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1.
Ann Agric Environ Med ; 26(4): 600-605, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31885234

RESUMO

OBJECTIVE: The aim of the study was evaluation of the relationship between severity of symptoms of climacteric syndrome, depressive disorders and sleep problems, and the self-rated work ability of peri-menopausal and post-menopausal women in non-manual employment. MATERIAL AND METHODS: The study included 287 women aged 45-60 years, employed in various institutions as non-manual workers. Work Ability Index, Greene Climacteric Scale, Beck Depression Inventory, and Athens Insomnia Scale were used. RESULTS: The examined peri-menopausal and post-menopausal women in non-manual employment obtained good work ability on the Work Ability Index. The severity of menopausal syndrome, according to the Greene Climacteric Scale, was moderate, placing the examined women between results for the general population of women and the pattern for menopausal women. Depressive disorders ranked between low mood and moderate depression. No depression was observed in 59% of the women, whereas moderate depression was observed in 39%, and severe depression in only 2%. Sleep disorders were on the border of normal range. As many as 46% of the women had no sleep problems, which was on the border of normal range in 36%. Only 19% of the examined women suffered from insomnia. Work ability correlated negatively with depression and insomnia severity, as well as with psychological and vasomotor symptoms of climacteric syndrome, but not to its somatic symptoms. CONCLUSIONS: Preventing the occurrence and treatment of menopausal symptoms, sleep and mood disorders may contribute to maintaining the work ability of women in peri- and post-menopausal age.


Assuntos
Climatério/fisiologia , Depressão/fisiopatologia , Perimenopausa/psicologia , Pós-Menopausa/psicologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Climatério/psicologia , Depressão/economia , Depressão/psicologia , Emprego , Feminino , Humanos , Pessoa de Meia-Idade , Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Distúrbios do Início e da Manutenção do Sono/economia , Distúrbios do Início e da Manutenção do Sono/psicologia , Avaliação da Capacidade de Trabalho
2.
Neuropsychiatr ; 33(4): 207-211, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31696411

RESUMO

BACKGROUND: Learning, competence development and scientific thinking in medicine need several strategies to facilitate new diagnostic and therapeutic ways. The optimal collaboration between creative thinking and biomedical informatics provides innovation for the individual patient and for a medical school or society. Utilizing the flexibilities of an e­learning platform, a case based blended learning (CBBL) framework consisting of A) case based textbook material, B) online e­CBL with question driven learning scenarios and C) simulated patient (SP) contact seminars was developed and implemented in multiple medical fields. Real-life clinical cases were anonymized and transferred into an interactive and an interdisciplinary eLearning platform. METHODS: As an example of the offered clinical teaching-case collection, an example of a psychiatric case for the disease "posttraumatic stress disorder (PTSD)" is presented: a 30-year-old man with a history of insomnia with difficulties in falling asleep and sleeping through, nightmares, nervousness and psychomotor restlessness. The students are challenged to identify possible differential diagnoses and further get to know the patient's personal history (loss of relatives due to war, torture and flight from home country). Further, the students are guided through the principles of fear conditioning including translational aspects like neurotransmitter signaling of PTSD pathomechanism (translational and research aspects like dopamine transporter gene polymorphism, long term potentiation and synaptic signaling). RESULTS/CONCLUSION: The case presentation comprises different learning aspects: First, declarative knowledge has to be acquired and collected in basic medical sciences, knowledge that is in fact available and can be accessed on the conscious and preconscious level in long-term memory. Second, associative learning leads to the formation of neuronal connections and is an important way of learning and discovering, founded in neural associations. Third, polythematic-crosslinking thinking is needed as ability to link information in a meaningful way. These steps are a typical intellectual ability of gifted learners and researchers that combine previously seemingly unrelated areas to each other and drive innovation.


