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

Miller, Brian J.; McCall, William Vaughn; Xia, Lei; Li, Wenzheng; Yao, Xianhu; Liu, Huanzhong

doi:10.1016/j.pnpbp.2020.110202

Cited by 24 publications

(17 citation statements)

References 41 publications

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“…Our research noted that 22.9% of middle-aged and elderly CS patients had insomnia symptoms, which was more consistent with previous studies (7,8). In addition, older age, higher depressive factor scores, and lower physical activity were related factors of insomnia symptoms.…”

Section: Discussionsupporting

confidence: 92%

“…Patients suffer from serious abnormalities in cognition, thinking, and behavior (5), with a lifetime prevalence of approximately 1% worldwide (6). Previous literature stated that the population with mental disorders suffered poorer sleep quality than the general population, and about 20-40% of patients with chronic schizophrenia (CS) were comorbid insomnia symptoms (7)(8)(9). Furthermore, research suggested that worse sleep quality was strongly related to more severe psychotic symptoms (10) and that insomnia symptoms could even exacerbate psychiatric symptoms and lead to increased somatic comorbidity.…”

Section: Introductionmentioning

confidence: 99%

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Physical activity levels associated with insomnia and depressive symptoms in middle-aged and elderly patients with chronic schizophrenia

Liu¹,

Sun²,

Wang³

et al. 2023

Front. Psychiatry

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BackgroundPrevious evidence suggested that physical activity had beneficial effects on psychopathological symptoms, insomnia, or depressive symptoms in people with schizophrenia. This study investigated the association between physical activity levels and insomnia and depressive symptoms in middle-aged and elderly hospitalized patients with chronic schizophrenia (CS).Methods179 participants were enrolled. We used the 30-item Positive and Negative Syndrome Scale (PANSS–30) to assess the psychopathological symptoms. We used the Insomnia Severity Index scale (ISI) and 17-item Hamilton Depression Scale (HAMD-17) to evaluate insomnia and depressive symptoms. Daily physical activity time less than 30 min, within 30–60 min, and more than 60 min were defined as physical inactivity, moderate physical activity, and vigorous physical activity, respectively. The Chi-square test, analysis of variance (ANOVA), and Mann–Whitney U-test were applied for categorical, continuous, and non-normal distribution variables, respectively. The Pearson or Spearman’s correlation analyses were utilized to examine the association between physical activity levels, ISI total scores, HAMD total scores, and socio-demographic and clinical variables. Finally, socio-demographic variables with a P-value < 0.05 in the comparison between insomnia/depressive group and non-insomnia/depressive group were considered for inclusion in binary logistic regression analysis to determine the relationship between physical activity levels and insomnia or depressive symptoms.ResultsThe ISI total scores (r = –0.247, P = 0.001) and HAMD total scores (r = –0.312, P < 0.001) were negatively correlated with physical activity levels. Logistic regression analysis revealed that older age, higher depressive factor scores, and lower physical activity level were influential factors of insomnia symptoms in CS patients (P < 0.05). In addition, vigorous physical activity (compared with physical inactivity) and higher negative and depressive factor scores were independently associated with depressive symptoms in CS patients (P < 0.05).ConclusionPhysical activity levels were influential factors in comorbid insomnia and depressive symptoms in CS patients. Given the benefits of physical activity, it should be strengthened as a routine adjunct to clinical treatment or psychiatric care so as to improve the physical and mental health of patients with psychiatric symptoms.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Physical activity levels associated with insomnia and depressive symptoms in middle-aged and elderly patients with chronic schizophrenia

Liu¹,

Sun²,

Wang³

et al. 2023

Front. Psychiatry

Self Cite

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“…In particular, several studies have reported poorer quality of life in patients with schizophrenia and insomnia [1,2,4]. There is also evidence that insomnia is correlated with greater severity of psychopathology in schizophrenia, including total, positive, and general symptoms [5,6 ▪ ,7], including depression [4,8]. Furthermore, insomnia predicts both the persistence of positive symptoms of psychosis [9], as well as worsening of positive symptoms after antipsychotic discontinuation [10].…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of insomnia, suicide, and psychopathology in schizophrenia

