetitive transcranial magnetic stimulation (rTMS) has the potential to modulate this specific region. Recent advances have enabled treatment technology to precisely target the left dorsolateral prefrontal cortex (DLPFC) and modify the functional connectivity (FC) between DLPFC and NAc in adolescent patients with anhedonia. Therefore, we plan to conduct a study to explore the safety and effectiveness of using resting-state functional connectivity magnetic resonance imaging (fcMRI)-guided rTMS to alleviate anhedonia in adolescents diagnosed with MDD. METHODS The aim of this article is to provide a study protocol for a parallel-group randomized, double-blind, placebo-controlled experiment. The study will involve 88 participants who will be randomly assigned to receive either active rTMS or sham rTMS. The primary object is to measure the percentage change in the severity of anhedonia, using the Snaith-Hamilton Pleasure Scale (SHAPS). The assessment will be conducted from the baseline to 8-week post-treatment period. The secondary outcome includes encompassing fMRI measurements, scores on the 17-item Hamilton Rating Scale for Depression (HAMD-17), the Montgomery Asberg Depression Rating Scale (MADRS), the Chinese Version of Temporal Experience of Pleasure Scale (CV-TEPS), and the Chinese Version of Beck Scale for Suicide Ideation (BSI-CV). The Clinical Global Impression (CGI) scores will also be taken into account, and adverse events will be monitored. These evaluations will be conducted at baseline, as well as at 1, 2, 4, and 8 weeks. DISCUSSION If the hypothesis of the current study is confirmed, (fcMRI)-guided rTMS could be a powerful tool to alleviate the core symptoms of MDD and provide essential data to explore the mechanism of anhedonia. TRIAL REGISTRATION ClinicalTrials.gov NCT05544071. Registered on 16 September 2022.
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Affiliation(s)
- Runxin Lv
- Department of Psychiatry of Xijing Hospital of Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi Province, China
| | - Min Cai
- Department of Psychiatry of Xijing Hospital of Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi Province, China
| | - Nailong Tang
- Department of Psychiatry of Xijing Hospital of Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi Province, China
- Department of Psychiatry, 907 Hospital, No. 99 Binjiang North Road, Yanping District, Nanping City, Fujian Province, China
| | - Yifan Shi
- Department of Psychiatry of Xijing Hospital of Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi Province, China
| | - Yuyu Zhang
- Department of Psychiatry of Xijing Hospital of Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi Province, China
| | - Nian Liu
- Department of Psychiatry of Xijing Hospital of Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi Province, China
| | - Tianle Han
- Department of Psychiatry of Xijing Hospital of Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi Province, China
| | - Yaochi Zhang
- Department of Psychiatry of Xijing Hospital of Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi Province, China
| | - Huaning Wang
- Department of Psychiatry of Xijing Hospital of Air Force Medical University, 127 Changle West Road, Xi'an, Shaanxi Province, China.
