Associations of independent living and labor force participation with impairment indicators in schizophrenia and bipolar disorder at 20-year follow-up

Strassnig, Martin; Kotov, Roman; Fochtmann, Laura J.; Kalin, Marc; Bromet, Evelyn J.; Harvey, Philip D.

doi:10.1016/j.schres.2018.02.009

Cited by 52 publications

(48 citation statements)

References 45 publications

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“…There was a slight improvement in ISI scores, no change in FOSQ scores and a trend towards worsening of PSQI scores. A disconnect between objective functional outcomes and subjective impairment indicators have been previously noted in people with schizophrenia ( Strassnig et al, 2018 ), our data similarly suggests subjective self-ratings are not an accurate reflection of objective sleep quality in people with schizophrenia.…”

Section: Discussionsupporting

confidence: 78%

Cognition in schizophrenia improves with treatment of severe obstructive sleep apnoea: A pilot study

Myles

Coetzer

Adams

et al. 2019

Schizophrenia Research: Cognition

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Previous studies have shown that people with schizophrenia have high rates of Obstructive Sleep Apnoea (OSA). Despite this, intervention studies to treat OSA in this population have not been undertaken. The ASSET (Assessing Sleep in Schizophrenia and Evaluating Treatment) pilot study investigated Continuous Positive Airway Pressure (CPAP) treatment of severe OSA in participants recruited from a clozapine clinic in Adelaide. Participants with severe untreated OSA (Apnoea-Hypopnoea Index (AHI) > 30), were provided with CPAP treatment, and assessed at baseline and six months across the following domains: physical health, quality of sleep, sleepiness, cognition, psychiatric symptoms and CPAP adherence. Six of the eight ASSET participants with severe OSA accepted CPAP. At baseline, half of the cohort had hypertension, all were obese with a mean BMI of 45, and they scored on average 1.47 standard deviations below the normal population in cognitive testing. The mean AHI was 76.8 and sleep architecture was markedly impaired with mean rapid eye movement (REM) sleep 4.1% and mean slow wave sleep (SWS) 4.8%. After six months of treatment there were improvements in cognition (BACS Z score improved by an average of 0.59) and weight loss (mean weight loss 7.3 ± 9 kg). Half of the participants no longer had hypertension and sleep architecture improved with mean REM sleep 31.4% of the night and mean SWS 24% of the night. Our data suggests CPAP may offer novel benefits to address cognitive impairment and sleep disturbance in people with schizophrenia.

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Section: Discussionsupporting

confidence: 78%

Cognition in schizophrenia improves with treatment of severe obstructive sleep apnoea: A pilot study

Myles

Coetzer

Adams

et al. 2019

Schizophrenia Research: Cognition

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“…After controlling for subjective and objective sleep duration, functioning in BDs remained significant (B=−0.04, 95% CI=−0.07, −0.01, p=0.012 controlling for subjective duration; B=−0.05, 95% CI=−0.08, −0.02, p=0.005 controlling for objective duration), indicating correlations were due to inaccuracy and not solely underlying components contributing to the inaccuracy measure. Finally, given there is some evidence to suggest that depression and other psychopathology is correlated with functioning in BD patients, 16 and that prior to Bonferroni correction a relationship was found between HAM-D (and to a lesser extent BPRS) with inaccuracy, we conducted analyses examining functioning with inaccuracy after controlling for these variables. Results showed functioning to still be associated with inaccuracy (B=−0.04, 95% CI=−0.07, −0.00 after controlling for HAM-D; B=−0.04, 95% CI=−0.08, −0.01 after controlling for BPRS).…”

Section: Resultsmentioning

confidence: 99%

Inaccuracy between subjective reports and objective measures of sleep duration and clinical correlates in bipolar disorder

Kaufmann

Nakhla

Lee

et al. 2019

Journal of Affective Disorders

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Background: Sleep disturbances are common in Bipolar Disorder (BD) and are often assessed by self-report at clinic visits over the course of BD treatment. Self-report may be subject to recall bias based upon current mood/affect states. This study sought to identify the degree of inaccuracy between subjective and objective measures of sleep duration in those with and without BD, and to assess the demographic and clinical correlates of this inaccuracy. Methods: Thirty-one individuals with BD and 54 healthy control (HC) participants reported on the number of hours slept a night over the past month and subsequently completed up to 14 days/ nights of wrist actigraphy which provided an objective measure of sleep duration. We compared the subjective rating to the average of all nights of objective sleep duration, and correlated the magnitude of inaccuracy with demographic and clinical characteristics in the BD and HC groups. Results: On average, both BD and HC groups overestimated their sleep, and there were no differences in inaccuracy between groups. In the BD group, greater inaccuracy was associated

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“…[9][10][11] Obesity has significant negative impacts on medical morbidity and is also associated with greater impairment in everyday activities, especially physical domains of functioning and disability. 12 Medical burden may exert not only direct effects on cognition, but also indirect effects on social functioning in SMI patients. 13 The importance of health status limitations for predicting outcomes was confirmed in both schizophrenia and bipolar disorder, with schizophrenia representing the worse outcome group.…”

Section: Introductionmentioning

confidence: 99%

Differences in outcomes between older community‐dwelling patients with bipolar disorder and schizophrenia with illness onset at young age

et al. 2020

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Aim Older community‐dwelling patients with severe mental illness (SMI), particularly those with illness onset at young age, constitute a group of survivors with unique long‐term care needs. Using an Asian sample in Taiwan, we attempted to find out the differences in outcomes related to physical health, cognition, and social functioning between older community‐dwelling adults with bipolar disorder and schizophrenia with early age onset. Methods Community‐dwelling patients aged >50 years with bipolar I disorder or schizophrenia whose illness developed before the age of 40 years were recruited. Clinical data were obtained by reviewing all available medical records and by interviewing the patients and their reliable family members. Medical morbidities, Mini‐Mental State Examination (MMSE), Cumulative Illness Rating Scale for Geriatrics (CIRS‐G), and Global Assessment of Functioning (GAF) scores were compared between the two groups. Results In total, 113 bipolar patients and 104 schizophrenic ones (mean ages = 59.8 and 59.2 years, respectively) became the final subjects. The rates of cognitive impairment (MMSE score <24) were comparable in bipolar disorder (26.5%) and schizophrenia (24.0%) and the mean MMSE scores did not significantly differ from each other. The concurrence (54.9%) of cardiovascular disease (CVD) in the bipolar group was also similar to 51.0% in the schizophrenic one. In a multiple logistic regression analysis, the bipolar group exhibited significantly higher CIRS‐G total scores (95% confidence interval (CI) for odds ratio (OR) = 1.01–1.27), body mass index (95% CI for OR = 1.02–1.21), and GAF scores (95% CI for OR = 1.04–1.14). Conclusion Given better social functioning and the same cognitive function in older community‐dwelling patients with bipolar disorder, they may remain at higher risk for obesity and medical morbidity than schizophrenic patients. Treatments targeting cognitive impairment and CVDs across their life span are both necessary to promote the health of community‐dwellers with SMI.

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Associations of independent living and labor force participation with impairment indicators in schizophrenia and bipolar disorder at 20-year follow-up

Cited by 52 publications

References 45 publications

Cognition in schizophrenia improves with treatment of severe obstructive sleep apnoea: A pilot study

Cognition in schizophrenia improves with treatment of severe obstructive sleep apnoea: A pilot study

Inaccuracy between subjective reports and objective measures of sleep duration and clinical correlates in bipolar disorder

Differences in outcomes between older community‐dwelling patients with bipolar disorder and schizophrenia with illness onset at young age

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