Assuntos
Competência Clínica , Instrução por Computador , Aprendizagem , Estudantes de Medicina/psicologia , Adulto , Diagnóstico Diferencial , Educação Médica , Humanos , Masculino , Distúrbios do Início e da Manutenção do Sono/complicações , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia
3.
Medicine (Baltimore) ; 98(47): e17971, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764803

RESUMO

Sleep deprivation is a common phenomenon among older population and is commonly linked to behavioral, physiological, and psychosocial factors. Not much is known about sleep deprivation among older population in Africa. Therefore, in this study we aimed to investigate the basic sociodemographic and psychosocial predictors of self-reported sleep deprivation among older population.In this study we analyzed cross-sectional data on 1495 community dwelling men and women aged 50 years and above. Data were collected from the SAGE Well-Being of Older People Study conducted in South Africa and Uganda. Outcome variable was self-reported sleep difficulty last 30 days. Multivariable logistic regression models were used to identify the variables significantly associated with sleep difficulty.The prevalence of mild-moderate sleep difficulty was 32.6% (27.9, 37.6) and severe/extreme 23.0% (20.3, 26.0) respectively. Multivariable analysis revealed that sleep difficulty was associated with several behavioral, environment, and illness conditions. In South Africa, those who reported dissatisfaction with living condition had 1.592 [1.087, 2.787] times higher odds of reporting mild/moderate sleep difficulty. Poor subjective quality of life (QoL) was associated with higher odds of severe/extreme sleep difficulties (odds ratios [OR] = 4.590, 95% confidence interval [CI] = 2.641, 7.977 for South Africa, and OR = 4.461, 95% CI = 2.048 and 9.716 for Uganda). In Uganda, perceived depression was associated with higher odds of severe/extreme (OR = 2.452, 95% CI = 1.073, 5.602) sleep difficulties among men, and both mild/moderate (OR = 1.717; 95% CI = 1.011, 2.914) and severe/extreme sleep difficulties among women (OR = 2.504, 95% CI = 1.408, 4.453).More than half of the participants had sleep difficulty of certain degrees, emphasising an urgent need for intervention for sleep deprivation in the population. Interventions targeting to promote subjective health, quality of life, and living environment may prove beneficial for improving sleep health in this regard.


Assuntos
Privação do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Prevalência , Autorrelato , Privação do Sono/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Fatores Sociológicos , África do Sul/epidemiologia , Uganda/epidemiologia
4.
Prim Health Care Res Dev ; 20: e130, 2019 09 12.
Artigo em Inglês | MEDLINE | ID: mdl-31511115

RESUMO

AIM: The objectives of this study were to validate the Patient Empowerment Strategies Questionnaire (PES-Q) in a Greek sample and to study its psychometric properties in a sample of patients diagnosed with chronic insomnia. BACKGROUND: This is a validation of the PES-Q in Attikon General Hospital, School of Medicine, National and Kapodistrian University of Athens. The questionnaire was administered to 93 subjects aged between 18 and 85 years (mean age ± SD: 54.7 ± 15.2, 28% males). METHODS: The criterion validity of the questionnaire was tested with the use of four specific criteria: the Athens Insomnia Scale, the Pittsburg questionnaire (Pittsburg Sleep Quality Index), the Depression, Anxiety and Stress Scale, and the Self-Esteem Scale. FINDINGS: According to factor analysis results, the structure of the original scale was confirmed by the presence of one main factor in the Greek sample, explaining 40.1% of the variance of PES-Q queries. The questionnaire showed satisfactory reliability (Cronbach's α = 0.887). The results of the current study suggest that the PES-Q may be used as an accurate psychometric instrument for the purposes of chronic insomnia. Future research should examine the psychometric qualities of the PES-Q Greek version in a larger sample.


Assuntos
Doença Crônica/psicologia , Pacientes/psicologia , Psicometria , Distúrbios do Início e da Manutenção do Sono/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Grécia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-31491841

RESUMO

In this study, we used structural equation modeling to investigate the interplay among Intolerance of Uncertainty (IU), Anxiety Sensitivity (AS), and sleep problems. Three hundred undergraduate students completed the Intolerance of Uncertainty Scale, the Intolerance of Uncertainty Inventory, the Anxiety Sensitivity Index, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. 68% and 40% of the students reported poor sleep quality or sub-threshold insomnia problems, respectively. Depression and anxiety levels were above the cut-off for about one-fourth of the participants. Structural equation modeling revealed that IU was strongly associated with AS, in turn influencing both insomnia severity and sleep quality via depression and anxiety. Significant indirect effects revealed that an anxious pathway was more strongly associated with insomnia severity, while a depression pathway was more relevant for worsening the quality of sleep. We discussed the results in the frameworks of cognitive models of insomnia. Viewing AS and IU as antecedents of sleep problems and assigning to AS a pivotal role, our study suggested indications for clinical interventions on a population at risk for sleep disorders.


