1
|
Zhao S, Tang Y, Li Y, Shen H, Liu A. Associations between Life's Essential 8 and depression among US adults. Psychiatry Res 2024; 338:115986. [PMID: 38850892 DOI: 10.1016/j.psychres.2024.115986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/26/2024] [Accepted: 05/27/2024] [Indexed: 06/10/2024]
Abstract
Few studies have examined the association of Life's Essential 8 (LE8) with depression among US adults. This is a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2020. LE8 score was measured as the mean score of eight metrics (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipid, blood glucose, and blood pressure). CVH was categorized into low, moderate, and high according to tertiles of LE8 score. Depression was defined based on the 9-Item Patient Health Questionnaire (PHQ-9). Weighted logistic regressions were conducted to assess the associations of depression with CVH. Compared with participants with low CVH, the fully adjusted ORs of depression were 0.45 (0.37, 0.55) in the moderate CVH and 0.21 (0.15, 0.30) in the high CVH participants, respectively. The results remained robust in subgroup and sensitivity analyses. All eight LE8 metrics were negatively associated with depression, while nicotine exposure and sleep health were identified as two major metrics contributing to the association. Better CVH evaluated by LE8 was associated with decreased depression prevalence among US adults. Adherence to a higher CVH score, especially targeting smoking cessation and proper sleep duration, might be beneficial for prevention of depression.
Collapse
Affiliation(s)
- Songfeng Zhao
- Department of Neurosurgery, the Third Xiangya Hospital, Central South University, Hunan, China
| | - Ying Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yifan Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hongxian Shen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
| | - Aihua Liu
- Department of Neurosurgery, the Third Xiangya Hospital, Central South University, Hunan, China; Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
2
|
Qiao MX, Yu H, Li T. Non-invasive neurostimulation to improve sleep quality and depressive symptoms in patients with major depressive disorder: A meta-analysis of randomized controlled trials. J Psychiatr Res 2024; 176:282-292. [PMID: 38905761 DOI: 10.1016/j.jpsychires.2024.06.023] [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: 11/28/2023] [Revised: 05/29/2024] [Accepted: 06/13/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND Non-invasive neurostimulation, including bright light therapy (BLT), repetitive transcranial magnetic (rTMS) and transcranial direct current stimulation (tDCS), has been shown to alleviate depressive symptoms in major depressive disorder (MDD). However, the efficacy of these interventions in addressing sleep disturbances in MDD patients remains a subject of debate. OBJECTIVE We aimed to conduct a meta-analysis of available randomized controlled trials (RCTs) to assess the effectiveness of non-invasive neurostimulation in improving sleep disturbances and depressive symptoms in MDD patients. METHODS Systematic searches for relevant RCTs were conducted in the databases PubMed, Cochrane Library, Web of Science, EMBASE, Wanfang and China National Knowledge Infrastructure up to January 2024. Data on outcomes comparable across the studies were meta-analyzed using Review Manager 5.3 and Stata 14. The pooled results were reported as standardized mean differences (SMD) with their respective 95% confidence intervals (CI). RESULTS Our analysis encompassed 15 RCTs involving 1348 patients. Compared to sham or no stimulation, non-invasive neurostimulation significantly improved sleep quality (SMD -0.74, 95%CI -1.15 to -0.33, p = 0.0004) and sleep efficiency (SMD 0.35, 95%CI 0.10 to 0.60, p = 0.006). It also significantly reduced severity of depressive symptoms (SMD -0.62, 95%CI -0.90 to -0.35, p < 0.00001). Subgroup analysis further demonstrated that patients experiencing sleep improvements due to neurostimulation showed a marked decrease in depressive symptoms compared to the control group (SMD = -0.90, 95% CI [-1.26, -0.54], p < 0.0001). CONCLUSION Current evidence from RCTs suggests that neurostimulation can enhance sleep quality and efficiency in individuals with MDD, which in turn may be associated with mitigation of depressive symptoms. PROSPERO REGISTRATION CRD42023423844.
Collapse
Affiliation(s)
- Meng-Xuan Qiao
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China; Affiliated Mental Health Center & Hangzhou Seventh People's Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Hua Yu
- Affiliated Mental Health Center & Hangzhou Seventh People's Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China; Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China; NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China.
| | - Tao Li
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China; Affiliated Mental Health Center & Hangzhou Seventh People's Hospital and School of Brain Science and Brain Medicine, Zhejiang University School of Medicine, Hangzhou, 310058, China; Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China; NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou 310058, China.
| |
Collapse
|
3
|
Baena D, Toor B, Ray LB, Smith D, Kong P, Lopez J, Hoffmann R, Bertram H, Robillard R, Armitage R, Fogel SM. Sleep spindles in adolescents with major depressive disorder. J Affect Disord 2024; 344:535-545. [PMID: 37827259 DOI: 10.1016/j.jad.2023.10.039] [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: 04/12/2023] [Revised: 09/26/2023] [Accepted: 10/08/2023] [Indexed: 10/14/2023]
Abstract
Sleep spindle differences in adolescents with major depressive disorder (MDD) compared to healthy adolescents is an ongoing debate. Results mostly indicate decreased sleep spindle activity in adolescents with MDD. Given that sleep spindles predominate NREM and that acutely delaying the sleep period via a "sleep delay challenge" (SDC) increases non-rapid eye movement (NREM) sleep duration, it may be possible to increase spindle density in adolescents with MDD, which may provide a therapeutic benefit to depression symptoms. Here, we examined the impact of a SDC on spindle density and depression symptomology in adolescents with MDD (n = 66) and healthy controls (n = 62) tested across three nights: adaptation, normal sleep, and a SDC night which delayed bedtime by three hours. The results showed that; (1) there was no difference in spindle density between groups on the normal sleep night, (2) following the SDC, both males and females with MDD had a decrease in the frequency of slow spindles, while only females with MDD had an increase in the frequency of fast spindles, (3) acute SDC reduced depression symptoms in both groups, and (4) light sleep on the normal sleep night and slow spindle frequency at SDC predicted an 8 % improvement in depression symptoms, regardless of sex or MDD diagnosis. Taken together, these results suggest that; (a) spindles may be a useful biological marker of depression symptomatology regardless of clinical MDD diagnosis, and (b) that acute SDC may help alleviate depression symptoms in adolescents with MDD.
