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Sleep problems in bipolar disorders: more than just insomnia.

https://arctichealth.org/en/permalink/ahliterature279446
Source
Acta Psychiatr Scand. 2016 May;133(5):368-77
Publication Type
Article
Date
May-2016
Author
M K Steinan
J. Scott
T V Lagerberg
I. Melle
O A Andreassen
A E Vaaler
G. Morken
Source
Acta Psychiatr Scand. 2016 May;133(5):368-77
Date
May-2016
Language
English
Publication Type
Article
Keywords
Adult
Bipolar Disorder - epidemiology
Comorbidity
Cross-Sectional Studies
Disorders of Excessive Somnolence - epidemiology
Female
Humans
Male
Middle Aged
Norway - epidemiology
Sleep Initiation and Maintenance Disorders - epidemiology
Abstract
Sleep problems in bipolar disorder (BD) are common, but reported rates vary from 10% to 80%, depending on definitions, methodologies and management of potential confounding factors. This multicenter study seeks to address these issues and also compares BD cases with Hypersomnia as well as the more commonly investigated Insomnia and No Sleep Problem groups.
A cross-sectional comparison of sleep profiles in 563 BD I and II individuals who participated in a structured assessment of demographic, clinical, illness history and treatment variables.
Over 40% cases met criteria for Insomnia and 29% for Hypersomnia. In univariate analysis, Insomnia was associated with BD II depression whilst Hypersomnia was associated with BD I depression or euthymia. After controlling for confounders and covariates, it was demonstrated that Hypersomnia cases were significantly more likely to be younger, have BD I and be prescribed antidepressants whilst Insomnia cases had longer illness durations and were more likely to be prescribed benzodiazepines and hypnotics.
Whilst Insomnia symptoms are common in BD, Hypersomnia is a significant, frequently underexplored problem. Detailed analyses of large representative clinical samples are critical to extending our knowledge of differences between subgroups defined by sleep profile.
PubMed ID
26590799 View in PubMed
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No progressive brain changes during a 1-year follow-up of patients with first-episode psychosis.

https://arctichealth.org/en/permalink/ahliterature276617
Source
Psychol Med. 2016 Feb;46(3):589-98
Publication Type
Article
Date
Feb-2016
Author
U K Haukvik
C B Hartberg
S. Nerland
K N Jørgensen
E H Lange
C. Simonsen
R. Nesvåg
A M Dale
O A Andreassen
I. Melle
I. Agartz
Source
Psychol Med. 2016 Feb;46(3):589-98
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Bipolar Disorder - drug therapy - pathology
Case-Control Studies
Cerebral Cortex - pathology
Disease Progression
Female
Follow-Up Studies
Humans
Linear Models
Longitudinal Studies
Magnetic Resonance Imaging
Male
Middle Aged
Norway
Psychotic Disorders - drug therapy - pathology
Schizophrenia - drug therapy - pathology
Young Adult
Abstract
First-episode psychosis (FEP) patients show structural brain abnormalities. Whether the changes are progressive or not remain under debate, and the results from longitudinal magnetic resonance imaging (MRI) studies are mixed. We investigated if FEP patients showed a different pattern of regional brain structural change over a 1-year period compared with healthy controls, and if putative changes correlated with clinical characteristics and outcome.
MRIs of 79 FEP patients [SCID-I-verified diagnoses: schizophrenia, psychotic bipolar disorder, or other psychoses, mean age 27.6 (s.d. = 7.7) years, 66% male] and 82 healthy controls [age 29.3 (s.d. = 7.2) years, 66% male] were acquired from the same 1.5 T scanner at baseline and 1-year follow-up as part of the Thematically Organized Psychosis (TOP) study, Oslo, Norway. Scans were automatically processed with the longitudinal stream in FreeSurfer that creates an unbiased within-subject template image. General linear models were used to analyse longitudinal change in a wide range of subcortical volumes and detailed thickness and surface area estimates across the entire cortex, and associations with clinical characteristics.
FEP patients and controls did not differ significantly in annual percentage change in cortical thickness or area in any cortical region, or in any of the subcortical structures after adjustment for multiple comparisons. Within the FEP group, duration of untreated psychosis, age at illness onset, antipsychotic medication use and remission at follow-up were not related to longitudinal brain change.
We found no significant longitudinal brain changes over a 1-year period in FEP patients. Our results do not support early progressive brain changes in psychotic disorders.
PubMed ID
26526001 View in PubMed
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