Assuntos
Ansiedade/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Sono , Incerteza , Adulto , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Estudantes , Adulto Jovem
6.
Health Psychol ; 38(11): 1025-1035, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31380685

RESUMO

OBJECTIVE: Preterm birth (PTB) is a prevalent public health concern. Pregnancy anxiety, poor sleep quality, and short sleep duration have been associated with an increased risk of PTB. Theoretically, sleep variables could moderate the strength of the relationship between pregnancy anxiety and PTB; investigating this question was the primary aim of this study. METHOD: The sample consisted of 290 pregnant women who were assessed at 2 time points in pregnancy: Time 1 (< 22 weeks gestational age [GA]; MGA = 15.04, SD = 3.55) and Time 2 (32 weeks GA; MGA = 32.44, SD = 0.99). Pregnancy anxiety was assessed with the Pregnancy-Related Anxiety Scale, sleep quality was assessed by the Pittsburgh Sleep Quality Index, and sleep duration was assessed via actigraphy. Data on gestational age at birth were obtained from the electronic medical record. RESULTS: After adjustment for relevant covariates, higher levels of pregnancy anxiety were associated with shorter gestational length and an increased risk of PTB. There were no direct associations between sleep quality or sleep duration and gestational length or PTB. Pregnancy anxiety interacted with sleep duration such that pregnancy anxiety was significantly associated with shorter gestational length and PTB only when women had relatively shorter sleep duration (approximately < 8.3 hr). CONCLUSIONS: This study reveals new evidence of an interaction between pregnancy anxiety and sleep duration in the prediction of the timing of delivery. The findings point to avenues to better understand and potentially ameliorate risk for PTB. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Ansiedade/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Sono/fisiologia , Adulto , Feminino , Humanos , Estudos Longitudinais , Gravidez , Fatores de Risco
7.
Sleep Health ; 5(5): 495-500, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31416799

RESUMO

OBJECTIVES: Sleep complaints, such as insomnia and sleep disturbances caused by posttraumatic stress disorder (PTSD), are more common among women veterans than nonveteran women. Alcohol use among some women may be partially motivated by the desire to improve sleep. This study evaluated rates of alcohol use as a sleep aid among women veterans and explored the relationship between alcohol use to aid sleep and drinking frequency and sleeping pill use. DESIGN AND SETTING: National cross-sectional population-based residential mail survey on sleep and other symptoms. PARTICIPANTS: Random sample of women veteran VA users who completed a postal survey (N = 1533). INTERVENTIONS: None. MEASUREMENTS: The survey included demographics, Insomnia Severity Index, Primary Care PTSD screen, and items on alcohol use frequency (days/week), use of prescription or over-the-counter sleep medications, and use of alcohol as a sleep aid (yes/no for each item) over the past month. RESULTS: A total of 14.3% of respondents endorsed using alcohol to aid sleep. Logistic regression models showed more severe insomnia (odds ratio [OR] = 1.03; 95% confidence interval [CI]: 1.01-1.06) and PTSD (OR = 2.11; 95% CI: 1.49-2.97) were associated with increased odds of using alcohol to aid sleep. Alcohol use to aid sleep was associated with increased odds of daily drinking (OR = 8.46; 95% CI: 4.00-17.87) and prescription (OR = 1.79; 95% CI: 1.34-2.38) and over-the-counter sleep aid use (OR = 1.54; 95% CI: 1.12-2.11). CONCLUSIONS: Insomnia and PTSD may increase risk for using alcohol as a sleep aid, which may increase risk for unhealthy drinking and for mixing alcohol with sleep medications. Findings highlight the need for alcohol use screening in the context of insomnia and for delivery of cognitive-behavioral therapy for insomnia to women veterans with insomnia.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Medicamentos Indutores do Sono/uso terapêutico , Veteranos/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Assunção de Riscos , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Veteranos/estatística & dados numéricos
8.
Behav Ther ; 50(5): 910-923, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31422847