Collapse
Affiliation(s)
- D Baena
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada; Sleep Research Unit, The Royal's Institute of Mental Health Research, Ottawa K1Z 7K4, Canada
| | - B Toor
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada; Sleep Research Unit, The Royal's Institute of Mental Health Research, Ottawa K1Z 7K4, Canada
| | - L B Ray
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada
| | - D Smith
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada; Sleep Research Unit, The Royal's Institute of Mental Health Research, Ottawa K1Z 7K4, Canada
| | - P Kong
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada
| | - J Lopez
- Department of Psychiatry, University of Michigan, MI 48109, USA; Department of Clinical and Diagnostic Sciences, University of Alabama at Birmingham, Birmingham 35294, USA
| | - R Hoffmann
- Department of Psychiatry, University of Michigan, MI 48109, USA
| | - H Bertram
- Department of Psychiatry, University of Michigan, MI 48109, USA
| | - R Robillard
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada; Sleep Research Unit, The Royal's Institute of Mental Health Research, Ottawa K1Z 7K4, Canada
| | - R Armitage
- Department of Psychiatry, University of Michigan, MI 48109, USA
| | - S M Fogel
- School of Psychology, University of Ottawa, Ottawa K1N 6N5, Canada; Sleep Research Unit, The Royal's Institute of Mental Health Research, Ottawa K1Z 7K4, Canada; University of Ottawa Brain & Mind Research Institute, Ottawa K1H 8M5, Canada.
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
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.
Collapse
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.)
| |
Collapse
|
6
|
Cooper R, Di Biase MA, Bei B, Allen NB, Schwartz O, Whittle S, Cropley V. Development of morning-eveningness in adolescence: implications for brain development and psychopathology. J Child Psychol Psychiatry 2023; 64:449-460. [PMID: 36325967 PMCID: PMC10952670 DOI: 10.1111/jcpp.13718] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Morning-evening preference is defined as an individual's preference for a morning- or evening-oriented rhythm. Across adolescence, a preference for eveningness becomes more predominant. Although eveningness is cross-sectionally associated with internalizing and externalizing psychopathology, few studies have examined developmental changes in eveningness and its potential biological substrates. Here, we investigated the longitudinal relationships among the trajectory of eveningness preference, internalizing and externalizing psychopathology and white matter development, across adolescence. METHODS Two-hundred and nine adolescents (49% male) were assessed longitudinally at four separate time points between 12 and 19 years of age. Morning-evening preference and internalizing and externalizing symptoms were assessed at each time point. Diffusion-weighted images were acquired on a subset of participants at the final two time points to estimate changes in global mean fractional anisotropy (FA). Linear mixed models were performed to estimate the change in eveningness over time. A series of linear regression models assessed the influence of change in eveningness on psychopathology and white matter development at age 19. RESULTS Across the sample, a preference for eveningness became more predominant by 19 years of age. Greater individual-level change towards eveningness significantly predicted greater severity in externalizing, but not internalizing, symptoms at 19 years of age. In contrast, change in psychopathology from 12 to 19 years of age was not associated with morning-eveningness at age 19. A change towards eveningness predicted an attenuated increase in FA between 17 and 19 years of age. CONCLUSIONS This study suggests that developmental changes in morning-evening preference may predict both neurodevelopmental and psychological outcomes in adolescents.
Collapse
Affiliation(s)
- Rebecca Cooper
- Melbourne Neuropsychiatry CentreThe University of Melbourne and Melbourne HealthMelbourneVictoriaAustralia
| | - Maria A. Di Biase
- Melbourne Neuropsychiatry CentreThe University of Melbourne and Melbourne HealthMelbourneVictoriaAustralia
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Bei Bei
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMelbourneVictoriaAustralia
| | | | - Orli Schwartz
- Orygen Centre for Youth Mental HealthMelbourneVictoriaAustralia
| | - Sarah Whittle
- Melbourne Neuropsychiatry CentreThe University of Melbourne and Melbourne HealthMelbourneVictoriaAustralia
| | - Vanessa Cropley
- Melbourne Neuropsychiatry CentreThe University of Melbourne and Melbourne HealthMelbourneVictoriaAustralia
| |
Collapse
|
7
|
Wen LY, Shi LX, Zhu LJ, Zhou MJ, Hua L, Jin YL, Chang WW. Associations between Chinese college students’ anxiety and depression: A chain mediation analysis. PLoS One 2022; 17:e0268773. [PMID: 35653383 PMCID: PMC9162318 DOI: 10.1371/journal.pone.0268773] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/07/2022] [Indexed: 11/19/2022] Open
Abstract
Objective Anxiety and depression are great public health concerns among college students. The purpose of this study was to explore whether sleep quality and quality of life (QoL) play mediating roles in anxiety and depression among Chinese college students. Method A total of 2757 college students (mean age = 19.07; SD = 1.14) completed the questionnaires, including a brief demographic survey. The 2-item General Anxiety Disorder (GAD-2) and the 2-item Patient Health Questionnaire (PHQ-2) were used to assess the symptoms of anxiety and depression, respectively. And the Pittsburgh Sleep Quality Index (PSQI) and the Short-Form 36 Health Survey (SF-36) were used to evaluate college students’ sleep quality and QoL, respectively. Mediation analyses were conducted by using PROCESS macro in the SPSS software. Result Anxiety had both direct and indirect effects on depression. Sleep quality and QoL were not only independent mediators in the relationship between anxiety and depression but also chain mediators. Conclusion The results of the current study highlight the crucial role of early intervention for depression with a focus on college students with anxiety, more especially, on those with poorer sleep quality and lower QoL.
Collapse
Affiliation(s)
- Li-ying Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Liu-xia Shi
- Department of Oral Medicine, School of Stomatology, Wannan Medical College, Wuhu, China
| | - Li-jun Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Meng-jie Zhou
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Long Hua
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Yue-long Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
- * E-mail: (YLJ); (WWC)
| | - Wei-wei Chang
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
- * E-mail: (YLJ); (WWC)
| |
Collapse
|
8
|
Kuula L, Halonen R, Lipsanen J, Pesonen AK. Adolescent circadian patterns link with psychiatric problems: A multimodal approach. J Psychiatr Res 2022; 150:219-226. [PMID: 35397335 DOI: 10.1016/j.jpsychires.2022.03.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/04/2022] [Accepted: 03/31/2022] [Indexed: 11/20/2022]
Abstract
Circadian rhythms orchestrate brain function and mental wellbeing. We compared circadian patterns derived from continuous measurements of body temperature, sleep actigraphy and self-reported circadian preference in relation to different psychiatric disorders. 342 adolescents (70% females) aged 17.4y underwent M.I.N.I. psychiatric interviews, wore Ibutton 1922L skin temperature loggers (n = 281; 3 days), completed one-week GeneActiv Original actigraphy measurements (n = 306) and responded to Morningness-Eveningness Questionnaire (MEQ; n = 330). We derived circadian period length and amplitude from the temperature loggers. Actigraphy measures included sleep duration, midpoint, efficiency, and irregularity as well as Delayed Sleep Phase (DSP) characteristics (bedtime after 1 a.m. 3 times/week). M.I.N.I. psychiatric interviews suggested that 36% of participants had one or more psychiatric problem, with 21% suffering from comorbidity. Severe depression was associated with longer circadian period (p = 0.002). Suicidality was associated with later midpoint (p = 0.007) and more irregular sleep (p = 0.007). Those with agoraphobia slept longer (p = 0.013). Manic episodes and psychotic disorders were associated with irregular sleep (p-values <0.02). DSP was related to suicidality (p = 0.026), panic disorder (p = 0.022), and greater comorbidity (p = 0.026). Preference for eveningness was similarly related to higher prevalence of Generalized Anxiety Disorder (p = 0.014), social anxiety (p = 0.03), agoraphobia (p = 0.026), panic disorder (p = 0.004), suicidality (p = 0.018), severe depression (p < 0.001), and comorbidity (p < 0.001). Deviations in circadian rhythms were widely associated with psychiatric problems, whereas sleep duration was not. Especially suicidality linked with several markers of circadian disruption: later sleep midpoint, irregular sleep, and DSP characteristics. Longer circadian period length was associated with severe depression.
