No abstract

Behavioral treatments were evaluated for their effect on the subjective and objective sleep of older adult insomniacs (N = 53) aged 47 to 76 years. Conditions were support and sleep hygiene, support and sleep hygiene plus progressive relaxation, support and sleep hygiene plus stimulus control, or a measurement control group. The results indicated that all groups, including the measurement control group, were effective in improving the sleep diary assessed awakenings, naptime, and feeling refreshed upon awakening. Subjects at 3 weeks felt less depressed and felt that they had more control over their sleep. Stimulus control was most effective in improving sleep at the posttherapy period. A 2‐year follow‐up showed that the stimulus control subjects most frequently used the treatment instructions and had shorter sleep latencies and highest sleep quality. Behavioral treatments were found to be effective in improving the perception of sleep among older adult insomniacs.

Residents' perceived stigma for clinical situations was an influential factor, strongly affecting concern about jeopardizing training status and likelihood of avoiding care at their home institution.

Maintenance electroconvulsive therapy (ECT) can sometimes be the only treatment that yields extended periods of euthymia to patients with severe, treatment-resistant mania. We describe a case of a patient with recurrent and severe mania who responded acutely to ECT after failing various medication trials and could only maintain euthymia with maintenance ECT.