RESUMO

While evidence-based interventions can help the substantial number of veterans diagnosed with comorbid PTSD and depression, an emerging literature has identified sleep disturbances as predictors of treatment nonresponse. More specifically, predicting effects of residual insomnia and nightmares on postintervention PTSD and depressive symptoms among veterans with comorbid PTSD and depression has remained unclear. The present study used data from a clinical trial of Behavioral Activation and Therapeutic Exposure (BA-TE), a combined approach to address comorbid PTSD and depression, administered to veterans (N = 232) to evaluate whether residual insomnia and nightmare symptoms remained after treatment completion and, if so, whether these residual insomnia and nightmare symptoms were associated with higher levels of comorbid PTSD and depression at the end of treatment. Participants (ages 21 to 77 years old; 47.0% Black; 61.6% married) completed demographic questions, symptom assessments, and engagement-related surveys. Hierarchical multiple linear regression models demonstrated that residual insomnia was a significant predictor of PTSD and depression symptom reduction above and beyond the influence of demographic and engagement factors (e.g., therapy satisfaction). Consistent with previous research, greater residual insomnia symptoms were predictive of smaller treatment gains. Findings illustrate the potential significance of insomnia during the course of transdiagnostic treatment (e.g., PTSD and depression), leading to several important clinical assessment and treatment implications.


Assuntos
Depressão/complicações , Distúrbios do Início e da Manutenção do Sono/complicações , Transtornos do Sono-Vigília/complicações , Transtornos de Estresse Pós-Traumáticos/complicações , Veteranos/psicologia , Adulto , Idoso , Depressão/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos do Sono-Vigília/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Veteranos/estatística & dados numéricos , Adulto Jovem
9.
Behav Ther ; 50(5): 994-1001, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31422853

RESUMO

Discrepancy between objective and subjective sleep parameters is a frequent symptom in persons suffering from insomnia. Since it has an impairing effect on daytime well-being and neglects possible positive objective improvements, it would be useful if it was treated. Apart from hypnotics, cognitive behavior therapy (CBT-I) is the therapy of choice for chronic forms of insomnia. However, there is limited information about whether CBT-I can also improve subjective-objective sleep discrepancy. We investigated a large sample of patients showing chronic forms of insomnia regarding their subjective-objective sleep discrepancy pre and post CBT-I. Objective sleep data were obtained from 3 nights (2 baseline nights and 1 night after therapy) using polysomnography in our sleep laboratory. All 92 patients participated in a 14-day inpatient program with CBT-I including psychoeducation about subjective-objective sleep discrepancy. Repeated measures analyses showed an improvement in subjective-objective sleep discrepancy parameters after CBT-I. Those parameters were also correlated with perceived quality of sleep. We conclude that CBT-I is a useful tool to improve subjective-objective sleep discrepancy in patients showing chronic forms of insomnia.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Distúrbios do Início e da Manutenção do Sono/terapia , Vigília/fisiologia , Feminino , Humanos , Pacientes Internados/psicologia , Masculino , Pessoa de Meia-Idade , Polissonografia/métodos , Distúrbios do Início e da Manutenção do Sono/psicologia , Resultado do Tratamento
10.
Sleep Health ; 5(4): 370-375, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31400882

RESUMO

OBJECTIVES: This study aim is to compare anxiety levels among individuals experiencing different symptoms of insomnia. DESIGN: Case-control study. SETTING: The Nord-Trøndelag Health Study (the HUNT3 study, Norway). PARTICIPANTS: Of the 50,802 individuals taking part in the HUNT3 study, the current sample comprised 7933 individuals, including 4317 cases with insomnia and 3616 controls. MEASUREMENTS: Symptoms of anxiety were assessed using Hospital Anxiety and Depression Scale, whereas insomnia symptoms were assessed according to the core Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, nocturnal symptoms. Anxiety levels of the 4317 individuals reporting at least 1 insomnia symptom were compared with the 3616 controls reporting no symptoms. Level of anxiety among participants experiencing combinations of insomnia symptoms was also investigated. RESULTS: Anxiety levels were significantly higher in individuals reporting insomnia symptoms (M = 2.5, SD = 2.4) compared to controls (5.5, SD = 3.7, P < .001). Anxiety levels also differed significantly between different insomnia symptoms (P < .001). Participants reporting all 3 insomnia symptoms had the highest anxiety score (M = 6.8, SD = 4.3), followed in decreasing order by sleep onset insomnia with terminal insomnia (M = 6.7, SD = 4.0), sleep onset insomnia with sleep maintenance insomnia (M = 6.3, SD = 3.8), sleep onset insomnia only (M = 5.8, SD = 3.7), sleep maintenance insomnia with terminal insomnia (M = 5.6, SD = SD = 3.4), terminal insomnia (M = 5.2, SD = 3.4), and sleep maintenance insomnia only (M = 4.5, SD = 3). CONCLUSIONS: Difficulties initiating sleep, both alone and in combination with 1 or 2 of the other symptoms, seem to play a key role in rising anxiety levels.


