Supplementary material : Sleep quality and emotional reactivity cluster in bipolar disorders and impact on functioning
24 Nov 2017-
TL;DR: Abnormalities in ER and SQ delineated three clusters of patients with BD and significantly impacted on functioning, including minimal mood symptoms, better sleep profile and higher functioning.
Abstract: Abstract Objective: Bipolar disorders (BD) are characterized by sleep disturbances and emotional dysregulation both during acute episodes and remission periods. We hypothesized that sleep quality (SQ) and emotional reactivity (ER) defined clusters of patients with no or abnormal SQ and ER and we studied the association with functioning. Method: We performed a bi-dimensional cluster analysis using SQ and ER measures in a sample of 533 outpatients patients with BD (in remission or with subsyndromal mood symptoms). Clusters were compared for mood symptoms, sleep profile and functioning. Results: We identified three clusters of patients: C1 (normal ER and SQ, 54%), C2 (hypo-ER and low SQ, 22%) and C3 (hyper-ER and low SQ, 24%). C1 was characterized by minimal mood symptoms, better sleep profile and higher functioning than other clusters. Although highly different for ER, C2 and C3 had similar levels of subsyndromal mood symptoms as assessed using classical mood scales. When exploring sleep domains, C2 showed poor sleep efficiency and a trend for longer sleep latency as compared to C3. Interestingly, alterations in functioning were similar in C2 and C3, with no difference in any of the sub-domains. Conclusion: Abnormalities in ER and SQ delineated three clusters of patients with BD and significantly impacted on functioning.
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TL;DR: In this article, the authors evaluated the subjective emotional reactivity of 145 subjects (90 control subjects and 55 normothymic bipolar patients), using an emotional induction method based on the viewing of a set of slides (6 positive, 6 negative, 6 neutral) extracted from International Affective Picture System.
9 citations
TL;DR: In this paper , a two-sample MR study was conducted to assess the causal effects of socioeconomic status and individual behaviors (SES/IB) on mental disorders, including bipolar disorder, major depressive disorder and schizophrenia.
Abstract: Abstract Background There is increasing attention on the association of socioeconomic status and individual behaviors (SES/IB) with mental health. However, the impacts of SES/IB on mental disorders are still unclear. To provide evidence for establishing feasible strategies on disease screening and prevention, we implemented Mendelian randomization (MR) design to appraise causality between SES/IB and mental disorders. Methods We conducted a two-sample MR study to assess the causal effects of SES and IB (dietary habits, habitual physical activity, smoking behaviors, drinking behaviors, sleeping behaviors, leisure sedentary behaviors, risky behaviors, and reproductive behaviors) on three mental disorders, including bipolar disorder, major depressive disorder and schizophrenia. A series of filtering steps were taken to select eligible genetic instruments robustly associated with each of the traits. Inverse variance weighted was used for primary analysis, with alternative MR methods including MR-Egger, weighted median, and weighted mode estimate. Complementary methods were further used to detect pleiotropic bias. Results After Bonferroni correction and rigorous quality control, we identified that SES (educational attainment), smoking behaviors (smoking initiation, number of cigarettes per day), risky behaviors (adventurousness, number of sexual partners, automobile speeding propensity) and reproductive behavior (age at first birth) were causally associated with at least one of the mental disorders. Conclusions MR study provides robust evidence that SES/IB play broad impacts on mental disorders.
5 citations
TL;DR: It is found that a strong modulatory interaction between sleep processes and emotional states resides on the activity of several key brain structures, such as the amygdala, prefrontal cortex, hippocampus, and brainstem nuclei.
