scholarly journals S88. THE EFFECT OF SLEEP QUALITY ON ATTENUATED PSYCHOTIC SYMPTOMS IN A NON-CLINICAL SAMPLE OF YOUNG ADULTS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S67-S68
Author(s):  
Donncha Hanna ◽  
Ciaran James Shannon ◽  
Stephen Clarke ◽  
Sarah Davidson ◽  
Ciaran Mulholland
Keyword(s):  
At Risk ◽  
General Population ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Mental State ◽  
Psychotic Symptoms ◽  
Poor Sleep ◽  
Unique Contribution ◽  
Poor Sleep Quality ◽  
At Risk Mental State

Abstract Background Background: One factor known to be associated with attenuated psychotic symptoms is poor sleep but it is not known if poor sleep increases the likelihood of experiencing multiple attenuated psychotic symptoms, which research suggests may be suggestive of an At-Risk Mental State (ARMS). The study aimed to determine if poor sleep quality makes a unique contribution to predicting the number of attenuated psychotic symptoms endorsed in a prodromal questionnaire and the level of distress associated with the symptoms, when accounting for demographics, depression and drug/alcohol use variables. Methods Method: An online survey was conducted using Amazon’s online crowdsourcing service Mechanical Turk (MTurk). The sample was 1,013 adults (18 to 36 years) from the general population in the USA. The survey consisted of the Prodromal Questionnaire 16 (PQ-16), the Pittsburgh Sleep Quality Index, the Patient Health Questionnaire 9 (PHQ-9), the DAST-10 and the AUDIT. Regression analyses were performed with the PQ-16 as the dependent variable, and sleep quality as the predictor variable, while controlling for sociodemographic variables, depression, and alcohol/drug abuse. Results Results: 37% of the sample endorsed six or more PQ-16 items, which may be suggestive of an at-risk mental state, with sleep disturbance significantly increasing the likelihood (Odds ratio 2.09 <.001) of endorsing six or more PQ-16 items. After controlling for socio-demographic variables, depression and drug/alcohol abuse, poor sleep quality made a unique contribution of 5.8% of the variance accounted for in level of distress experienced by attenuated psychotic symptoms. Discussion Conclusion: A significant proportion of young adults in the general population may have an at-risk mental state. The results add to the evidence that sleep disturbance is a contributory factor in attenuated psychotic symptoms. Further research is required to investigate the possible mechanisms (e.g. impaired cognitive processes) through which poor sleep influences attenuated psychotic symptoms and if effective treatment of sleep disturbance can influence the likelihood of developing an at-risk mental state.

scholarly journals Gambling Problems Are Associated with Alcohol Misuse and Insomnia: Results from a Representative National Telephone Survey

2021 ◽  
Vol 18 (13) ◽  
pp. 6683
Author(s):  
Hannah Briony Thorne ◽  
Matthew Justus Rockloff ◽  
Sally Anne Ferguson ◽  
Grace Elizabeth Vincent ◽  
Matthew Browne
Keyword(s):  
At Risk ◽  
Alcohol Consumption ◽  
Sleep Quality ◽  
Problem Gambling ◽  
Alcohol Misuse ◽  
Sleep Problems ◽  
Online Gambling ◽  
Poor Sleep ◽  
Gambling Problems ◽  
Poor Sleep Quality

Gambling has significant costs to the community, with a health burden similar in scale to major depression. To reduce its impact, it is necessary to understand factors that may exacerbate harm from gambling. The gambling environment of late-night licensed venues and 24/7 online gambling has the potential to negatively impact sleep and increase alcohol consumption. This study explored gambling, alcohol, and sleep problems to understand whether there is a relationship between these three factors. Telephone interviews were conducted with a representative sample of Australian adults (n = 3760) combined across three waves of the National Social Survey. Participants completed screening measures for at-risk gambling, at-risk alcohol consumption, insomnia (2015 wave only), and sleep quality. There were small but significant positive correlations between problem gambling and alcohol misuse, problem gambling and insomnia, and problem gambling and poor sleep quality. A regression model showed that gambling problems and alcohol misuse were significant independent predictors of insomnia. A separate regression showed gambling problems (and not alcohol misuse) were a significant predictor of poor sleep quality, but only in one survey wave. Findings suggest that gambling, alcohol, and sleep problems are related within persons. Further research should examine the mechanisms through which this relationship exists.

