Subscription RequiredScientific InvestigationsInsomnia and suicide as reported adverse effects of second-generation antipsychotics and mood stabilizers Brian J. Miller, MD, PhD, MPH, William V. McCall, MD, MS Brian J. Miller, MD, PhD, MPH Search for more papers by this author , William V. McCall, MD, MS Address correspondence to: William V. McCall, MD, MS, Department of Psychiatry and Health Behavior, Augusta University, 997 Saint Sebastian Way, Augusta, GA 30912; Tel: (706) 721-6719; Fax: (706) 721-1793; Email: E-mail Address: [email protected] Search for more papers by this author Published Online:February 1, 2022https://doi.org/10.5664/jcsm.9646Cited by:1 

Insomnia and suicide as reported adverse effects of second-generation antipsychotics and mood stabilizers

Sex differences in prevalence and clinical correlates of insomnia in Chinese patients with chronic schizophrenia

Meta-analysis of clozapine and insomnia in schizophrenia

Abstract Background The pathogenesis of schizophrenia remains unknown. Nearly half of the patients with schizophrenia have a combination of depressive symptoms and even some impulsive behaviors. Accurate diagnosis of this disorder has been a great challenge. Molecular biology plays an important role in the study of its pathogenesis. Objective This study is committed to analyze the correlation between depressed mood and impulsive behavior and serum protein factor levels in first-episode drug-naive schizophrenia patients. Methods Seventy first-episode drug-naive schizophrenia patients and 69 healthy controls from a physical examination center during the same period participated in this study. Peripheral blood concentrations of brain-derived neurotrophic factor (BDNF), phosphatidylinositol-3 kinase (PI3K), protein kinase B (AKT), and cAMP response element binding protein (CREB) were measured using Enzyme Linked Immunosorbent Assay (ELISA) in the patient and control groups. The Chinese version of the Calgary Depression Scale for Schizophrenia (CDSS) was used to assess depressed mood. The Chinese version of the Short UPPS-P Impulsive Behavior Scale (S-UPPS-P) was used to assess impulsive behavior. Results Serum BDNF, PI3K and CREB concentrations in the patient group were lower than those in the control group, while AKT concentrations were higher than those in the control group. The total CDSS and S-UPPS-P scores were higher in the patient group than in the control group. The total CDSS score was negatively correlated with the concentrations of BDNF, PI3K and CREB, and positively correlated with the concentrations of AKT in the patient group. The total S-UPPS-P score in the patient group was negatively correlated with BDNF, PI3K, and CREB concentrations and positively correlated with AKT concentrations. Premeditation subscore of S-UPPS-P was not significantly correlated with BDNF, PI3K, AKT, and CREB concentrations. Conclusion Our findings show significant differences between the levels of BDNF, PI3K, AKT, and CREB concentrations in the peripheral blood of patients with first-episode drug-naive schizophrenia and controls. The concentration levels of these serum proteins could be used as biomarkers for the prediction of mood and impulsive behavior in schizophrenia. 

Concentration Levels of BDNF, PI3K, AKT, and CREB Predict Depressed Mood and Impulsive Behavior in First-Episode Drug- Naive Schizophrenia Patients

Insomnia and inflammation are both common in schizophrenia. In the general population, insomnia is associated with inflammation. In n=519 subjects from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) schizophrenia trial, terminal insomnia was investigated as an indicator of inflammation using non-parametric ANCOVA. After controlling for potential confounders, insomnia was significantly associated with higher blood IL-6 (F=4.12, p=0.007) and leptin (F=9.67, p

Insomnia and inflammation in phase 1 of the clinical antipsychotic trials of intervention effectiveness study.

Objectives Insomnia occurs frequently in the clinical course of schizophrenia. A growing literature has found associations between insomnia, suicidal ideation, and psychopathology in patients with schizophrenia. We explored these associations in a cross-sectional study of a large sample of patients with chronic schizophrenia in China. We hypothesized that insomnia would be associated with an increased odds of current suicidal ideation and higher current psychopathology scores. Methods We recruited 328 inpatients with chronic schizophrenia, all of whom were prescribed psychotropics. We investigated relationships between current insomnia, suicidal ideation over the past two weeks, and current psychopathology for subjects using regression models. Results After controlling for multiple potential confounding factors, current insomnia was an indicator of a significant, 2.5-fold increased odds of suicidal ideation (OR = 2.56, 95% CI 1.10–5.95, p = 0.029). Insomnia was also a significant indicator of lifetime suicide attempt (OR = 1.07) as well as higher Positive and Negative Syndrome Scale total (β = 0.134, p = 0.017), positive (β = 0.154, p = 0.006) and general (β = 0.145, p = 0.010) subscale scores. Conclusion Insomnia is associated with suicidal ideation, lifetime suicide attempt, and higher psychopathology scores in inpatients with chronic schizophrenia. Formal assessment of insomnia appears relevant to the clinical care of patients with schizophrenia as an indicator of suicidal thinking and behavior, depression, and symptom severity.

Huanzhong Liu

Papers

Insomnia, suicidal ideation, and psychopathology in Chinese patients with chronic schizophrenia