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Hao F, Zhang Z, Lau SSS, Chiang SK, Zhou D, Tan W, Tang X, Ho R. The emergence of COVID-19 over-concern immediately after the cancelation of the measures adopted by the dynamic zero-COVID policy in China. Front Public Health 2024; 11:1319906. [PMID: 38249361 PMCID: PMC10796473 DOI: 10.3389/fpubh.2023.1319906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/13/2023] [Indexed: 01/23/2024] Open
Abstract
Background This study aimed to report the prevalence of COVID-19 over-concern and its associated factors after the relaxation of the health-protective measures in China. Methods A team of seven experts in psychiatry and psychology specializing in COVID-19 mental health research from China, Hong Kong, and overseas reached a consensus on the diagnostic criteria for COVID-19 over-concern. Individuals had to meet at least five of the following criteria: (1) at least five physical symptoms; (2) stocking up at least five items related to protecting oneself during the COVID-19 pandemic; (3) obsessive-compulsive symptoms related to the COVID-19 pandemic; (4) illness anxiety related to the COVID-19 pandemic; (5) post-traumatic stress symptoms; (6) depression; (7) anxiety; (8) stress and (9) insomnia. An online survey using snowball sampling collected data on demographics, medical history, views on COVID-19 policies, and symptoms of COVID-19 over-concern. Multivariate linear regression was performed using significant variables from the previous regressions as independent variables against the presence of COVID-19 over-concern as the dependent variable. Breush-Pagan test was used to assess each regression model for heteroskedasticity of residuals. Results 1,332 respondents from 31 regions in China participated in the study for 2 weeks from December 25 to 27, 2022, after major changes in the zero-COVID policy. After canceling measures associated with the dynamic zero-COVID policy, 21.2% of respondents fulfilled the diagnostic criteria for COVID-19 over-concern. Factors significantly associated with COVID-19 over-concern were poor self-rated health status (β = 0.07, p < 0.001), concerns about family members getting COVID-19 (β = 0.06, p < 0.001), perceived usefulness of COVID-19 vaccine (β = 0.03, p = 0.012), impact on incomes, employment and studies (β = 0.045, p < 0.001) and impact on families (β = 0.03, p = 0.01). Conclusion After removing measures associated with the dynamic zero-COVID policy in China, approximately one-fifth of respondents met the diagnostic criteria for COVID-19 over-concern.
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Affiliation(s)
- Fengyi Hao
- Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
- Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Zhisong Zhang
- Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Sam S. S. Lau
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
- Multidisciplinary Research Centre, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
- College of International Education, School of Continuing Education, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
- Institute of Bioresource and Agriculture, Hong Kong Baptist University, Kowloon, Hong Kong SAR, China
| | - Soon-Kiat Chiang
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dewen Zhou
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Wanqiu Tan
- National University of Singapore (Chongqing) Research Institute, Chongqing, China
| | - Xiangdong Tang
- Sleep Medicine Center, Mental Health Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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Elkins A, Petersen M, Nirjar U, Monticello N, Martel M. Evidence-Based Assessment of Developmental Disorders. Assessment 2024; 31:3-23. [PMID: 37303168 DOI: 10.1177/10731911231178290] [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] [Indexed: 06/13/2023]
Abstract
Developmental disorders are diverse, common, and impairing; still, many clinicians lack comprehensive training in their assessment. This review presents thorough guidelines for the evaluation and diagnosis of common communication, sleeping, feeding, and elimination disorders that often onset in the early developmental period and that are commonly encountered in clinical practice. Thorough guidance on the evidence-based assessment of developmental disorders is critical, as they are prevalent, impairing, and commonly comorbid with other psychiatric disorders of childhood. This review is the first of its kind-providing critically needed, step-by-step guidance on the existing evidence-based methodologies and assessment tools available for diagnosis. This review also makes clear the dire need for further development and validation of relevant screening and diagnostic measure and calls for specific attention to the development of specific screening and diagnostic assessment measures for feeding disorders and elimination disorders in particular. Clinicians and researchers alike may find this article useful in guiding diagnostic, treatment, and research procedures.
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Chung S, Ahmed O, Cho E, Bang YR, Ahn J, Choi H, Um YH, Choi JW, Kim SJ, Jeon HJ. Psychometric Properties of the Insomnia Severity Index and Its Comparison With the Shortened Versions Among the General Population. Psychiatry Investig 2024; 21:9-17. [PMID: 38281736 PMCID: PMC10822735 DOI: 10.30773/pi.2023.0189] [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] [Received: 06/08/2023] [Revised: 08/08/2023] [Accepted: 09/17/2023] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVE The aim of this study was to explore the psychometric properties of the Insomnia Severity Index (ISI) based on modern test theory, such as item response theory (IRT) and Rasch analysis, with shortened versions of the ISI among the general population. METHODS We conducted two studies to evaluate the reliability and validity of the shortened versions of the ISI in a Korean population. In Study I, conducted via online survey, we performed an exploratory factor analysis (n=400). In Study II, confirmatory factor analysis (CFA) was conducted (n=400). IRT and Rasch analysis were performed on all samples. Participants symptoms were rated using the ISI, Dysfunctional Beliefs and Attitudes about Sleep-16 items, Dysfunctional Beliefs about Sleep-2 items, Patient Health Questionnaire-9 items, and discrepancy between desired time in bed and desired total sleep time. RESULTS CFA showed a good fit for the 2-factor model of the ISI (comparative fit index=0.994, Tucker-Lewis index=0.990, root-meansquare-error of approximation=0.039, and standardized root-mean-square residual=0.046). The 3-item versions also showed a good fit for the model. All scales showed good internal consistency reliability. The scale information curve of the 2-item scale was similar to that of the full-scale ISI. The Rasch analysis outputs suggested a good model fit. CONCLUSION The shortened 2-factor ISI is a reliable and valid model for assessing the severity of insomnia in the Korean population. The results are needed to be explored further among the clinical sample of insomnia.