Assuntos
Ansiedade/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-31454934

RESUMO

Sleep and work-family problems attract a great attention in the construction industry because construction professionals are usually prone to work-family conflicts and sleep problems. The objective of this study was to analyze the effect of Family-Role Overload (FRO) and Work Interference with Family (WIF) on sleep sufficiency. We also included life satisfaction as a mediator and family supportive supervision behaviors (FSSB) as a moderator. Using a sample of 193 Chinese construction professionals, we collected objectively-measured sleep sufficiency data with validated wrist actigraphies and self-reported sleep sufficiency data, FRO, WIF, life satisfaction and FSSB with questionnaires through multiple waves. Results demonstrated that FRO was negatively associated with both objectively-measured and self-reported sleep sufficiency and life satisfaction played an important mediating role in this relationship. The moderating effect of life satisfaction on the path between WIF and sleep sufficiency is trivial. In addition, no significant moderating effects of FSSB were found. More substantial policies should be taken to improve the life satisfaction and sleep sufficiency of construction professionals.


Assuntos
Indústria da Construção , Conflito Familiar/psicologia , Relações Familiares/psicologia , Satisfação Pessoal , Distúrbios do Início e da Manutenção do Sono/psicologia , Engajamento no Trabalho , Tolerância ao Trabalho Programado/psicologia , Adulto , Grupo com Ancestrais do Continente Asiático/psicologia , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
12.
PLoS One ; 14(7): e0219093, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291302

RESUMO

This cross-sectional study is aimed at assessing the quality of life in a cohort of breast cancer patients at the Oncology Department, King Abdulaziz University Hospital (KAUH), King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA), and to differentiate QoL among different groups. Mean time since diagnosis was 3.97±1.90 years. European Organization for Research and Treatment of Cancer Quality of Life Questionnaires-Core30 and BR23 (EORTC QLQ-C30 & BR23) were used to assess QoL in breast cancer survivors. ANOVA and independent t-test (parametric tests) were used for the categorical variables and Kruskal-Wallis and Mann-Whitney tests used for non-parametric tests. Linear regression analysis was done to measure predictors' significance and to calculate the coefficient of determination. Two hundred and eighty-four patients completed the survey. Global health status and functional scales, in most of the domains, were high, while symptom scales were moderate-to-low for most items, showing better QoL. Insomnia and fatigue were the most disturbing symptoms. Patients exhibited higher scores for body image and future perspective, while the least score is for sexual functioning. Global health, physical functioning, and role functioning were better in the age group ≤50 years (p<0.05). Premenopausal and perimenopausal patients showed a better level of functioning as compared to postmenopausal patients (p = 0.001). Premenopausal patients scored higher for sexual enjoyment, as compared to peri- and post-menopausal patients (p = 0.04). Systemic therapy side effects were more evident in the breast conservative surgery group. Predictors explained 8% of the variation in Physical functioning (R-squared = 0.08). A predictor that had a remarkable influence on physical functioning, as compared to the other predictors in the model, was menopausal status (P = 0.02). So, it was concluded that the breast cancer patients visiting our institute had a better quality of life regarding overall global health status as well as functional and symptom scales. Some issues, for instance, fatigue, insomnia, hair loss, and others, warrant good supportive therapy.