Collapse
Affiliation(s)
- Liisa Kuula
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland.
| | - Risto Halonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anu-Katriina Pesonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland
| |
Collapse
|
9
|
Gender Differences in Sleep and Mental Health among Saudi Adolescents. SLEEP DISORDERS 2021; 2021:5513817. [PMID: 34540293 PMCID: PMC8448587 DOI: 10.1155/2021/5513817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 08/20/2021] [Indexed: 12/02/2022]
Abstract
Among adolescents, mental health issues (i.e., stress and depressive symptoms) negatively affect sleep. We assessed whether the association between mental health and sleep varied between genders among Saudi adolescents. A total of 2206 school students (grades 7-12) from 40 randomly selected schools in four cities of Al-Qassim province in Saudi Arabia participated in this cross-sectional study. The survey assessed demography, lifestyle, sleep (12-item Medical Outcomes Study Sleep Scale), depression (Depression, Anxiety, Stress Scale (DASS-21)) and stress (10-item Perceived Stress Scale). Adjusted associations with sleep were tested with linear and logistic regressions. Of the sample, 55% were girls, and their average sleep score was lower than that of the boys (58.7 vs. 63.4, p < 0.001). Girls had worse mental health than boys; the proportion of girls with both severe stress and severe depressive symptoms was three times higher than that of the boys (12% vs. 4%, p < 0.001). For both boys and girls, those with severe depressive symptoms only or both severe depressive symptoms and severe stress had significantly lower sleep scores than those who had neither of the two conditions (reference group). On the other hand, among those who had severe stress only, the sleep score was significantly lower for the girls (p = 0.002) than for the boys (p = 0.19). Overall, girls had a significantly lower sleep score and worse mental health than boys. The association between mental health and sleep significantly differed between the sexes. Severe stress was negatively associated with sleep in girls but not in boys.
Collapse
|
10
|
O'Callaghan VS, Couvy-Duchesne B, Strike LT, McMahon KL, Byrne EM, Wright MJ. A meta-analysis of the relationship between subjective sleep and depressive symptoms in adolescence. Sleep Med 2021; 79:134-144. [PMID: 33524839 DOI: 10.1016/j.sleep.2021.01.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Adolescence is a risk period for the development of mental illness, as well as a time for pronounced change in sleep behaviour. While prior studies, including several meta-analyses show a relationship between sleep and depressive symptoms, there were many inconsistences found in the literature. OBJECTIVE To investigate the relationship between subjective sleep and depressive symptoms. METHODS Following PRISMA guidelines, we conducted a literature search that yielded forty-nine recent studies (2014-2020) with adolescent samples aged 9 to 25-year-olds, and more than double the sample size of previous meta-analyses (N = 318,256). RESULTS In a series of meta-analyses, we show that while several common categories of subjective sleep are associated with depressive symptoms in adolescents, the strength of this relationship varies. Measures of sleep perception: poor sleep quality (r = 0.41), insomnia (r = 0.37), sleep disturbances (r = 0.36), wake after sleep onset (r = 0.31), and daytime sleepiness (r = 0.30) correlated more strongly with depressive symptoms, than measures of sleep behaviour: sleep latency (r = 0.22), and sleep duration (r = -0.19). CONCLUSIONS These findings suggest that in studies of depressive symptoms it may be important to assess an adolescent's perception about their sleep, in addition to their sleep/wake behaviours.
Collapse
Affiliation(s)
| | - Baptiste Couvy-Duchesne
- Institute of Molecular Bioscience, University of Queensland, Brisbane, Australia; Paris Brain Institute, ARAMIS INRIA Team, Paris, France
| | - Lachlan T Strike
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Katie L McMahon
- Queensland University of Technology, Faculty of Health, School of Clinical Science and Institute of Health and Biomedical Innovation, Brisbane, Australia
| | - Enda M Byrne
- Institute of Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - Margaret J Wright
- Queensland Brain Institute, University of Queensland, Brisbane, Australia; Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
| |
Collapse
|
11
|
Vermeulen MC, van der Heijden KB, Kocevska D, Treur JL, Huppertz C, van Beijsterveldt CE, Boomsma DI, Swaab H, Van Someren EJ, Bartels M. Associations of sleep with psychological problems and well-being in adolescence: causality or common genetic predispositions? J Child Psychol Psychiatry 2021; 62:28-39. [PMID: 32396669 PMCID: PMC7818180 DOI: 10.1111/jcpp.13238] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/18/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Whereas short and problematic sleep are associated with psychological problems in adolescence, causality remains to be elucidated. This study therefore utilized the discordant monozygotic cotwin design and cross-lagged models to investigate how short and problematic sleep affect psychological functioning. METHODS Adolescent twins (N = 12,803, 13-20 years, 42% male) completed questionnaires on sleep and psychological functioning repeatedly over a two-year interval. Monozygotic twin pairs were classified as concordant or discordant for sleep duration and trouble sleeping. Resulting subgroups were compared regarding internalizing problems, externalizing problems, and subjective well-being. RESULTS Cross-sectional analyses indicated associations of worse psychological functioning with both short sleep and problematic sleep, and cross-lagged models indicate bidirectional associations. Longitudinal analyses showed that an increase in sleep problems experienced selectively by one individual of an identical twin pair was accompanied by an increase of 52% in internalizing problem scores and 25% in externalizing problem scores. These changes were significantly different from the within-subject changes in cotwins with unchanged sleep quality (respectively, 3% increase and 5% decrease). Psychological functioning did, however, not worsen with decreasing sleep duration. CONCLUSIONS The findings suggest that sleep quality, rather than sleep duration, should be the primary target for prevention and intervention, with possible effect on psychological functioning in adolescents.