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Affiliation(s)
- Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Eulah Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Rong Bang
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Junseok Ahn
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hayun Choi
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jae-Won Choi
- Department of Psychiatry, Nowon Eulji University Hospital, Eulji University School of Medicine, Seoul, Republic of Korea
| | - Seong Jae Kim
- Department of Psychiatry, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Hong Jun Jeon
- Department of Psychiatry, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
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Cheung DST, Yu BYM, Lam SC, Leung DYP, Chung KF, Ho FYY, Chen SC, Yeung WF. A longitudinal study on the change in sleep across three waves of the COVID-19 outbreaks in Hong Kong. Sleep Biol Rhythms 2024; 22:93-102. [PMID: 38476851 PMCID: PMC10899949 DOI: 10.1007/s41105-023-00486-w] [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: 05/31/2023] [Accepted: 08/19/2023] [Indexed: 03/14/2024]
Abstract
In the year 2020, Hong Kong experienced four COVID-19 epidemic waves. The present study aimed to examine the transition of sleep disturbances and explore its associated factors across the later three epidemic waves. Among the 1138 respondents who participated in an online survey at the second wave (T1, April 2020), 338 and 378 participants also completed a follow-up at the third (T2, August 2020) and fourth waves (T3, December 2020), respectively. Participants completed the Insomnia Severity Index and an investigator-designed questionnaire regarding potential factors associated with sleep change such as perceived risk of being infected, economic stress, and confidence in the government and health care professional. Sample of this study were mainly female (67.7%), married (50.3%), young adults (54.2%) with tertiary education (81.6%). Maintaining normal sleep was the most prevalent trajectory of sleep of all three waves (50.5%), followed by persistent insomnia (17.2%) and remitted insomnia (9.0%). Besides female, older-age and lower education level, the results showed that increment in worry about family being infected (adjusted risk ratio, RR = 1.28), perceived interference of daily lives (adjusted RR = 1.19), and economic distress (adjusted RR = 1.24) were significantly associated with the development of clinical insomnia during the three epidemic waves. These factors were also associated with worsening of other sleep parameters. Insomnia being persistent across the three waves of COVID-19 outbreaks was common. Increasing economic distress, daily interference, and worry about family members being infected were associated with an increasing risk of clinical insomnia across the three COVID-19 outbreaks. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-023-00486-w.