Assuntos
Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Fadiga/psicologia , Qualidade de Vida/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Adulto , Neoplasias da Mama/terapia , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/psicologia , Pré-Menopausa/psicologia , Psicometria , Análise de Regressão , Arábia Saudita , Inquéritos e Questionários , Centros de Atenção Terciária
13.
Artigo em Russo | MEDLINE | ID: mdl-31317891

RESUMO

AIM: To study self-medication and its factors in patients with depressive and neurotic disorders at premorbid stage. MATERIAL AND METHODS: The sample included 131 first-time admitted patients and 85 recurrent patients with depressive or neurotic disorders, who reported taking medication to cope with the symptoms during preadmission period. Lazarus coping strategies test, Shmishek personality test, test on disease attitude and patient activation were used. Social and demographic characteristics, subjective characteristics of disease, medical literacy and behavioral coping strategies were studied. RESULTS AND CONCLUSION: Over 50% of the patients used self-medication to cope with the symptoms during the preadmission period. Coping anxiety and insomnia was a key motivation to self-medication. Most frequently used medications included tranquilizers and herbal anxiolytics. Misunderstanding of origin of their state, searching for information about treatment of disease via internet, increased emotiveness and tension, lack of their correction with psychotherapy were the factors of self-medication.


Assuntos
Transtornos Neuróticos , Automedicação , Distúrbios do Início e da Manutenção do Sono , Adaptação Psicológica , Ansiedade , Transtornos de Ansiedade , Depressão , Humanos , Transtornos Neuróticos/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia
14.
Int J Behav Med ; 26(4): 437-442, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31264100

RESUMO

BACKGROUND: Exposure to violence, which is experienced at disproportionally higher levels by black versus white youth, is associated with disruptions in sleep and elevated cardiovascular risk. Further, poor sleep hygiene is associated with insulin resistance. However, research to date examining disruptions in sleep and cardiovascular risk in African-American adolescents has not taken the impact of exposure to violence into account, nor considered how gender might affect patterns of association. The present study addressed this gap by testing a path model linking exposure to community violence, sleep disruption, and insulin resistance in a sample of African-American adolescents and evaluating model fit across gender. METHOD: African-American adolescents (N = 107; 56% female; Mage = 14.29, SD = 1.17) completed structured interviews at home and provided a blood sample after fasting overnight. RESULTS: The model fit connecting exposure to violence with sleep disruption and insulin resistance, adjusting for depressive symptoms and body mass index z score, was excellent. Multiple group analysis indicated gender differences in model fit. Path analysis revealed significant positive associations between exposure to violence and sleep disruption and sleep disruption and insulin resistance for females but not males. CONCLUSION: These data indicate that low-income, urban African-American female adolescents who witness violence and experience sleep disruptions may already be at elevated risk for health problems compared with their male counterparts. Additional research should attempt to replicate and explicate the underlying reasons for the gender differences observed here, with the goal of improving health and disrupting the path leading to health disparities.


Assuntos
Exposição à Violência/psicologia , Resistência à Insulina , Pobreza/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , População Urbana/estatística & dados numéricos , Adolescente , Afro-Americanos/psicologia , Feminino , Humanos , Masculino , Fatores Sexuais , Sono
16.
Medicine (Baltimore) ; 98(29): e16512, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335727

RESUMO

Previous studies have indicated that sleep plays an important role in emotional memory and decision-making. However, very little attention has been given to emotional memory and decision-making in patients with primary insomnia (PI). We investigated whether PI influences the accuracy of emotional memory and social decision-making.We examined 25 patients with PI and 20 healthy controls (HC) using an emotional picture memory task and the Iowa Gambling Task (IGT). In the emotional picture memory task, participants completed two testing sessions: an emotional picture evaluation and a delayed recognition phase. During the emotional picture evaluation phase, participants were presented with 48 pictures with different valence (16 positive, 16 neutral, and 16 negative), which they had to evaluate for emotional valence and arousal. During the recognition phase, participants were asked to make a yes/no memory assessment of a set of pictures, which contained the 48 target pictures intermingled with 48 non-target pictures.The performance of the participants with PI was the same as that of the HC in the emotional picture evaluation task. However, the PI group showed worse recognition of the positive and neutral pictures than did the HC group, although recognition of negative pictures was similar in the 2 groups. In the IGT, participants in the PI group more frequently selected cards from the risky decks as the game progressed and selected more disadvantageous cards than did participants in the HC group after the first block.Our findings suggest that insomnia had different effects on memory, depending on the valence of the memory. Specifically, memory performance was impaired for positive and neutral items, but the recognition of negative stimuli seemed to be more resistant to the effects of insomnia. Our results also suggest that decision-making, which is known to be mediated by the ventromedial prefrontal cortex, including decision-making under conditions of uncertainty, may be vulnerable in PI.