Collapse
Affiliation(s)
- Marije C.M. Vermeulen
- Department of Sleep and CognitionNetherlands Institute for Neurosciencean Institute of the Royal Netherlands Society for Arts and SciencesAmsterdamThe Netherlands,Department of Clinical Child and Adolescent StudiesInstitute of Education and Child StudiesLeiden UniversityLeidenThe Netherlands
| | - Kristiaan B. van der Heijden
- Department of Clinical Child and Adolescent StudiesInstitute of Education and Child StudiesLeiden UniversityLeidenThe Netherlands,Leiden Institute for Brain and CognitionLeiden UniversityLeidenThe Netherlands
| | - Desana Kocevska
- Department of Sleep and CognitionNetherlands Institute for Neurosciencean Institute of the Royal Netherlands Society for Arts and SciencesAmsterdamThe Netherlands,Department of Child and Adolescent PsychiatryErasmus Medical CenterRotterdamThe Netherlands
| | - Jorien L. Treur
- Department of Biological PsychologyNetherlands Twin RegisterVU University AmsterdamAmsterdamThe Netherlands,Amsterdam Public Health Research InstituteAmsterdam UMCAmsterdamThe Netherlands,School of Experimental PsychologyUniversity of BristolBristolUK
| | - Charlotte Huppertz
- Department of Biological PsychologyNetherlands Twin RegisterVU University AmsterdamAmsterdamThe Netherlands,Amsterdam Public Health Research InstituteAmsterdam UMCAmsterdamThe Netherlands,Department of Psychiatry, Psychotherapy and PsychosomaticsFaculty of MedicineRWTH Aachen UniversityAachenGermany
| | - Catharina E.M. van Beijsterveldt
- Department of Biological PsychologyNetherlands Twin RegisterVU University AmsterdamAmsterdamThe Netherlands,Amsterdam Public Health Research InstituteAmsterdam UMCAmsterdamThe Netherlands
| | - Dorret I. Boomsma
- Department of Biological PsychologyNetherlands Twin RegisterVU University AmsterdamAmsterdamThe Netherlands,Amsterdam Public Health Research InstituteAmsterdam UMCAmsterdamThe Netherlands,Amsterdam NeuroscienceAmsterdam UMCAmsterdamThe Netherlands
| | - Hanna Swaab
- Department of Clinical Child and Adolescent StudiesInstitute of Education and Child StudiesLeiden UniversityLeidenThe Netherlands,Leiden Institute for Brain and CognitionLeiden UniversityLeidenThe Netherlands
| | - Eus J.W. Van Someren
- Department of Sleep and CognitionNetherlands Institute for Neurosciencean Institute of the Royal Netherlands Society for Arts and SciencesAmsterdamThe Netherlands,Amsterdam NeuroscienceAmsterdam UMCAmsterdamThe Netherlands,Departments of Psychiatry and Integrative NeurophysiologyCenter for Neurogenomics and Cognitive Research (CNCR)Vrije Universiteit AmsterdamAmsterdam UMCAmsterdamThe Netherlands
| | - Meike Bartels
- Department of Biological PsychologyNetherlands Twin RegisterVU University AmsterdamAmsterdamThe Netherlands,Amsterdam Public Health Research InstituteAmsterdam UMCAmsterdamThe Netherlands
| |
Collapse
|
12
|
Hrafnkelsdottir SM, Brychta RJ, Rognvaldsdottir V, Chen KY, Johannsson E, Gudmundsdottir SL, Arngrimsson SA. Less screen time and more physical activity is associated with more stable sleep patterns among Icelandic adolescents. Sleep Health 2020; 6:609-617. [PMID: 32331863 DOI: 10.1016/j.sleh.2020.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/17/2019] [Accepted: 02/04/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Emerging evidence suggests that inconsistent sleep may affect physical and psychological health. Thus, it is important to identify modifiable determinants of sleep variability. Screen time and physical activity are both thought to affect sleep, but studies of their relationship to sleep variability using objective measures are lacking. We examined cross-sectional associations between these variables in mid-teen adolescents using objectively measured sleep and activity. METHODS Wrist-worn accelerometers were used to measure one week of sleep and activity in 315 tenth grade students (mean age 15.8y) from six Reykjavík compulsory schools. Participants reported their daily hours of screen time. Regression analysis was used to explore associations of screen time and physical activity with variability in duration, quality, and timing of sleep, adjusting for DXA-measured body fat percentage, parental education, and physical activity or screen time. RESULTS Screen time, especially game playing, was associated with variability in duration, timing, and quality of sleep, most strongly with variation in bedtime. Physical activity was inversely associated with variability in duration, timing, and quality of sleep, most strongly with variation in the number of awakenings. Boys had less stable sleep patterns and higher screen time than girls, and sex-specific associations of screen time with sleep variability parameters were significant for boys only. CONCLUSIONS Less screen time and more physical activity were independently associated with less sleep variability among mid-teen adolescents. Our results indicate that encouraging youngsters toward an active lifestyle with limited screen use may be important to achieve more consistent sleep.
Collapse
Affiliation(s)
| | - Robert J Brychta
- Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | | | - Kong Y Chen
- Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Erlingur Johannsson
- Center of Sport and Health Sciences, University of Iceland, Reykjavik, Iceland; Department of Sport and Physical Activity, Western Norway University of Applied Sciences, Bergen, Norway
| | | | | |
Collapse
|
13
|
Sleep symptoms and long-term outcome in adolescents with major depressive disorder: a naturalistic follow-up study. Eur Child Adolesc Psychiatry 2020; 29:595-603. [PMID: 31696307 PMCID: PMC7250797 DOI: 10.1007/s00787-019-01436-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 10/31/2019] [Indexed: 12/22/2022]
Abstract
Sleep abnormalities in major depressive disorder (MDD) have been suggested to represent a vulnerability trait, which might predispose the individual to long-term psychiatric morbidity. In this study, we sought to assess whether the presence of sleep symptoms among adolescents with MDD is associated with poorer long-term outcome in young adulthood during naturalistic follow-up. Adolescent outpatients diagnosed with MDD (n = 166; age 13-19 years, 17.5% boys) were followed up during 8 years in naturalistic settings. N = 112 adolescents (16.1% boys) completed the 8-year assessment. Sleep symptoms and psychosocial functioning were assessed with structured clinical interviews, and depressive and anxiety symptoms with questionnaires. The severity of sleep symptoms at baseline was not associated with worse outcome at 8 years in terms of any of the outcome measures tested. In particular, the presence of a disturbed sleep-wake rhythm at baseline was associated with a more favourable outcome at 8 years: less depression and anxiety symptoms and higher level of psychosocial functioning. The presence of sleep symptoms in young adulthood was associated with the presence of current depression and anxiety symptoms and poorer psychosocial functioning. The presence of sleep symptoms at follow-up seems to be state-dependent: they are observed in conjunction with other psychiatric symptoms. Contrary to our hypothesis, our results suggest that sleep complaints among adolescents with MDD do not lead to poorer long-term clinical outcome in young adulthood. The link between sleep-wake rhythm disturbance and better long-term outcome needs to be confirmed and examined in detail in further studies, but here we speculate about possible explanations.