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Affiliation(s)
- Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China
| | - Branda Yee-Man Yu
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Ka-Fai Chung
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shu-Cheng Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechic University, Hong Kong, Hong Kong SAR
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Hu L, Wang Z, Yang Y, Liu X. Psychometric properties of the Youth Self-rated Insomnia Scale (YSIS) in adolescent psychiatric patients. Sleep Biol Rhythms 2024; 22:103-111. [PMID: 38476857 PMCID: PMC10900025 DOI: 10.1007/s41105-023-00487-9] [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: 05/10/2023] [Accepted: 08/29/2023] [Indexed: 03/14/2024]
Abstract
The 8-item Youth Self-rated Insomnia Scale (YSIS) was developed to assess insomnia severity in the past month among youths. The YSIS has satisfactory psychometric properties in the general adolescent population. This study examined psychometric properties of the YSIS in a large sample of adolescent psychiatric patients. A total of 536 patients aged 10-19 years were consecutively recruited from the outpatient department of Shandong Mental Health Center between December 2021 and March 2022. Patients completed a structured questionnaire consisting of the YSIS scale and questions about sleep duration, nightmares, psychiatric history, depression, psychiatric and sleep medications, and demographics. Patients were diagnosed following the ICD-10 criteria. Of the participants, the mean age was 15.30 years (SD = 1.95), 61.0% were female, 60.9% were diagnosed with mood disorders, 65.7% were on antidepressants, and 49.0% were on anxiolytics or hypnotics. The mean YSIS score was 22.6 (SD = 8.07). Coefficient omega was 0.84. Exploratory factor analysis revealed one factor and two correlated residuals. The YSIS scores were significantly correlated with depression scores (r = 0.68) and significantly increased with sleep onset latency, short sleep duration, nightmare frequency, and sleep medication use. The YSIS demonstrated satisfactory internal consistency reliability, construct validity, and criteria-related validity in adolescent psychiatric patients. The YSIS appears to be a reliable and valid scale for measuring insomnia severity in adolescent psychiatric patients.
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Affiliation(s)
- Lei Hu
- Shandong Mental Health Center, Shandong University, 49 Wen Hua Dong Road, Jinan, 250014 China
| | - Ziyang Wang
- School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yanyun Yang
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL 32306 USA
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA 19104 USA
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Guo N, Weng X, Zhao SZ, Zhang J, Wang MP, Li L, Wang L. Adverse childhood experiences on internet gaming disorder mediated through insomnia in Chinese young people. Front Public Health 2023; 11:1283106. [PMID: 38074757 PMCID: PMC10703159 DOI: 10.3389/fpubh.2023.1283106] [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: 08/25/2023] [Accepted: 10/24/2023] [Indexed: 12/18/2023] Open
Abstract
Background Adverse childhood experiences (ACEs) have been associated with addictions such as substance use disorders. Few have examined ACEs on internet gaming disorder (IGD) as a newly established behavioral addiction, and the potential mediating role of insomnia remains unclear. We examined the associations between ACE number and types, IGD, and insomnia. Methods Participants included 1, 231 Chinese university students (54.5% male; 56.9% aged 18-20 years) who had played internet games at least once in the previous month. ACEs were measured using the 10-item ACE questionnaire (yes/no). Symptoms of insomnia and IGD were measured using the Insomnia Severity Index and the 9-item Internet Gaming Disorder Scale-Short-Form, respectively. Multivariable regressions examined the associations, adjusting for sex, age, maternal and paternal educational attainment, monthly household income, smoking, and alcohol drinking. The mediating role of insomnia symptoms was explored. Results The prevalence of ACEs≥1 was 40.0%. Childhood verbal abuse was the most prevalent (17.4%), followed by exposure to domestic violence (17.1%) and childhood physical abuse (15.5%). More ACE numbers showed an association with IGD symptoms (adjusted OR = 1.11, 95% CI 1.04, 1.17). Specifically, IGD symptoms were observed for childhood physical neglect, emotional neglect, sexual abuse, parental divorce or separation, and household substance abuse. Insomnia symptoms mediated the associations of ACE number and types with IGD symptoms (proportion of total effect mediated range 0.23-0.89). Conclusion The number and specific types of ACEs showed associations with IGD mediated through insomnia. Screening of ACEs is recommended in future studies on IGD. Longitudinal data are warranted to determine the causality of the observed associations.