Assuntos
Tomada de Decisões , Emoções , Distúrbios do Início e da Manutenção do Sono/psicologia , Adulto , Feminino , Humanos , Masculino , Córtex Pré-Frontal/fisiologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia
17.
BMC Pregnancy Childbirth ; 19(1): 254, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331286

RESUMO

BACKGROUND: Poor sleep, including symptoms of insomnia are common during pregnancy and postpartum periods. Poor sleep during the perinatal period is linked to impaired daytime functioning, mood disturbance, and risk for chronic insomnia. Cognitive behavioural therapy (CBT) is consistently shown to be efficacious in treating insomnia, but it is largely inaccessible to new mothers, and surprisingly, not part of current perinatal care. This study aims to evaluate the feasibility and efficacy of a scalable CBT-based intervention for better sleep quality. METHODS: In this single-blind randomised controlled trial, eligible nulliparous women are randomised in a 1:1 ratio to either the intervention (CBT) or active control (healthy diet) condition. The interventions are provided from the third trimester till 6 months postpartum. The primary outcome is maternal sleep quality and secondary outcomes are maternal sleep-related impairment, mood, health-related quality of life, relationship satisfaction, and mother-infant-relationship, all assessed using validated instruments at 30- (baseline) and 35 weeks gestation (pregnancy endpoint), and 1.5, 3, and 6 months (postpartum endpoint) after childbirth, with follow-up assessments conducted at 1-year and 2-year postpartum. DISCUSSION: This study has the potential to address the need for an evidence-based, non-pharmacological sleep intervention tailored for the pregnancy and postpartum periods. The intervention is designed to maximise reach and minimise cost, with the potential to scale up and incorporate in routine perinatal care. With outcomes measured at 8 time points, from the third trimester of pregnancy to 2-year postpartum, this study has the potential to examine both short- and long-term impact on maternal sleep and wellbeing. TRIAL REGISTRATION: ACTRN12616001462471 ; retrospectively registered on 19/10/2016.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Assistência Perinatal/métodos , Distúrbios do Início e da Manutenção do Sono , Adulto , Feminino , Humanos , Serviços de Saúde Materna , Gravidez , Método Simples-Cego , Higiene do Sono , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Distúrbios do Início e da Manutenção do Sono/terapia
18.
Ann Hematol ; 98(10): 2357-2366, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31338572

RESUMO

We aimed to compare the health-related quality of life and health behaviors of acute leukemia (AL) survivors with that of the general population from two cohorts. AL survivors (n = 149) completed a set of questionnaires to evaluate quality of life, mental status, and health behaviors. AL survivors had more physical and mental difficulties (problems with usual activities, 15% vs. 5%, p < 0.001; anxiety or depression, 24% vs. 9%, p < 0.001; pain, 35% vs. 20%, p = 0.002) and more financial difficulties (p < 0.001) than the general population. Survivors who received stem cell transplantation (SCT) had significantly worse problems with role functioning, fatigue, pain, dyspnea, and insomnia, and had higher depression scores than chemotherapy group (p = 0.024). In terms of health behaviors, AL survivors had lower rates of smoking and drinking and higher influenza vaccination rates than the general population. However, only 17% of survivors had been recommended to receive screening for other cancers from health-care providers, and 67% thought their risk for other cancers was equal or lower than that of the general population. Cancer screening rates were even lower in the SCT group than in the chemotherapy group (p = 0.041). Our study indicates that clinicians should establish more appropriate survivorship care plans.