Collapse
|
14
|
Hamann C, Rusterholz T, Studer M, Kaess M, Tarokh L. Association between depressive symptoms and sleep neurophysiology in early adolescence. J Child Psychol Psychiatry 2019; 60:1334-1342. [PMID: 31512761 DOI: 10.1111/jcpp.13088] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Depression is highly prevalent among adolescents, and depressive symptoms rise rapidly during early adolescence. Depression is often accompanied by subjective sleep complaints and alterations in sleep neurophysiology. In this study, we examine whether depressive symptoms, measured on a continuum, are associated with subjective and objective (sleep architecture and neurophysiology) measures of sleep in early adolescence. METHODS High-density sleep EEG, actigraphy, and self-reported sleep were measured in 52 early adolescents (12.31 years; SD: 1.121; 25 female). Depressive symptoms were measured on a continuum using the Center for Epidemiological Studies Depression Scale (CES-D). The association between depressive symptoms and 2 weeks of actigraphy, self-reported sleep, sleep architecture, and sleep neurophysiology (slow wave activity and sigma power) was determined via multiple linear regression with factors age, sex, and pubertal status. RESULTS Despite no association between polysomnography measures of sleep quality and depressive symptoms, individuals with more depressive symptoms manifested worse actigraphically measured sleep. Less sleep spindle activity, as reflected in nonrapid eye movement sleep sigma power, was associated with more depressive symptoms over a large cluster encompassing temporal, parietal, and occipital regions. Furthermore, worse subjectively reported sleep quality was also associated with less sigma power over these same areas. Puberty, age, and sex did not impact this association. CONCLUSIONS Sleep spindles have been hypothesized to protect sleep against environmental disturbances. Thus, diminished spindle power may be a subtle sign of disrupted sleep and its association with depressive symptoms in early adolescence may signal vulnerability for depression.
Collapse
Affiliation(s)
- Christoph Hamann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Thomas Rusterholz
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland.,Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
| | - Martina Studer
- Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Section for Translational Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Leila Tarokh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| |
Collapse
|
15
|
Ämmälä AJ, Urrila AS, Lahtinen A, Santangeli O, Hakkarainen A, Kantojärvi K, Castaneda AE, Lundbom N, Marttunen M, Paunio T. Epigenetic dysregulation of genes related to synaptic long-term depression among adolescents with depressive disorder and sleep symptoms. Sleep Med 2019; 61:95-103. [DOI: 10.1016/j.sleep.2019.01.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 01/18/2019] [Accepted: 01/23/2019] [Indexed: 12/14/2022]
|
16
|
Anttila M, Kurki M, Välimäki M. Sleeping behaviors of adolescents with depressive disorders: adolescent self-description of sleeping reported through a web-based support system. Inform Health Soc Care 2019; 44:338-350. [PMID: 31340708 DOI: 10.1080/17538157.2019.1640223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Depression is the leading health disorder in adolescence and often manifests itself as sleeping problems. A number of quantitative analyses have assessed the quality of adolescents' sleeping, but there is still a lack of information on how adolescents themselves perceive their sleeping behavior. METHOD Using a mixed-methods approach, we describe sleeping behaviors and sleeping habits among adolescents with depressive disorders, who have been referred to psychiatric outpatient services. RESULTS Adolescents monitored their own sleeping patterns (n = 13) and reported on them through self-reflecting writings (n = 16) on a web-based support system for one week. They went to bed to about 23:00, remained awake for around 40 minutes, slept eight and a half hours, woke up at 9:00, and described themselves as being tired after the night. Adolescents were able to self-reflect on their sleeping in various ways and find meanings and interpretations of it. CONCLUSION The results contribute valuable information to health care personnel who work with adolescents, for example school nurses and mental health professionals. More emphasis should be put on adolescents' perceptions of their sleeping behavior and how to increase their insight into their own wellbeing.
Collapse
Affiliation(s)
- Minna Anttila
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Marjo Kurki
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland.,Development Unit, Hospital District of Southwest Finland, Turku, Finland.,School of Nursing, Hong Kong Polytechnic University, Hong Kong, China (SAR)
| |
Collapse
|
17
|
Yang S, Chu S, Gao Y, Ai Q, Liu Y, Li X, Chen N. A Narrative Review of Cancer-Related Fatigue (CRF) and Its Possible Pathogenesis. Cells 2019; 8:cells8070738. [PMID: 31323874 PMCID: PMC6679212 DOI: 10.3390/cells8070738] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/10/2019] [Accepted: 07/17/2019] [Indexed: 12/16/2022] Open
Abstract
Many cancer patients suffer from severe fatigue when treated with chemotherapy or radiotherapy; however, the etiology and pathogenesis of this kind of fatigue remains unknown. Fatigue is associated with cancer itself, as well as adjuvant therapies and can persist for a long time. Cancer patients present a high degree of fatigue, which dramatically affects the quality of their everyday life. There are various clinical research studies and reviews that aimed to explore the mechanisms of cancer-related fatigue (CRF). However, there are certain limitations in these studies: For example, some studies have only blood biochemical texts without histopathological examination, and there has been insufficient systemic evaluation of the dynamic changes in relevant indexes. Thus, we present this narrative review to summarize previous studies on CRF and explore promising research directions. Plenty of evidence suggests a possible association between CRF and physiological dysfunction, including skeletal muscular and mitochondrial dysfunction, peripheral immune activation and inflammation dysfunction, as well as central nervous system (CNS) disorder. Mitochondrial DNA (mtDNA), mitochondrial structure, oxidative pressure, and some active factors such as ATP play significant roles that lead to the induction of CRF. Meanwhile, several pro-inflammatory and anti-inflammatory cytokines in the peripheral system, even in the CNS, significantly contribute to the occurrence of CRF. Moreover, CNS function disorders, such as neuropeptide, neurotransmitter, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction, tend to amplify the sense of fatigue in cancer patients through various signaling pathways. There have been few accurate animal models established to further explore the molecular mechanisms of CRF due to different types of cancer, adjuvant therapy schedules, living environments, and physical status. It is imperative to develop appropriate animal models that can mimic human CRF and to explore additional mechanisms using histopathological and biochemical methods. Therefore, the main purpose of this review is to analyze the possible pathogenesis of CRF and recommend future research that will clarify CRF pathogenesis and facilitate the formulation of new treatment options.