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Affiliation(s)
- Ningyuan Guo
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Xue Weng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
| | - Sheng Zhi Zhao
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Juan Zhang
- The International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Li Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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Lu Y, Zhou Y, Li Y, Cao J, Zhao W, Hu Y, Wang J, Zhu H, Xu Z. Mental health during the omicron pandemic: A comparison between medical staff and non-medical staff. J Affect Disord 2023; 340:221-227. [PMID: 37541598 DOI: 10.1016/j.jad.2023.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND A considerable number of people suffered from mental disorders due to coronavirus disease 2019 (COVID-19). As the virus mutated, the effect of COVID-19 changed. This study intends to compare the mental health between the medical staff and non-medical staff during the Omicron pandemic, and to analyze the relevant risk factors. METHODS The cross-sectional study was conducted by a set of online questionnaires, 1246 medical staff and 1246 non-medical staff were selected after a 1:1 propensity score matching. The questionnaires included the demographic characteristics, the Coronavirus Anxiety Scale (CAS), the Center for Epidemiologic Studies Depression Scale (CES-D), the Insomnia Severity Index Scale (ISI), and the Psychological Resilience Scale(CD-RISC). RESULTS Compared with medical staff, non-medical staff scored higher on CAS and CES-D (both P < 0.001). Non-medical staff had higher prevalence of anxiety (55.0 % versus 47.3 %; adjusted OR = 1.45, 95 % CI = 1.23-1.70), depression (62.4 % versus 53.4 %; adjusted OR = 1.46, 95 % CI = 1.23-1.73) and insomnia (46.5 % versus 43.4 %; adjusted OR = 1.21, 95 % CI = 1.02-1.43). Multivariate logistic regression analysis showed that being female, being younger than 40 years, having an annual income of <50,000 yuan, paying attention to omicron, in the course of an infection and below bachelor degree influenced anxiety, depression and insomnia of the medical staff and non-medical staff to different degree. LIMITATIONS AND CONCLUSIONS This study only collected data through the network. Therefore, the validity was reduced to some extent. The outbreak of the Omicron epidemic posed a significant challenge to public mental health, with non-medical staff at the highest risk for mental health problems.
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Affiliation(s)
- Yanyu Lu
- Department of Applied Psychology, South-Central Minzu University, Wuhan, Hubei, China
| | - Yuliang Zhou
- Department of Neuropsychology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yahong Li
- Department of Applied Psychology, South-Central Minzu University, Wuhan, Hubei, China.
| | - Jing Cao
- Department of Neuropsychology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Wenyan Zhao
- Department of Neuropsychology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yingying Hu
- Department of Neuropsychology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jing Wang
- Department of Neuropsychology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Hong Zhu
- Department of Neuropsychology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Zhipeng Xu
- Department of Neuropsychology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
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Zeng Z, Peng L, Liu S, Yang Q, Wang H, He Z, Hu Y. Serotonergic multilocus genetic variation moderates the association between interpersonal relationship and adolescent depressive symptoms. J Affect Disord 2023; 340:616-625. [PMID: 37597782 DOI: 10.1016/j.jad.2023.08.085] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/07/2023] [Accepted: 08/14/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Research suggests that genetic variants linked to serotonin functioning moderate the association between environmental stressors and depressive symptoms, but examining gene-environment interactions with single polymorphisms limits power. METHODS A multilocus genetic profile score (MGPS) approach to measuring serotonergic multilocus genetic variation and examined interactions with interpersonal relationship, insomnia with depressive symptoms as outcomes in an adolescent sample (average age = 14.15 ± 0.63 years since first measurement; range: 13 to 15). RESULTS (1) interpersonal relationship predicted adolescent depressive symptoms; (2) insomnia mediated the effect of interpersonal relationships on adolescent depressive symptoms; (3) the THP2 gene rs4570625 polymorphism G allele was a key risk factor for depressive symptom, and the MGPS moderated the effects of teacher-student relationship and insomnia on adolescent depressive symptom. Specifically, as the MGPS increased, the effects of insomnia on adolescent depressive symptom were enhanced; further, when the MGPS score increased, the effect of teacher-student relationship on depression showed a similar phenomenon with an increased slope and enhanced prediction; and (4) the results of sensitivity analysis showed that multilocus genetic interaction with the environment had a better explanatory power and stability for depression than single polymorphism studies. CONCLUSION MGPS provides substantial power to examine gene-environmental interactions linked to affective outcomes among adolescents.