scholarly journals Negative psychotic symptoms and impaired role functioning predict transition outcomes in the at-risk mental state: a latent class cluster analysis study

2013 ◽  
Vol 43 (11) ◽  
pp. 2311-2325 ◽  
Author(s):  
L. R. Valmaggia ◽  
D. Stahl ◽  
A. R. Yung ◽  
B. Nelson ◽  
P. Fusar-Poli ◽  
...  
Keyword(s):  
At Risk ◽  
Cluster Analysis ◽  
Mental State ◽  
Latent Class ◽  
Mental States ◽  
Psychotic Symptoms ◽  
Role Functioning ◽  
Latent Class Cluster Analysis ◽  
At Risk Mental State

BackgroundMany research groups have attempted to predict which individuals with an at-risk mental state (ARMS) for psychosis will later develop a psychotic disorder. However, it is difficult to predict the course and outcome based on individual symptoms scores.MethodData from 318 ARMS individuals from two specialized services for ARMS subjects were analysed using latent class cluster analysis (LCCA). The score on the Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to explore the number, size and symptom profiles of latent classes.ResultsLCCA produced four high-risk classes, censored after 2 years of follow-up: class 1 (mild) had the lowest transition risk (4.9%). Subjects in this group had the lowest scores on all the CAARMS items, they were younger, more likely to be students and had the highest Global Assessment of Functioning (GAF) score. Subjects in class 2 (moderate) had a transition risk of 10.9%, scored moderately on all CAARMS items and were more likely to be in employment. Those in class 3 (moderate–severe) had a transition risk of 11.4% and scored moderately severe on the CAARMS. Subjects in class 4 (severe) had the highest transition risk (41.2%), they scored highest on the CAARMS, had the lowest GAF score and were more likely to be unemployed. Overall, class 4 was best distinguished from the other classes on the alogia, avolition/apathy, anhedonia, social isolation and impaired role functioning.ConclusionsThe different classes of symptoms were associated with significant differences in the risk of transition at 2 years of follow-up. Symptomatic clustering predicts prognosis better than individual symptoms.

Sleep Disturbance in Psoriatic Disease: Prevalence and Associated Factors

2017 ◽  
Vol 44 (9) ◽  
pp. 1369-1374 ◽  
Author(s):  
Ian T.Y. Wong ◽  
Vinod Chandran ◽  
Suzanne Li ◽  
Dafna D. Gladman
Keyword(s):  
Psoriatic Arthritis ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Quality Index ◽  
Short Form ◽  
Life Quality ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Psoriatic Disease ◽  
Patient Reported

Objective.We aimed to determine the prevalence and quality of sleep in patients with psoriatic arthritis (PsA) and those with psoriasis without PsA (PsC) followed in the same center, to identify factors associated with sleep disturbance, and to compare findings to those of healthy controls (HC).Methods.The study included 113 PsA [ClASsification for Psoriatic ARthritis (CASPAR) criteria] and 62 PsC (PsA excluded by a rheumatologist) patients and 52 HC. Clinical variables were collected using a standard protocol. The sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Other patient-reported outcomes collected included the Health Assessment Questionnaire (HAQ), Dermatology Life Quality Index, EQ-5D, Medical Outcomes Study Short Form-36 survey, patient’s global assessment, and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) scale. Statistical analyses included descriptive statistics, Wilcoxon rank-sum test, and linear regression.Results.The prevalence of poor sleep quality was 84%, 69%, and 50% in PsA, PsC, and HC, respectively. Total PSQI score was higher in both patients with PsA and patients with PsC compared with HC (p < 0.01) and higher in patients with PsA compared to patients with PsC (p < 0.0001). EQ-5D anxiety component, EQ-5D final, and FACIT-fatigue were independently associated with worse PSQI in patients with PsC and those with PsA (p < 0.05). Actively inflamed (tender or swollen) joints are independently associated with worse PSQI in patients with PsA (p < 0.01).Conclusion.Patients with psoriatic disease have poor sleep quality. Poor sleep is associated with fatigue, anxiety, and lower EQ-5D. In patients with PsA, poor sleep is associated with active joint inflammation.

scholarly journals The reality of at risk mental state services: a response to recent criticisms