Collapse
Affiliation(s)
- Songwei Yang
- College of Pharmacy, Hunan University of Chinese Medicine, Changsha 410208, Hunan, China
- Hunan Engineering Technology Center of Standardization and Function of Chinese Herbal Decoction Pieces, Changsha 410208, Hunan, China
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medical, Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Shifeng Chu
- College of Pharmacy, Hunan University of Chinese Medicine, Changsha 410208, Hunan, China
- Hunan Engineering Technology Center of Standardization and Function of Chinese Herbal Decoction Pieces, Changsha 410208, Hunan, China
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medical, Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Yan Gao
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medical, Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Qidi Ai
- College of Pharmacy, Hunan University of Chinese Medicine, Changsha 410208, Hunan, China
- Hunan Engineering Technology Center of Standardization and Function of Chinese Herbal Decoction Pieces, Changsha 410208, Hunan, China
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medical, Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Yingjiao Liu
- College of Pharmacy, Hunan University of Chinese Medicine, Changsha 410208, Hunan, China
- Hunan Engineering Technology Center of Standardization and Function of Chinese Herbal Decoction Pieces, Changsha 410208, Hunan, China
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medical, Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Xun Li
- College of Pharmacy, Hunan University of Chinese Medicine, Changsha 410208, Hunan, China
- Hunan Engineering Technology Center of Standardization and Function of Chinese Herbal Decoction Pieces, Changsha 410208, Hunan, China
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medical, Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
| | - Naihong Chen
- College of Pharmacy, Hunan University of Chinese Medicine, Changsha 410208, Hunan, China.
- Hunan Engineering Technology Center of Standardization and Function of Chinese Herbal Decoction Pieces, Changsha 410208, Hunan, China.
- State Key Laboratory of Bioactive Substances and Functions of Natural Medicines, Institute of Materia Medical, Neuroscience Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China.
| |
Collapse
|
18
|
Conroy DA, Czopp AM, Dore-Stites DM, Dopp RR, Armitage R, Hoban TF, Arnedt JT. Modified Cognitive Behavioral Therapy for Insomnia in Depressed Adolescents: A Pilot Study. Behav Sleep Med 2019; 17:99-111. [PMID: 28332858 DOI: 10.1080/15402002.2017.1299737] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective/Background: The purpose of the study was to pilot a five-week insomnia treatment in adolescents with major depressive disorder (MDD) and insomnia. This was an open-label trial of a modified-group cognitive behavioral therapy for insomnia (CBTI). Participants: Adolescents with MDD (n = 16; mean age = 17.3 +/- 1.7), characterized by the Children's Depression Rating Scale-Revised T-score ≥ 55 and insomnia, characterized by > 30 min to fall or return to sleep and an Insomnia Severity Index (ISI) score of ≥ 7 participated. Methods: Sleep diaries, actigraphy, weekly ISI, Quick Inventory of Depressive Symptomatology (QIDS), and Multidimensional Fatigue Inventory (MFI) were completed. Results: Paired t-tests comparing pre- and posttreatment revealed a decrease in sleep onset latency from 41 min +/- 14 min to 18 min +/- 8.9 min (t = 5.9, p = .004). Linear mixed modeling across sessions revealed that ISI (B = 11.0, SE = 0.94, p < .001), QIDS (B = 11.3, SE = 0.96, p < .001), and MFI (B = 30.0, SE = 4.4, p < .001) improved across treatment. Daily sleep diaries showed decreased wake during the night (B = 22.8, SE = 7.19, p = .008), increased sleep time (B = 382.4, SE = 71.89, p < .001), and increased quality of sleep (B = 3.7, SE = 0.37, p < .001). When asked whether group members would recommend this group, 27% responded "yes" and 73% responded "definitely yes." Conclusions: Additional controlled studies utilizing sleep-focused therapy in depressed adolescents with insomnia are warranted.
Collapse
Affiliation(s)
- Deirdre A Conroy
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Alison M Czopp
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Dawn M Dore-Stites
- Pediatric Behavioral Development, University of Michigan, Ann Arbor, Michigan
| | - Richard R Dopp
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Roseanne Armitage
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Timothy F Hoban
- Pediatric Sleep Medicine and Clinical Neurophysiology, University of Michigan, Ann Arbor, Michigan
| | - J Todd Arnedt
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
19
|
Zou L, Wu X, Tao S, Xu H, Xie Y, Yang Y, Tao F. Mediating Effect of Sleep Quality on the Relationship Between Problematic Mobile Phone Use and Depressive Symptoms in College Students. Front Psychiatry 2019; 10:822. [PMID: 31798473 PMCID: PMC6865206 DOI: 10.3389/fpsyt.2019.00822] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/17/2019] [Indexed: 12/24/2022] Open
Abstract
Background and Aim: Problematic mobile phone use (PMPU) and depression are great public health concerns among adolescents. The aim of this study was to determine the association between PMPU and symptoms of depression, as well as the mediating role of sleep quality. Methods: A total of 4,624 college students participated in this study. The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU), Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire-9 (PHQ-9) were administered to assess PMPU, sleep quality, and symptoms of depression. Mediation analysis was conducted using PROCESS macro in the SPSS software. Results: Of the participants, 27.5% were classified as PMPU, 44.9% exhibited symptoms of depression, and 15.6% reported sleep problems. Compared with those without PMPU, those with PMPU exhibited higher rates of sleep problems and depressive symptoms. The mediation analysis further revealed partial mediation effects of sleep quality on the association between PMPU and depression. Conclusions: This study demonstrated that PMPU was associated with mental health in college students, and sleep quality played a mediating role in this relationship. Our findings highlight the critical role of early intervention for depression with a focus on those with PMPU and, more specifically, on those with sleep problems.
Collapse
Affiliation(s)
- Liwei Zou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Xiaoyan Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
| | - Shuman Tao
- Department of Nephrology, the Second Hospital of Anhui Medical University, Hefei, China
| | - Honglv Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Yang Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Yajuan Yang
- School of Nursing, Anhui Medical University, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.,MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
| |
Collapse
|
20
|
Urrila AS, Hakkarainen A, Castaneda A, Paunio T, Marttunen M, Lundbom N. Frontal Cortex Myo-Inositol Is Associated with Sleep and Depression in Adolescents: A Proton Magnetic Resonance Spectroscopy Study. Neuropsychobiology 2018; 75:21-31. [PMID: 28793304 DOI: 10.1159/000478861] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 06/19/2017] [Indexed: 01/07/2023]
Abstract
AIM This study used proton magnetic resonance spectroscopy (1H MRS) to evaluate the neurochemistry of the frontal cortex in adolescents with symptoms of sleep and depression. METHODS Nineteen non-medicated adolescent boys (mean age 16.0 years; 9 clinical cases with depression/sleep symptoms and 10 healthy controls) underwent 1H MRS at 3 T. MR spectra were acquired from the anterior cingulate cortex (ACC), the dorsolateral prefrontal cortex, and frontal white matter. Concentrations of N-acetyl aspartate, total creatine, choline-containing compounds, total glutamine plus glutamate, and myo-inositol (mI) were compared in the 2 subgroups, and correlated with sleep and clinical measures in the total sample. Sleep was assessed with self-report questionnaires and ambulatory polysomnography recordings. RESULTS Concentrations of mI were lower in both frontal cortical regions among the depressed adolescents than in controls. No statistically significant differences in other metabolite concentrations were observed between the subgroups. Frontal cortex mI concentrations correlated negatively with depression severity, subjective daytime sleepiness, insomnia symptoms, and the level of anxiety, and correlated positively with total sleep time and overall psychosocial functioning. The correlations between mI in the ACC and total sleep time as well as daytime sleepiness remained statistically significant when depression severity was controlled in the analyses. CONCLUSION Lower frontal cortex mI may indicate a disturbed second messenger system. Frontal cortical mI may thus be linked to the pathophysiology of depression and concomitant sleep symptoms among maturing adolescents. Short sleep and daytime sleepiness may be associated with frontal cortex mI independently from depression.