Assuntos
Sobreviventes de Câncer , Comportamentos Relacionados com a Saúde , Leucemia Mieloide Aguda/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários , Adulto , Idoso , Idoso de 80 Anos ou mais , Aloenxertos , Depressão/psicologia , Dispneia/psicologia , Fadiga/psicologia , Feminino , Humanos , Leucemia Mieloide Aguda/terapia , Masculino , Pessoa de Meia-Idade , Dor/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transplante de Células-Tronco
19.
Arch Clin Neuropsychol ; 34(7): 1127-1137, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31250888

RESUMO

OBJECTIVE: To examine associations between subjectively-reported sleep and objectively-measured sleep (i.e., actigraphy) with different domains of cognitive functioning, and determine whether age may moderate these associations. METHOD: In this cross-sectional study, a total of 489 participants (mean age = 45.4 years; SD = 18.8) completed a self-reported sleep measure and one week of actigraphy. Participants also completed a battery of cognitive tests measuring episodic memory, social cognition, executive functioning, and complex cognition (i.e., reasoning, visuospatial, and language abilities). RESULTS: Multiple regression analyses revealed that greater objective sleep quality and longer onset latencies were both associated with better performance on measures of conceptual flexibility. In contrast, subjective sleep quality was not associated with performance in any cognitive domain after accounting for objective sleep variables. Age moderated sleep-cognition relationships in differing ways based on cognitive domain and facet of sleep assessed. For example, whereas poorer subjective sleep quality was associated with poorer complex cognition in younger, but not older adults, poorer objective sleep quality was associated with poorer conceptual flexibility in older, but not younger adults. CONCLUSIONS: Objectively-measured and self-reported sleep are associated with differing aspects of executive functioning, with the latter related to executive functioning broadly and the former associated with conceptual flexibility in particular. Age moderates sleep-cognition relationships differentially depending on the method by which sleep quality and quantity are measured.


Assuntos
Cognição , Função Executiva , Distúrbios do Início e da Manutenção do Sono/psicologia , Sono , Actigrafia , Fatores Etários , Estudos Transversais , Feminino , Humanos , Masculino , Memória Episódica , Pessoa de Meia-Idade , Testes Neuropsicológicos , Autorrelato
20.
Trials ; 20(1): 262, 2019 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-31068225

RESUMO

BACKGROUND: Insomnia is a prevalent sleep disorder associated with significant economic and personal burdens. Cognitive behavioural therapy for insomnia (CBTI) is considered the gold standard intervention for insomnia and its efficacy has been well demonstrated. However, the core treatment strategies of CBTI require significant behavioural change, which many individuals find challenging. As a result, although CBTI is efficacious, its effectiveness is reduced by modest levels of adherence in typical clinical settings. This is problematic as adherence is essential to attain desired treatment outcomes. Sleep is often a dyadic process, with approximately 60% of Australian adults sharing a bed. Hence, the present study aims to determine whether incorporating bed partners into treatment for insomnia increases treatment adherence and completion. The impact of adherence on symptoms of insomnia will also be examined. METHODS: This study is a mixed-effects randomised effectiveness trial of partner-assisted CBTI (PA-CBTI). It is an "effectiveness" (as opposed to "efficacy") trial, due to the focus on "real world" clinic-based clients and adherence/attrition as outcomes. Participants will include 120 clients with insomnia who are randomly assigned, in equal numbers, to PA-CBTI, traditional individual CBTI (i-CBTI), or partner-assisted sleep management therapy (PA-SMT; which serves as the control group). All interventions consist of seven weekly 1-h sessions. Treatment outcome is evaluated using clinician-rated treatment adherence, and diary-based adherence to stimulus control and sleep restriction. Clients and partners complete major assessments at pre- and post-treatment, and at 6-month follow-up. Secondary outcome variables include actigraphy, self-report measures related to sleep, comorbid psychopathology, and relationship functioning. DISCUSSION: This is the first randomised clinical trial to examine the impact of incorporating the bed partner in the treatment of insomnia. Results will provide new information about the role partners play in clients' insomnia presentation and treatment response, and better define the role of adherence in CBTI. This trial has the potential to optimise treatment outcomes for insomnia by improving adherence and reducing attrition. Results could have far-reaching impacts. Improvements in insomnia have been linked to improvements in mental and physical health and, given the high financial costs of insomnia, this study could have a positive economic impact. TRIAL REGISTRATION: ACTRN, ACTRN12616000586415 . Registered on 5 May 2016.


Assuntos
Terapia Cognitivo-Comportamental , Cooperação do Paciente , Distúrbios do Início e da Manutenção do Sono/terapia , Sono , Cônjuges/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Fatores de Tempo , Resultado do Tratamento , Vitória
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