2019 ◽  
pp. 1-7 ◽  
Author(s):  
Alison R. Yung ◽  
Stephen J. Wood ◽  
Ashok Malla ◽  
Barnaby Nelson ◽  
Patrick McGorry ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Psychotic Disorder ◽  
Mental State ◽  
Help Seeking ◽  
Psychotic Symptoms ◽  
Ultra High Risk ◽  
Psychological Medicine ◽  
Poor Outcomes ◽  
At Risk Mental State

AbstractBackgroundIn the 1990s criteria were developed to detect individuals at high and imminent risk of developing a psychotic disorder. These are known as the at risk mental state, ultra high risk or clinical high risk criteria. Individuals meeting these criteria are symptomatic and help-seeking. Services for such individuals are now found worldwide. Recently Psychological Medicine published two articles that criticise these services and suggest that they should be dismantled or restructured. One paper also provides recommendations on how ARMS services should be operate.MethodsIn this paper we draw on the existing literature in the field and present the perspective of some ARMS clinicians and researchers.ResultsMany of the critics' arguments are refuted. Most of the recommendations included in the Moritz et al. paper are already occurring.ConclusionsARMS services provide management of current problems, treatment to reduce risk of onset of psychotic disorder and monitoring of mental state, including attenuated psychotic symptoms. These symptoms are associated with a range of poor outcomes. It is important to assess them and track their trajectory over time. A new approach to detection of ARMS individuals can be considered that harnesses broad youth mental health services, such as headspace in Australia, Jigsaw in Ireland and ACCESS Open Minds in Canada. Attention should also be paid to the physical health of ARMS individuals. Far from needing to be dismantled we feel that the ARMS approach has much to offer to improve the health of young people.

scholarly journals Identifying patients at risk of psychosis: a qualitative study of GP views in South West England

2020 ◽  
pp. bjgp20X713969
Author(s):  
Daniela Strelchuk ◽  
Nicola Wiles ◽  
Catherine Derrick ◽  
Stanley Zammit ◽  
Katrina Turner
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Patient Group ◽  
Continuity Of Care ◽  
Mental State ◽  
Psychotic Symptoms ◽  
Structured Interviews ◽  
South West ◽  
South West England ◽  
At Risk Mental State

BackgroundEarly intervention in people with an at-risk mental state for psychosis can decrease the rates of transition to psychosis. GPs play a key role in the identification of this patient group but very few studies have explored GPs’ awareness of patients who are at risk of psychosis.AimTo explore GPs’ views and experiences of identifying patients with an at-risk mental state for psychosis, and the barriers and facilitators to identification.Design and settingIn-depth semi-structured interviews were held with GPs working in South West England primary care. The interviews were conducted between March and July 2019.MethodA topic guide was used to ensure consistency across interviews. This guide was revised to incorporate a definition of the at-risk mental state for psychosis, as after conducting a few interviews it became clear that some GPs were not familiar with this construct. Interviews were audiorecorded and analysed thematically.ResultsA total of 20 GPs were interviewed. Some GPs were not familiar with the concept of being at risk of developing psychosis, and perceived that they may not have the right skills to identify this patient group. Other barriers related to patients not presenting or disclosing psychotic symptoms, and limitations imposed by scarce resources on the structure and provision of NHS services, such as lack of continuity of care and high thresholds for accessing specialised services.ConclusionIdentifying people at risk of psychosis in primary care is difficult. Provision of GP training, development of policies that support continuity of care, and improved access to specialised services could help improve the identification of this patient group.

scholarly journals Quality of sleep and associated factors among people living with HIV/AIDS on follow up at Ethiopian Zewditu Memorial Hospital,2018