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Affiliation(s)
- Zihao Zeng
- School of Educational Science, Hunan Normal University, Changsha 410081, China; Department of Clinical Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands
| | - Liyi Peng
- School of Educational Science, Hunan Normal University, Changsha 410081, China
| | - Shuangjin Liu
- School of Educational Science, Hunan Normal University, Changsha 410081, China
| | - Qin Yang
- School of Educational Science, Hunan Normal University, Changsha 410081, China
| | - Hongcai Wang
- School of Educational Science, Hunan Normal University, Changsha 410081, China
| | - Zhen He
- School of Educational Science, Hunan Normal University, Changsha 410081, China
| | - Yiqiu Hu
- School of Educational Science, Hunan Normal University, Changsha 410081, China; Research Center for Mental Health Education of Hunan Province, Changsha 410100, China; Cognition and Human Behavior Key Laboratory of Hunan Province, Changsha 410081, China; Center for Mind-Brain Science, Hunan Normal University, Changsha 410081, China.
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Gao T, Tao Y, Wang Q, Liu J, Du Z, Xing Y, Chen F, Mei J. A bibliometric analysis of insomnia in adolescent. Front Psychiatry 2023; 14:1246808. [PMID: 37965363 PMCID: PMC10641400 DOI: 10.3389/fpsyt.2023.1246808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023] Open
Abstract
Background The negative effects of insomnia on adolescents' development, academic performance, and quality of life place a burden on families, schools, and society. As one of the most important research directions for insomnia, adolescent insomnia has significant research value, social value, and practical significance. Unfortunately, there is no bibliometric analysis in this field of study. This study aims to analyze published articles using bibliometrics, summarize the current research progress and hot topics in this field systematically and exhaustively, and predict the future direction and trend of research. Methods For this study, the Web of Science Core Collection (WoSCC) database was searched between 2002 and 2022 for publications related to adolescent insomnia. The R-bibliometrix, VOSViewer, and CiteSpace software were utilized for bibliometric analysis. Results This investigation included 2468 publications from 3102 institutions in 87 countries, led by China and the United States. This field of research has entered a period of rapid development since 2017. The journal with the most publications on adolescent insomnia is Sleep, which is also the most co-cited journal. American Journal of Psychology has the highest impact factor among the top 10 journals. These papers were written by 10605 authors; notably, Liu Xianchen emerged as the author with the highest frequency of publications, while Mary A. Carskadon was the most frequently co-cited author. Mental health and comorbid diseases were the main research directions in this field. "Depression," "anxiety," "mental health," "COVID-19," "stress," "quality of life," "heart rate variability," and "attention-deficit hyperactivity disorder" were hot spots and trends in this field at the current moment. Conclusion The research on adolescent insomnia has social value, research value, and research potential; its development is accelerating, and an increasing number of researchers are focusing on it. This study summarized and analyzed the development process, hot spots, and trends of adolescent insomnia research using bibliometric analysis, which identified the current hot topics in this field and predicted the development trend for the future.
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Affiliation(s)
- Tianci Gao
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Yulei Tao
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Qianfei Wang
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Jiayi Liu
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Zekun Du
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - YueYi Xing
- School of Basic Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Fenqiao Chen
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
| | - Jianqiang Mei
- Graduate School, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- First Affiliated Hospital, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
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Mlyncekova Z, Hutka P, Visnovcova Z, Ferencova N, Kovacova V, Macejova A, Tonhajzerova I, Ondrejka I. Effects of Vortioxetine on Sleep Architecture of Adolescents with Major Depressive Disorder. Clocks Sleep 2023; 5:627-638. [PMID: 37987393 PMCID: PMC10660849 DOI: 10.3390/clockssleep5040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 11/22/2023] Open
Abstract
The relationship between depression and insomnia is bidirectional and both conditions need to be treated adequately, especially in a vulnerable neurodevelopmental stage of adolescence. This study aimed to evaluate the effects of antidepressant treatment using vortioxetine (VOR) on the sleep architecture of depressed adolescents by using video-polysomnography (v-PSG), which has not been researched before. The v-PSG was performed on 30 adolescent in-patients (mean age of 15.0 years ± 1.5 SD, 21 girls) treated with VOR (dosage of 10/15/20 mg/day) administered orally once a day, before and after VOR treatment. The evaluated parameters were conventional sleep parameters, sleep fragmentation parameters, and selected spectral power indices. Symptoms of depression and insomnia before and after the treatment period were evaluated using valid and reliable questionnaires (the Children´s Depression Inventory and the Athens Insomnia Scale). Depressed adolescents showed higher REM latency and decreased REM sleep percentage after treatment than before the treatment period (p = 0.005, p = 0.009, respectively). Our study revealed REM suppression (increased REM latency and reduced REM sleep percentage), indicating altered sleep architecture as a potential result of VOR treatment, which seems to be dose-dependent.
