A rating scale for drug-induced akathisia has been derived that incorporates diagnostic criteria for pseudoakathisia, and mild, moderate, and severe akathisia. It comprises items for rating the observable, restless movements which characterise the condition, the subjective awareness of restlessness, and any distress associated with the akathisia. In addition, there is an item for rating global severity. A standard examination procedure is recommended. The inter-rater reliability for the scale items (Cohen's kappa) ranged from 0.738 to 0.955. Akathisia was found in eight of 42 schizophrenic in-patients, and nine had pseudoakathisia, where the typical sense of inner restlessness was not reported.

A rating scale for drug-induced akathisia

Circadian rhythm disruption, manifested as circadian misalignment, difficulty initiating sleep, and sleep-wake irregularity, is often left unrecognized in patients with schizophrenia. Studies have shown multiple adverse consequences of sleep irregularity, but limited data is available on schizophrenia. This is a secondary analysis of a case-control study of 66 schizophrenia patients with delayed sleep-wake phase (with or without meeting criteria for the disorder) and normal sleep-wake phase (mean age = 44.08 years; 45.45% males). Potential correlates included sleep quality, daytime sleepiness, social rhythms, chronotype, psychiatric symptoms, psychosocial functioning, metabolic index, cognitive function, and sociodemographic, lifestyle and pharmacological factors. Square successive difference (SSD) scores, derived from 1-week sleep diary and actigraphy, were indexes of sleep irregularity. Multilevel modeling analysis, with SSD scores as level-1 measures and the hypothesized correlates as level-2 measures, was performed. Statistical significance was Bonferroni-adjusted. Higher SSD scores of sleep diary and actigraphy variables were significantly associated with positive and depressive symptoms, poor sleep quality, daytime sleepiness, irregular social rhythm, evening chronotype, delayed sleep-wake phase disorder, later caffeine use and dinner time, greater cigarette use, and lower dosages of hypnotics and antipsychotics. Our findings highlight the implications of sleep irregularity in schizophrenia and the need for a multimodal intervention.

Correlates of sleep irregularity in schizophrenia

Effects of general versus subarachnoid anaesthesia on circadian melatonin rhythm and postoperative delirium in elderly patients undergoing hip fracture surgery: A prospective cohort clinical trial.

Sleep diary- and actigraphy-derived sleep parameters of 8-hour fast-rotating shift work nurses: A prospective descriptive study

Moderators of Improvement From Mindfulness-Based vs Traditional Cognitive Behavioral Therapy for the Treatment of Provoked Vestibulodynia

Subjective methods are often employed for sleep assessment due to their ease of use, but the results may not concur with objective findings. This discrepancy may be present in schizophrenia; howeve...

Chui-Kwan Kan

Papers

Subjective-Objective Sleep Discrepancy in Schizophrenia.

Delayed sleep-wake phase disorder and delayed sleep-wake phase in schizophrenia: Clinical and functional correlates.