2020 ◽  
Author(s):  
Nebiyu Mengistu ◽  
Telake Azale ◽  
Solomon Yimer ◽  
Mahilet Fikreyesus ◽  
Elsa Melaku ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Associated Factors ◽  
Poor Sleep ◽  
People Living With Hiv ◽  
Quality Of Sleep ◽  
Poor Sleep Quality ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Background: Sleep disturbance is a common complaint in people living with HIV/AIDS. Despite the influence of sleep disturbance on treatment adherence, quality of life, work productivity, risk of chronic illness, it remains under-recognized and under-studied in Ethiopia. Therefore it is necessary to produce scientific evidence to fill the knowledge gap and areas of management. The current study aimed to assess sleep quality and its associated factors among people living with HIV/AIDS. Methods: An institution-based cross-sectional study was utilized among 408 participants who were selected by a systematic random sampling technique at Zewditu memorial hospital from April to May 2018. The Pittsburgh Sleep Quality Index questionnaire was used to measure sleep quality. Ethical clearance was obtained from the joint ethics committee of the University of Gondar and Amanuel Mental Specialized Hospital. Oral informed consent was obtained from each participant. Binary and multivariable logistic regression models were fitted. Odds ratios (OR) with the corresponding 95% confidence interval (95%CI) was computed. Results: The magnitude of poor sleep quality was 55.6%. Being female [AOR=3.40, 95% CI: (1.80, 6.41)], depression [AOR =3.52, 95% CI: (1.95, 6.32)], CD4count ≤ 200 cells/mm3 [AOR=3.18,95%CI: (1.65,6.13)], duration of HIV/AIDS diagnosis [AOR=3.43,95% CI: (1.61,7.29)], current use of tobacco [AOR=5.69, 95% CI: (2.04,15.9)] and chat or caffeinated drinks [AOR=2.65, 95% CI: (1.06,6.64)] and poor sleep hygiene [AOR=3.55, 95% CI: (1.85, 6.78)] were significantly associated with poor sleep quality.Conclusions: More than half of the study participants were found to have poor sleep quality. A range factors influence quality of sleep of people with HIV/AIDS. Routine screening of sleep condition among people living with HIV/AIDS and early intervention based on the findings is suggested.

scholarly journals Sleep Disturbance Among Patients with Myelodysplastic Syndromes and Acute Leukemia

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4786-4786
Author(s):  
Marlise Luskin ◽  
Eric Zhou ◽  
Zilu Zhang ◽  
Daniel J. DeAngelo ◽  
Richard Stone ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Myelodysplastic Syndromes ◽  
Research Funding ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Entire Cohort ◽  
Obstructive Sleep ◽  
Leukemia Data

BACKGROUND: Most patients with myelodysplastic syndromes (MDS) describe difficulty sleeping (Luskin et al Br J Haem 2017) and sleep disturbance is a likely contributor to the fatigue experienced by patients with MDS and acute leukemia. Data are sparse regarding the sleep of this patient population as formally assessed with sleep-focused survey instruments. METHODS: We surveyed consecutive adult patients with MDS, AML or ALL at the Dana-Farber Leukemia clinic. With permission from the treating oncologist, patients with a physician-assessed life expectancy ≥ 12 weeks were mailed a questionnaire packet assessing insomnia symptom severity (Insomnia Severity Index; ISI), sleep quality (Pittsburgh Sleep Quality Index; PSQI), obstructive sleep apnea risk (STOP-Bang), and depressive symptoms (Patient Health Questionnaire-9; PHQ-9). Respondents underwent concomitant medical record review. RESULTS: Of 332 eligible patients contacted, 158 (47.6%) responded. Responders were 56% male with a median age of 67 years. Overall, 42% of patients reported insomnia symptoms (ISI ≥10) with the prevalence of such symptoms similar among patients with MDS and acute leukemia (48% vs 38%, p=0.23). OSA risk was high (58%), particularly in patients with MDS (67% vs 52% p=0.10). Those with high OSA risk were more likely to have clinical insomnia as defined by ISI ≥10 (OR 2.6, p=0.01). Depression was uncommon: only 7% had PHQ-measured moderately severe or severe depression. Median sleep duration for the entire cohort was 6.9 hours (range 3-12) indicating that over half of respondents slept less than the 7 hours per night recommended by the National Sleep Foundation for healthy adults. Poor sleep quality (PSQI "Bad Sleep") was seen in 79% of the overall cohort. CONCLUSION: When measured with validated tools, disturbed sleep is common among patients with MDS and acute leukemia. OSA risk is also prevalent but does not likely explain all of the poor sleep quality seen. These data suggest that strategies are needed to improve both quantity and quality of sleep in this population. Table Disclosures DeAngelo: Abbvie: Research Funding; GlycoMimetics: Research Funding; Blueprint: Consultancy, Research Funding; Amgen: Consultancy; Celgene: Consultancy; Shire: Consultancy; Incyte: Consultancy; Novartis: Consultancy, Research Funding; Takeda Pharmaceuticals: Consultancy; Jazz Pharmaceuticals Inc: Consultancy; Pfizer: Consultancy. Garcia:Abbvie: Research Funding; Genentech: Research Funding. Winer:Jazz Pharmaceuticals, Pfizer: Consultancy. Steensma:Aprea: Research Funding; Arrowhead: Equity Ownership; Pfizer: Consultancy; H3 Biosciences: Other: Research funding to institution, not investigator.; Astex: Consultancy; Onconova: Consultancy; Stemline: Consultancy; Summer Road: Consultancy.