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Affiliation(s)
- Zuzana Mlyncekova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Peter Hutka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 03601 Martin, Slovakia; (Z.V.); (N.F.)
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4D, 03601 Martin, Slovakia; (Z.V.); (N.F.)
| | - Veronika Kovacova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Andrea Macejova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 4C, 03601 Martin, Slovakia;
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, University Hospital Martin, Comenius University in Bratislava, Kollarova 2, 03601 Martin, Slovakia; (Z.M.); (P.H.); (V.K.); (A.M.)
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Lin CY, Potenza MN, Pontes HM, Pakpour AH. Psychometric properties of the Persian Gaming Disorder Test and relationships with psychological distress and insomnia in adolescents. BMC Psychol 2023; 11:326. [PMID: 37817223 PMCID: PMC10566088 DOI: 10.1186/s40359-023-01368-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/30/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Gaming Disorder (GD) was recently included by the World Health Organization (WHO) as a psychiatric condition in the eleventh revision of the International Classification of Diseases (ICD-11) and is a concern worldwide, including in Iran. Thus, based on the ICD-11 criteria, a Persian version of the Gaming Disorder Test (GDT) was developed to facilitate assessment of GD. METHODS The present study used classical test theory and Rasch analysis to examine the psychometric properties of the Persian GDT. Iranian adolescents (n = 3837; 2171 [56.6%] males; mean [SD] age = 16.02 [1.4] years) completed the GDT and other instruments assessing disordered gaming, psychological distress, and insomnia. RESULTS Overall, the psychometric properties of the Persian GDT were satisfactory based on classical test theory (i.e., confirmatory factor analysis corroborated the unidimensional structure of GDT) and Rasch analysis (i.e., fit statistics suggested that all items were embedded in the concept of GD). Moreover, the Persian GDT was found to be sex-invariant, displaying no items with substantial differential item functioning across sexes. Additionally, it was found that GD mediated associations between time spent gaming and measures of psychological distress and insomnia. CONCLUSION The Persian GDT is a convenient and short instrument for assessing GD among Iranian adolescents. The mediating roles of GD in the associations between time spent gaming and psychological distress and between time spent gaming and insomnia suggest that targeting features of GD may reduce psychological distress and improve sleep for Iranian adolescents.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
- Biostatistics Consulting Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 701, Taiwan
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, 06510, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, 06109, USA
- Connecticut Mental Health Center, New Haven, CT, 06519, USA
- Wu Tsai Institute, Yale University, New Haven, CT, 06510, USA
| | - Halley M Pontes
- School of Psychological Sciences, Birkbeck, University of London, London, UK
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non- Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, 3419759811, Iran.
- Department of Nursing, School of Health and Welfare, Jönköping University, Gjuterigatan 5, Jönköping, 553 18, Sweden.