Collapse
Affiliation(s)
- Anna S Urrila
- Unit of Mental Health, Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | | | | | | | | | | |
Collapse
|
21
|
Conklin AI, Yao CA, Richardson CG. Chronic sleep deprivation and gender-specific risk of depression in adolescents: a prospective population-based study. BMC Public Health 2018; 18:724. [PMID: 29890964 PMCID: PMC5996474 DOI: 10.1186/s12889-018-5656-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/01/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Chronic exposure to sleep deprivation may increase the risk of depression in young people who are particularly vulnerable to changes in sleep and mental health. Sleep deprivation and incident depression may also differ by gender. We investigated the prospective association between cumulative sleep deprivation and subsequent levels of depressive symptomatology among adolescents from a gender perspective. METHODS A longitudinal study of 3071 young people in the British Columbia Adolescent Substance Use Survey (BASUS) cohort with three sleep time and two depression measures over 12 months (2011-12). Multivariable linear regression models with interaction terms estimated gender-specific associations between self-reported chronic sleep deprivation and changes in depressive symptomatology; post-estimation analysis calculated adjusted mean depression scores for each level of cumulative sleep deprivation. RESULTS Cumulative sleep deprivation was associated with a monotonic increase in depression scores at follow-up in young women, but no consistent pattern was seen in young men. During follow-up, 15% of young women were chronically sleep deprived and 29% were depressed (CESD ≥24). Young women reporting chronic exposure to sleep deprivation had higher CESD scores at follow-up (21.50 points, [CI95 19.55-23.45]), than those reporting no history (16.59 [15.72-17.45]); that remained after multivariable adjustment (19.48 [17.59-21.38]). CONCLUSION Results suggested that chronic sleep deprivation increases the risk of major depression among young women. Mental health promotion for young people should include relevant strategies to ensure young women can achieve recommended amounts of sleep.
Collapse
Affiliation(s)
- Annalijn I. Conklin
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Westbrook Mall, Vancouver, BC V6T 1Z3 Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Health Research Institute, Vancouver, Canada
| | - Christopher A. Yao
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Health Research Institute, Vancouver, Canada
| | - Christopher G. Richardson
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), Providence Health Research Institute, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| |
Collapse
|
22
|
Sleep Disturbances in Child and Adolescent Mental Health Disorders: A Review of the Variability of Objective Sleep Markers. Med Sci (Basel) 2018; 6:medsci6020046. [PMID: 29867064 PMCID: PMC6024884 DOI: 10.3390/medsci6020046] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 05/28/2018] [Accepted: 05/29/2018] [Indexed: 12/27/2022] Open
Abstract
Sleep disturbances are often observed in child and adolescent mental health disorders. Although previous research has identified consistent subjective reports of sleep disturbances, specific objective sleep markers have not yet been identified. We evaluated the current research on subjective and objective sleep markers in relation to attention deficit hyperactivity disorders, autism spectrum disorders, anxiety and depressive disorders. Subjective sleep markers are more consistent than objective markers of actigraphy, polysomnography, and circadian measures. We discuss the causes of variability in objective sleep findings and suggest future directions for research.
Collapse
|
23
|
Less screen time and more frequent vigorous physical activity is associated with lower risk of reporting negative mental health symptoms among Icelandic adolescents. PLoS One 2018; 13:e0196286. [PMID: 29698499 PMCID: PMC5919516 DOI: 10.1371/journal.pone.0196286] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 04/10/2018] [Indexed: 12/31/2022] Open
Abstract
Objective Few studies have explored the potential interrelated associations of screen time and physical activity with mental health in youth, particularly using objective methods. We examined cross-sectional associations of these variables among Icelandic adolescents, using objective and subjective measurements of physical activity. Methods Data were collected in the spring of 2015 from 315 tenth grade students (mean age 15.8 years) in six elementary schools in metropolitan Reykjavík, Iceland. Participants reported, via questionnaire, on demographics, weekly frequency of vigorous physical activity, daily hours of screen time and mental health status (symptoms of depression, anxiety and somatic complaints, self-esteem and life satisfaction). Total physical activity was measured over one week with wrist-worn accelerometers. Body composition was determined by DXA-scanning. Poisson regression analysis was used to explore independent and interactive associations of screen time and physical activity with mental health variables, adjusting for gender, body fat percentage and maternal education. Results Less screen time (below the group median of 5.3 h/day) and more frequent vigorous physical activity (≥4x/week) were each associated with reporting fewer symptoms of depression, anxiety, low self-esteem, and life dissatisfaction. No significant associations were observed between objectively measured physical activity and mental health outcomes. Interactive regression analysis showed that the group reporting both less screen time and more frequent vigorous physical activity had the lowest risk of reporting symptoms of depression, anxiety, low self-esteem, and life dissatisfaction. Conclusions Reports of less screen time and more frequent vigorous physical activity were associated with lower risk of reporting mental health problems among Icelandic adolescents. Those who reported a combination of engaging in less screen time and more frequent vigorous physical activity had the lowest risk, suggesting a synergistic relationship between the two behaviors on mental health outcomes. Our results support guiding youth towards more active and less sedentary/screen-based lifestyle.