Transition to Psychosis: 6-Month follow-up of a Chinese High-Risk Group in Hong Kong

2006 ◽  
Vol 40 (5) ◽  
pp. 414-420 ◽  
Author(s):  
May M.L. Lam ◽  
Se-Fong Hung ◽  
Eric Y.H. Chen
Keyword(s):  
At Risk ◽  
High Risk ◽  
Mental State ◽  
Functional Decline ◽  
High Risk Group ◽  
Psychotic Symptoms ◽  
Syndrome Scale ◽  
History Of ◽  
At Risk Mental State

Objectives: The identification of individuals at high risk of becoming psychotic within the near future creates opportunities for early intervention before the onset of psychosis. This study sets out to identify a group of symptomatic young people in a Chinese population with the high likelihood of transition to psychosis within a follow-up period of 6 months, and to determine the rate of transition to psychosis in this group. Method: Symptomatic individuals with a family history of psychotic disorder, subthreshold psychotic symptoms or brief transient psychotic symptoms were identified using the operationalized criteria of an ‘At Risk Mental State’. The individuals were prospectively assessed monthly on a measure of psychopathology for 6 months. Results: Eighteen out of 62 individuals (29%) made the transition to frank psychosis within a 6 month follow-up period, with the majority occurring within 3 months. In addition, significant differences were found in the intake Positive and Negative Syndrome Scale, Comprehensive Assessment of ‘At Risk Mental State’ and Global Assessment of Functioning scores between the group that ultimately became psychotic and the group that did not. Conclusion: The period of the highest risk of transition to psychosis was within the 3 months after the study began. Thus, distressed youths in our outpatient clinic, who meet the high-risk criteria should be monitored most closely in the initial 3 months, particularly those individuals with high levels of psychopathology and functional decline.

The Relationship Between Negative Symptoms and Cognitive Functioning in Patients with an at Risk Mental State for Psychosis

2017 ◽  
Vol 41 (S1) ◽  
pp. S270-S271
Author(s):  
L. Leanza ◽  
L. Egloff ◽  
E. Studerus ◽  
C. Andreou ◽  
U. Heitz ◽  
...  
Keyword(s):  
At Risk ◽  
Cognitive Functioning ◽  
Mental State ◽  
Verbal Fluency ◽  
Negative Symptoms ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Clinical Impression ◽  
The Relationship ◽  
At Risk Mental State

IntroductionNegative symptoms and cognitive impairments are both present in patients with an at risk mental state (ARMS) for psychosis and negatively affect functioning and outcome. According to previous studies in patients with first-episode psychosis, negative symptoms are negatively associated with cognitive functioning while positive symptoms do not seem to be associated. Yet, little is known about the specific relationship of negative symptoms and cognitive functioning in ARMS patients.ObjectiveTo evaluate, the relationship between negative symptoms and cognitive functioning in ARMS patients.MethodsData of 154 ARMS patients were collected within the prospective Basel early detection of psychosis (FePsy) study. Negative symptoms were assessed with the SANS, positive psychotic symptoms with the BPRS, cognitive functioning with an extensive neuropsychological test battery. Multiple regressions were applied and results were controlled for age and gender.ResultsRegression analyses showed a significant, negative association between negative but not positive psychotic symptoms and cognitive functioning, showing the strongest association with verbal fluency (see Fig. 1). However, results mainly did not withstand correction for multiple testing.ConclusionsThe association found between verbal fluency and negative symptoms may be indicative of an overlap between those constructs. Finally, verbal fluency might have a strong influence on the clinical impression of negative symptoms, especially on alogia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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