Abstract: Recently, increased interest and efforts were observed in describing the possible interaction between sleep and emotions. Human and animal model studies addressed the implication of both sleep patterns and emotional processing in neurophysiology and neuropathology in suggesting a bidirectional interaction intimately modulated by complex mechanisms and factors. In this context, we aimed to discuss recent evidence and possible mechanisms implicated in this interaction, as provided by both human and animal models in studies. In addition, considering the affective component of brain physiological patterns, we aimed to find reasonable evidence in describing the two-way association between comorbid sleep impairments and psychiatric disorders. The main scientific literature databases (PubMed/Medline, Web of Science) were screened with keyword combinations for relevant content taking into consideration only English written papers and the inclusion and exclusion criteria, according to PRISMA guidelines. We found that a strong modulatory interaction between sleep processes and emotional states resides on the activity of several key brain structures, such as the amygdala, prefrontal cortex, hippocampus, and brainstem nuclei. In addition, evidence suggested that physiologically and behaviorally related mechanisms of sleep are intimately interacting with emotional perception and processing which could advise the key role of sleep in the unconscious character of emotional processes. However, further studies are needed to explain and correlate the functional analysis with causative and protective factors of sleep impairments and negative emotional modulation on neurophysiologic processing, mental health, and clinical contexts.
4 citations
TL;DR: The FACE-BD cohort as discussed by the authors is an observational cohort of individuals with bipolar disorders who benefited from a systematic evaluation with evidence-based treatment recommendations and who were followed-up every year for 3 years in France.
4 citations
TL;DR: MinDag as discussed by the authors is an app for collection of multi-dimensional longitudinal data on BD-relevant symptoms and lifestyle-related behaviors, including mood, sleep, functioning/activities (social, occupational, physical exercise, leisure), substance use, emotional reactivity and psychotic experiences.
Abstract: Introduction The illness course of bipolar disorder (BD) is highly heterogeneous with substantial variation between individuals with the same BD subtype and within individuals over time. This heterogeneity is not well-delineated and hampers the development of more targeted treatment. Furthermore, although lifestyle-related behaviors are believed to play a role in the illness course, such mechanisms are poorly understood. To address some of these knowledge gaps, we aimed to develop an app for collection of multi-dimensional longitudinal data on BD-relevant symptoms and lifestyle-related behaviors. Methods An app named MinDag was developed at the Norwegian Center for Mental Disorders Research in Oslo, Norway. The app was designed to tap into selected areas: mood, sleep, functioning/activities (social, occupational, physical exercise, leisure), substance use, emotional reactivity, and psychotic experiences. Ethical, security and usability issues were highly prioritized throughout the development and for the final app solution. We conducted beta- and pilot testing to eliminate technical problems and enhance usability and acceptability. Results The final version of MinDag comprises six modules; three which are presented for the user once daily (the Sleep module in the morning and the Mood and Functoning/Activities modules in the evening) and three which are presented once weekly (Substance Use, Emotional Reactivity, and Psychotic Experiences modules). In general, MinDag was well received in both in the beta-testing and the pilot study, and the participants provided valuable feedback that was taken into account in the final development. MinDag is now in use as part of the research protocol at the NORMENT center and in a specialized treatment unit for BD at Oslo University Hospital in Norway. Discussion We believe that MinDag will generate unique longitudinal data well suited for capturing the heterogeneity of BD and clarifying important unresolved issues such as how life-style related behavior may influence BD symptoms. Also, the experiences and knowledge derived from the development of MinDag may contribute to improving the security, acceptability, and benefit of digital tools in mental health.
References
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11 Jun 2013
113,134 citations
TL;DR: The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
Abstract: Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
23,155 citations
"Supplementary material : Sleep qual..." refers background in this paper
...This 19-item self-questionnaire generated a total score ranging from 0 to 21 [40] and 7 sub-components (each ranging from 0 to 3): sleep quality (overall subjective sleep quality rated by the patient), sleep latency (time to fall asleep), sleep duration (number of hours of actual sleep), sleep disturbances (frequency of nightmares, snoring, abnormal awakening, or other problems during the night), sleep efficiency (ratio of the total time spent asleep in a night compared to the total amount of time spent in bed), use of sleeping medication (frequency of use per week to promote sleep) and daytime dysfunction due to sleepiness (trouble staying awake, lack of energy or enthusiasm)....
