Neuroticism and sleep-related problems in adolescence.

STUDY OBJECTIVE: To examine the relationship between neurotic personality characteristics and sleep habits/problems. DESIGN: A population-based cross-sectional study. SETTING: NA. PARTICIPANTS: Nine hundred sixty five students from two junior high schools in Taipei and their parents were randomly selected in December 1993 for inclusion in the study. The response rate was 96.4% (930) for students and 88.6% (855) for parents. INTERVENTIONS: NA. MEASUREMENTS AND RESULTS: Students were administered a sleep habit questionnaire and the Junior Eysenck Personality Inventory (JEPI) at both junior high schools in Taipei. For the JEPI, high and low neuroticism was operationally defined as scores that were one or more standard deviation above or below the sample mean, respectively. This yielded two extreme groups: high neuroticism group (n=183) and low neuroticism group (n=163). The high neuroticism group went to bed later and slept less than did the low neuroticism group. Using logistic regression, adjusting for sex and years at junior high school, the high neuroticism group had significantly different sleep habits and school performance from the low neuroticism group. Subjects in the high neuroticism group had significant risk of feelings of sleep insufficiency, tiredness, moodiness, and difficulty waking up in the morning; they also had more daytime sleepiness than did those in the low neuroticism group. The high neuroticism group also suffered from more sleep-related problems than did the low neuroticism group. CONCLUSIONS: The findings support the hypothesis that a high neuroticism score is associated with going to bed late on school days, short sleep duration, different sleep habits, sleep problems, and impaired daytime function in comparison with a low neuroticism score.

Psychiatric comorbidity of adolescents with sleep terrors or sleepwalking: a case-control study.

OBJECTIVE: This study investigated the psychiatric comorbidity, personality traits and family history of adolescents with sleep terrors and/or sleepwalking. METHOD: Thirty students with sleep terrors and/or sleepwalking and 30 classroom controls were selected on the basis of a sleep habit questionnaire. After completing the Junior Eysenck Personality Inventory (JEPI), the 60 subjects were interviewed by the first author with the Chinese-version Kiddie-SADS-E (Schedule for Affective Disorders and Schizophrenia for Children--Epidemiology Version). All subjects and their parents were interviewed for the subjects' sleep habits, sleep disorders, and personality characteristics in the previous year. The case and the control groups were divided based on whether the sleep terrors and/or sleepwalking had occurred in the previous year. There were 21 case and 30 control subjects in the final data analysis. RESULTS: The case group had more psychiatric diagnoses and problems; there were statistically significant differences in overanxious disorder, panic disorder, simple phobia and suicidal thoughts between the two groups. The case group had more sleeptalking and nightmares during the previous year as well as more enuresis in earlier years. From their parents' perspective, the case group was more nervous and pessimistic. The results of the JEPI showed a high neuroticism score in the case group. There was an increased familial occurrence of these two sleep disorders. CONCLUSIONS: Adolescents with sleep terrors and sleepwalking were found to have an increased prevalence of other sleep disorders, neurotic traits, and psychiatric disorders and problems. Whereas sleep terrors and sleepwalking in childhood are related primarily to genetic and developmental factors, their persistence and, especially, their onset in adolescence may be related to psychological factors.

[Long-term outcome studies of hyperactive children: literature review].

The attention deficit hyperactive disorder (hereinafter ADHD, children with this disease usually are named hyperactive children) is often one of the most frequent diagnosis of psychiatric outpatients for children. Though there are still some disputes in diagnosis, child psychiatrists can diagnose individual cases through interview, observation and the information provided by their parents and teachers. Besides the diagnosis and treatment, the result of long-term follow-up studies of hyperactive children also gradually indicate the most extreme signification. According to the long-term outcome studies of hyperactive children conducted in foreign countries for the past 20 to 30 years, symptoms of hyperactive children will not disappear completely as they grew up; instead, the residual symptoms can cause adaptive impairment in their adolescent and adult period. The core symptoms of ADHD (inattention, hyperactivity, impulsive behavior) can be satisfactorily managed if they can be diagnosed as earlier as possible, through medicine and behavioral therapy, plus medical staff and cooperation from family, school and society. If there is no early diagnosis or intervention, and let symptoms continue, after growing up, associated conduct problem or disorder, antisocial behavior, substance abuse and antisocial personality disorder, even criminal behavior will have higher opportunity to develop into adolescence and adulthood. These behavioral problems will cause very serious social problems. We have became more clearly aware of the accurate recognition of hyperactive children and have emphasized its importance in recent years. Unfortunately, there are still no long-term follow-up study reports regarding these children in our country; therefore we could not discover the effective predictors and higher risk groups for early intervention and prevention. This paper aims at reviewing long-term outcome studies of hyperactive children and trying to organize its adaptive problems and associated mental disorders after growing up. We also expect that the long-term follow-up studies on hyperactive children can be seen in the very near future at our country.

Kleine-Levin syndrome in a boy with Prader-Willi syndrome.

A 9 1/2-year-old Taiwanese boy with Prader-Willi syndrome had the following characteristics: difficulties with sucking, feeding and hypotonia during infancy, a dysmorphic face (triangular mouth, high arched palate, almond-shaped eyes and large head circumference with a relatively narrow bifrontal diameter), borderline intelligence, hypogonadism, hyperphagia, skin picking and truncal obesity. The boy experienced two hypersomnia episodes, at age 8 and 9 years, with both episodes lasting for 10 days. During the two episodes, he was found to have an exacerbated case of hyperphagia, pica, poor emotional control, stereotyped speech and agitated behavior upon awakening. After each episode, the boy had complete remission. Our findings show that the two episodes are compatible with Kleine-Levin syndrome. The relationship between the two syndromes, the Prader-Willi syndrome and the Kleine-Levin syndrome, deserves further study.

Sleep problems of junior high school students in Taipei.

The objective of this work was to study the relationship between daily sleep time and characteristics of students, e.g. grade level, gender, and academic program. A sleep habit questionnaire was designed to survey students at two junior high schools, one from northern Taipei and the other from southern Taipei. The impact of shortened duration of sleep on daily function was also evaluated. A total of 965 students and their parents were selected randomly in December 1993 for the questionnaire study. The response rate was 96.4% (930) for students and 88.6% (855) for parents. The self-reported daily sleep time of students declined, and daytime sleepiness and moodiness increased in the higher grades. The girls slept fewer hours than the boys and did not show an increase in daytime sleepiness. Those students not taking the senior high school joint entrance examination slept more hours at night and maintained more alertness in the daytime than those who were taking the examination. The more academic pressures that adolescents faced, the fewer hours they slept. Students not participating in the joint entrance examination seemed to show a healthier sleep pattern. Little sleep at night made the students feel sleepy in the daytime and tired, drowsy, moody and difficult at arising in the morning. The reason why girls slept less than boys needs further investigation.