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Zhuang YY, Wang LL, Song TH, Dietch JR, Wang TT, Qi M, Liu JM, Zhou SJ, Chen JX. Reliability and validity of the Chinese version of the Nightmare disorder index in adolescents. Stress Health 2023; 39:894-901. [PMID: 36719632 PMCID: PMC10387496 DOI: 10.1002/smi.3228] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/05/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023]
Abstract
The Nightmare Disorder Index Questionnaire (NDI) was developed to measure the impact of nightmares. The purpose of this study was to investigate the psychometric properties of NDI among Chinese adolescents. This study investigated the validity and internal consistency of the Nightmare Disorder Index Chinese (NDI-CV) among 6014 Chinese adolescents who completed the NDI-CV, Nightmare Distress Questionnaire-Chinese Version (NDQ-CV), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Chinese Adolescent Daytime Sleepiness Scale (CADSS), Generalized Anxiety Disorder-7 Questionnaire (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). In addition, we investigated the test-retest reliability of the NDI-CV among 423 adolescents who completed a retest of the NDI-CV after a 2-week interval. Finally, NDI-CV demonstrated good psychometric properties in a sample of Chinese adolescents (Cronbach's α coefficient of 0.876), and the 95% confidence interval for the 2-week retest correlation coefficient was 0.675-0.977 (p < 0.001).
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Affiliation(s)
- Yun-Yue Zhuang
- Department of Psychology, Chengde Medical University, Chengde, China
| | - Lei-Lei Wang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Tian-He Song
- Department of Psychology, Chengde Medical University, Chengde, China
| | - Jessica R. Dietch
- School of Psychological Science, Oregon State University, Corvallis, Oregon, USA
| | | | - Meng Qi
- Department of Psychology, Chengde Medical University, Chengde, China
| | - Jin-Meng Liu
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Shuang-Jiang Zhou
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Jing-Xu Chen
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
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50
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Li W, Li C, Liu T, Wang Y, Ma X, Xiao X, Zhang Q, Qu J. Self-reported sleep disorders and the risk of all cancer types: evidence from the Kailuan Cohort study. Public Health 2023; 223:209-216. [PMID: 37677850 DOI: 10.1016/j.puhe.2023.08.007] [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: 03/13/2023] [Revised: 06/18/2023] [Accepted: 08/03/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Previous studies that focussed on sleep disturbance have primarily examined specific aspects of sleep disorders rather than considering overall sleep quality. We aimed to investigate different sleep disorders and their combination as risk factors for different types of cancer. STUDY DESIGN Prospective cohort study. METHODS In this prospective cohort study, we included 78,232 participants. A self-reported questionnaire was used to address insomnia, daytime sleepiness, snoring, and sleep duration. Overall sleep quality was evaluated by summarising these four sleep parameters. Cox proportional hazards analysis was used to estimate the hazard ratios and their 95% confidence intervals for determining the effect of the overall sleep-quality score and its components on the risk of incident cancer. RESULTS During a median follow-up of 5.67 years, 1266 participants were diagnosed with incident cancer. Compared to participants in the best sleep-quality score group, participants in the worst sleep-quality score group had a higher subsequent risk of overall cancer, and colorectal, breast, uterine or uterine cervical, prostatic, kidney, and bladder cancer. Participants with insomnia and snoring status had an elevated risk of head and neck, breast, uterine or uterine cervical, prostatic, kidney, bladder cancer, and lymphoma. CONCLUSIONS Poor overall sleep-quality scores as well as poor scores for the scale's components, including insomnia and snoring status, elevated the risk of overall and several specific-site cancers. TRIAL REGISTRATION Kailuan Study, ChiCTR2000029767. Registered 12 February, 2020-Retrospectively registered, https://www.chictr.org.cn/showprojEN.html?proj=48316.
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Affiliation(s)
- W Li
- Department of General Surgery, Aerospace Centre Hospital, Beijing, 100038, China
| | - C Li
- Department of Oncology, Dazu Hospital of Chongqing Medical University, Chongqing, 402360, China
| | - T Liu
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038, China
| | - Y Wang
- Department of Hepatological Surgery, Kailuan General Hospital, Tangshan, 063000, China
| | - X Ma
- Department of Hepatological Surgery, Kailuan General Hospital, Tangshan, 063000, China
| | - X Xiao
- Department of Gynecology, Aerospace Center Hospital, 100038, China.
| | - Q Zhang
- Department of General Surgery, Kailuan General Hospital, Tangshan, 063000, China.
| | - J Qu
- Department of General Surgery, Aerospace Centre Hospital, Beijing, 100038, China.
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