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TL;DR: The construction of a depression rating scale designed to be particularly sensitive to treatment effects is described, and its capacity to differentiate between responders and non-responders to antidepressant treatment was better than the HRS, indicating greater sensitivity to change.
Abstract: The construction of a depression rating scale designed to be particularly sensitive to treatment effects is described. Ratings of 54 English and 52 Swedish patients on a 65 item comprehensive psychopathology scale were used to identify the 17 most commonly occurring symptoms in primary depressive illness in the combined sample. Ratings on these 17 items for 64 patients participating in studies of four different antidepressant drugs were used to create a depression scale consisting of the 10 items which showed the largest changes with treatment and the highest correlation to overall change. The inner-rater reliability of the new depression scale was high. Scores on the scale correlated significantly with scores on a standard rating scale for depression, the Hamilton Rating Scale (HRS), indicating its validity as a general severity estimate. Its capacity to differentiate between responders and non-responders to antidepressant treatment was better than the HRS, indicating greater sensitivity to change. The practical and ethical implications in terms of smaller sample sizes in clinical trials are discussed.
11,923 citations
"Supplementary material : Sleep qual..." refers methods in this paper
...Inclusion criteria were: (A) a diagnosis of BD type I, II or NOS (Not Otherwise Specified) (1), (B) the absence of any major mood episode (of any polarity) according to DMS-IV criteria (1) at inclusion and within three months before the assessment, (C) baseline scores 15 at the Mongomery-Asberg Depression Rating Scale [37] and at the Young Manic Rating Scale [38]....
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...Inclusion criteria were: (A) a diagnosis of BD type I, II or NOS (Not Otherwise Specified) (1), (B) the absence of any major mood episode (of any polarity) according to DMS-IV criteria (1) at inclusion and within three months before the assessment, (C) baseline scores < 15 at the Mongomery-Asberg Depression Rating Scale [37] and at the Young Manic Rating Scale [38]....
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TL;DR: The MRS score correlated highly with an independent global rating, and with scores of two other mania rating scales administered concurrently, and also correlated with the number of days of subsequent stay in hospital.
Abstract: An eleven item clinician-administered Mania Rating Scale (MRS) is introduced, and its reliability, validity and sensitivity are examined. There was a high correlation between the scores of two independent clinicians on both the total score (0.93) and the individual item scores (0.66 to 0.92). The MRS score correlated highly with an independent global rating, and with scores of two other mania rating scales administered concurrently. The score also correlated with the number of days of subsequent stay in hospital. It was able to differentiate statistically patients before and after two weeks of treatment and to distinguish levels of severity based on the global rating.
7,398 citations
"Supplementary material : Sleep qual..." refers methods in this paper
...Inclusion criteria were: (A) a diagnosis of BD type I, II or NOS (Not Otherwise Specified) (1), (B) the absence of any major mood episode (of any polarity) according to DMS-IV criteria (1) at inclusion and within three months before the assessment, (C) baseline scores 15 at the Mongomery-Asberg Depression Rating Scale [37] and at the Young Manic Rating Scale [38]....
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...Inclusion criteria were: (A) a diagnosis of BD type I, II or NOS (Not Otherwise Specified) (1), (B) the absence of any major mood episode (of any polarity) according to DMS-IV criteria (1) at inclusion and within three months before the assessment, (C) baseline scores < 15 at the Mongomery-Asberg Depression Rating Scale [37] and at the Young Manic Rating Scale [38]....
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TL;DR: This article reviews the modern literature on two key aspects of the central circuitry of emotion: the prefrontal cortex (PFC) and the amygdala, and places emphasis on affective chronometry, or the time course of emotional responding, as a key attribute of individual differences in propensity for anxiety that is regulated by this circuitry.
1,070 citations
"Supplementary material : Sleep qual..." refers background in this paper
...As mentioned in the introduction, this could be linked to an amplification of the amygdala responsiveness and/or a decrease in the functional inhibitor connectivity with the prefrontal cortex that were observed after sleep deprivation [33,50]....
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