Miller

McCall

2023

Current Opinion in Psychiatry

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Purpose of reviewInsomnia is common in schizophrenia. Insomnia has been associated with suicidal ideation and behavior, as well as greater severity of psychopathology, in schizophrenia. This review performs a meta-analysis of associations between insomnia, suicide, and psychopathology in patients with schizophrenia.Recent findingsWe searched major electronic databases from inception until November 2022 for studies of insomnia, suicide, and psychopathology in patients with schizophrenia. Random effects meta-analysis calculating odds ratios (ORs, for suicide) and effect sizes (ESs, for psychopathology) and 95% confidence intervals (CIs) were performed. Ten studies met the inclusion criteria, comprising 3428 patients with schizophrenia. Insomnia was associated with a significant increased odds of suicidal ideation (OR = 1.84, 95% CI 1.28–2.65, P < 0.01) and suicide attempt or death (OR = 5.83, 95% CI 1.61–2.96, P < 0.01). Insomnia was also associated with total (ES = 0.16, 95% CI 0.09–0.23, P < 0.01), positive (ES = 0.14, 95% CI 0.08–0.20, P = 0.02), and general (ES = 0.17, 95% CI 0.08–0.27, P < 0.01) psychopathology. In meta-regression analyses, BMI was negatively associated with suicidal ideation. Otherwise, age, sex, and study year were all unrelated to the associations.SummaryInsomnia is associated with suicide and psychopathology in schizophrenia. Formal assessment and treatment of insomnia appears relevant to the clinical care of schizophrenia.

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“…A part of previous studies revealed the clinical risk factors and possible pathophysiological mechanisms of depression and impulse in schizophrenia. The depressive symptoms of schizophrenic patients are associated with an early onset age, serious negative symptoms, serious common psychotic symptoms, akathisia, dyskinesia [ 11 ], cognitive impairment [ 2 ], high serum LDL and TC levels [ 12 ], and even insomnia [ 13 ]. Schizophrenic impulse is related to frontotemporal circuit dysfunction [ 14 ] and cortical thickness [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Study on correlations of BDNF, PI3K, AKT and CREB levels with depressive emotion and impulsive behaviors in drug-naïve patients with first-episode schizophrenia

Kang

et al. 2023

BMC Psychiatry

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Background The pathogenesis of schizophrenia is still unknown. Nearly a half of schizophrenic patients have depressive symptoms and even some impulsive behaviors. The definite diagnosis of schizophrenia is an immense challenge. Molecular biology plays an essential role in the research on the pathogenesis of schizophrenia. Objective This study aims to analyze the correlations of serum protein factor levels with depressive emotion and impulsive behaviors in drug-naïve patients with first-episode schizophrenia. Methods Seventy drug-naïve patients with first-episode schizophrenia and sixty-nine healthy volunteers from the health check center in the same period participated in this study. In both the patient group and control group, brain-derived neurotrophic factor (BDNF), phosphatidylin-ositol-3-kinase (PI3K), protein kinase B (AKT), and cAMP-response element binding protein (CREB) levels in the peripheral blood were tested by enzyme-linked immunosorbent assay (ELISA). The depressive emotion and impulsive behaviors were evaluated with Chinese versions of the Calgary Depression Scale for Schizophrenia (CDSS) and Short UPPS-P Impulsive Behavior Scale (S-UPPS-P), respectively. Results The serum levels of BDNF, PI3K, and CREB in the patient group were lower than those in the control group, while AKT level, total CDSS score and total S-UPPS-P score were all higher. In the patient group, total CDSS score, and total S-UPPS-P score were both correlated negatively with BDNF, PI3K, and CREB levels but positively with AKT level, and the lack-of-premeditation (PR) sub-scale score was not significantly correlated with BDNF, PI3K, AKT, and CREB levels. Conclusion Our study results showed that the peripheral blood levels of BDNF, PI3K, AKT, and CREB in drug-naïve patients with first-episode schizophrenia were significantly different from those in the control group. The levels of these serum protein factors are promising biomarkers to predict schizophrenic depression and impulsive behaviors.

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

Cited by 24 publications

References 41 publications

Physical activity levels associated with insomnia and depressive symptoms in middle-aged and elderly patients with chronic schizophrenia

Physical activity levels associated with insomnia and depressive symptoms in middle-aged and elderly patients with chronic schizophrenia

Meta-analysis of insomnia, suicide, and psychopathology in schizophrenia

Study on correlations of BDNF, PI3K, AKT and CREB levels with depressive emotion and impulsive behaviors in drug-naïve patients with first-episode schizophrenia

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