Collapse
|
24
|
Inderkum AP, Tarokh L. High heritability of adolescent sleep–wake behavior on free, but not school days: a long-term twin study. Sleep 2018; 41:4797120. [DOI: 10.1093/sleep/zsy004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/27/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Andrea P Inderkum
- Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
| | - Leila Tarokh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| |
Collapse
|
25
|
Tokiya M, Kaneita Y, Itani O, Jike M, Ohida T. Predictors of insomnia onset in adolescents in Japan. Sleep Med 2017; 38:37-43. [PMID: 29031754 DOI: 10.1016/j.sleep.2017.06.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 06/28/2017] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective of this study was to clarify the incidence rate and predictive factors of insomnia in Japanese junior and senior high school students. METHODS We conducted a baseline survey on first year junior and senior high school students (seventh and 10th graders) throughout the nation. A follow-up survey was then conducted two years later. For both surveys, we used self-administered questionnaires inquiring about sleep, mental health status, lifestyle, participation in club activities, and study hours. RESULTS A total of 3473 students (776 junior high and 2697 senior high) were suitable for analysis. During the two years leading to the follow-up study, the incidence rate of newly developed insomnia was 7.8% among junior high and 9.2% among senior high school students. Multiple logistic regression analyses revealed that factors associated with new insomnia onset were 'sleep paralysis experience' and 'poor mental health status' in junior high school students, and 'being woken by a nightmare', 'poor mental health status', '≥2 h of extracurricular learning per day' and 'mobile phone use for ≥2 h per day' in senior high school students. CONCLUSIONS In junior and senior high school students, parasomnias such as nightmares and sleep paralysis, and mental health status can be predictors of insomnia onset. For senior high school students, longer use of mobile phones can be a predictor of insomnia onset. The present findings suggest that sleep health must be promoted among junior and senior high school students in the future.
Collapse
Affiliation(s)
- Mikiko Tokiya
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| | - Yoshitaka Kaneita
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan.
| | - Osamu Itani
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| | - Maki Jike
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Takashi Ohida
- Division of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| |
Collapse
|
26
|
Merikanto I, Partonen T, Paunio T, Castaneda AE, Marttunen M, Urrila AS. Advanced phases and reduced amplitudes are suggested to characterize the daily rest-activity cycles in depressed adolescent boys. Chronobiol Int 2017; 34:967-976. [PMID: 28594248 DOI: 10.1080/07420528.2017.1332072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Self-reported eveningness has been previously associated with depressed mood among adults and adolescents. Here, we study how circadian indicators based on actigraphic data differ between depressed and healthy adolescent boys. Our sample consisted of 17 medication-free adolescent boys, aged 14.5 to 17.5 years, of which eight had depressive disorder and were currently depressed and nine were healthy comparison participants. Psychiatric assessment was conducted by diagnostic interviews and complemented with observer-rating and self-rating scales. Actigraphic data were collected with wrist actigraphs for a minimum period of 25 consecutive days (range of 25 to 44 days). The behavioral trait of morningness-eveningness was measured with the 19-item Horne-Östberg Morningness-Eveningness Questionnaire. Based on the self-report, the depressed boys were more prone to eveningness than healthy controls, but based on the actigraphic data, they had earlier phases especially on school days and lower activity levels especially on weekends. On weekends, the depressed boys showed a greater shift toward later-timed phases than healthy controls. Our results confirm a mismatch of the subjective morningness-eveningness preference (late-preference) and the objective rest-activity rhythm (early-prone) during school days in depressed adolescent boys.
Collapse
Affiliation(s)
- Ilona Merikanto
- a Department of Public Health Solutions, Mental Health Unit , National Institute for Health and Welfare , Helsinki , Finland.,b Orton Orthopaedics Hospital , Helsinki , Finland
| | - Timo Partonen
- a Department of Public Health Solutions, Mental Health Unit , National Institute for Health and Welfare , Helsinki , Finland
| | - Tiina Paunio
- c Department of Health, Genetics and Biomarkers Unit , National Institute for Health and Welfare , Helsinki , Finland.,d Department of Psychiatry , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Anu E Castaneda
- e Department of Welfare, Equality and Inclusion Unit , National Institute for Health and Welfare , Helsinki , Finland
| | - Mauri Marttunen
- a Department of Public Health Solutions, Mental Health Unit , National Institute for Health and Welfare , Helsinki , Finland.,d Department of Psychiatry , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Anna S Urrila
- a Department of Public Health Solutions, Mental Health Unit , National Institute for Health and Welfare , Helsinki , Finland.,d Department of Psychiatry , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| |
Collapse
|
27
|
Affiliation(s)
- N. Tuvia
- Laboratory of Chronobiology; Institute for Medical Immunology; Charité-Universitaetsmedizin Berlin; Berlin Germany
| | - P. B. Persson
- Institute of Vegetative Physiology; Charité-Universitaetsmedizin Berlin; Berlin Germany
| | | |
Collapse
|
28
|
Maasalo K, Fontell T, Wessman J, Aronen ET. Sleep and behavioural problems associate with low mood in Finnish children aged 4-12 years: an epidemiological study. Child Adolesc Psychiatry Ment Health 2016; 10:37. [PMID: 27713765 PMCID: PMC5053121 DOI: 10.1186/s13034-016-0125-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 09/27/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Few studies have examined the associations between sleep, mood and behaviour in young children in the early stages of developing psychopathology. The purpose here was to examine the association of emotional problems, especially mood, with family and child characteristics, sleep and behavioural problems in 4-12 year-old children. METHODS The sample was population-based and included 1714 children. Parents filled in the Strengths and Difficulties Questionnaire and a background questionnaire on child and family characteristics. The associations between (a) emotional symptoms/mood and background variables, (b) emotional problems and conduct problems/hyperactivity and (c) mood and conduct problems/hyperactivity were examined with ordinal regression in univariate and multivariate models. RESULTS Of the background variables, child's sleeping problems had the most powerful association with emotional symptoms and mood. Abnormal emotional problems score and emotional symptoms were associated with abnormal conduct problems and hyperactivity scores. Of the emotional symptoms, low mood was the one associated most strongly with conduct problems and hyperactivity after controlling for all significant background variables and other emotional symptoms. CONCLUSIONS We conclude that in young children sleep problems associate with low mood. Low mood associates with behavioural problems. When a child presents with low mood or behavioural problems, a comprehensive assessment of their psychiatric symptoms, as well as their sleep problems, is recommended.
Collapse
Affiliation(s)
- K. Maasalo
- Laboratory of Developmental Psychopathology, Helsinki Pediatric Research Center, Children’s Hospital, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Tukholmankatu 8 C 613, 00290 Helsinki, Finland
| | - T. Fontell
- Children’s Hospital, Child Psychiatry, Helsinki University Hospital, PL 355, 00029 HUS Helsinki, Finland
| | - J. Wessman
- Laboratory of Developmental Psychopathology, Helsinki Pediatric Research Center, Children’s Hospital, Child Psychiatry, University of Helsinki and Helsinki University Hospital, PL 353, 00029 HUS Helsinki, Finland
| | - E. T. Aronen
- Laboratory of Developmental Psychopathology, Helsinki Pediatric Research Center, Children’s Hospital, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Lastenlinnantie 2, 00250 Helsinki, Finland
| |
Collapse
|
29
|
Affiliation(s)
- P B Persson
- Institute of Vegetative Physiology, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
| | | |
Collapse
|
30
|
Affiliation(s)
- P. B. Persson
- Institute of Vegetative Physiology; Charité-Universitaetsmedizin Berlin; Berlin Germany
| |
Collapse
|