Shirley Xin Li1,2,3, Siu Ping Lam1, Jihui Zhang1, Mandy Wai Man Yu1, Joey Wing Yan Chan1, Cassandra Sheung Yan Chan1, Colin A Espie4, Daniel Freeman5, Oliver Mason3, Yun-Kwok Wing1. 1. Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR. 2. Sleep Research Laboratory, Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong SAR. 3. Department of Clinical, Educational and Health Psychology, University College London, London, UK. 4. Nuffield Department of Clinical Neurosciences and Sleep & Circadian Neuroscience Institute, University of Oxford, Oxford, UK. 5. Department of Psychiatry, University of Oxford, UK.
Abstract
STUDY OBJECTIVES: Disrupted sleep is one of the prominent but often overlooked presenting symptoms in the clinical course of psychotic disorders. The aims of this study were to examine the prevalence of sleep disturbances, particularly insomnia and nightmares, and their prospective associations with the risk of suicide attempts in patients with schizophrenia-spectrum disorders. METHODS: A naturalistic longitudinal study was conducted in outpatients diagnosed with schizophrenia-spectrum disorders recruited from the psychiatric outpatient clinic of a regional university-affiliated public hospital in Hong Kong. A detailed sleep questionnaire was completed by 388 patients at baseline in May-June 2006. Relevant clinical information was extracted from clinical case notes from June 2007-October 2014. RESULTS: Prevalence of frequent insomnia and frequent nightmares was 19% and 9%, respectively. Baseline frequent insomnia was significantly associated with an increased incidence of suicide attempts during the follow-up period (adjusted hazard ratio = 4.63, 95% confidence interval 1.40-15.36, P < 0.05). Nightmare complaint alone did not predict the occurrence of suicide attempts, but the comorbidity of nightmares and insomnia was associated with the risk of suicide attempt over follow-up (adjusted HR = 11.10, 95% confidence interval: 1.68-73.43, P < 0.05). CONCLUSIONS: Sleep disturbances are common in patients with schizophrenia-spectrum disorders. The association between sleep disturbances and suicidal risk underscores the need for enhanced clinical attention and intervention on sleep disturbances in patients with schizophrenia.
STUDY OBJECTIVES: Disrupted sleep is one of the prominent but often overlooked presenting symptoms in the clinical course of psychotic disorders. The aims of this study were to examine the prevalence of sleep disturbances, particularly insomnia and nightmares, and their prospective associations with the risk of suicide attempts in patients with schizophrenia-spectrum disorders. METHODS: A naturalistic longitudinal study was conducted in outpatients diagnosed with schizophrenia-spectrum disorders recruited from the psychiatric outpatient clinic of a regional university-affiliated public hospital in Hong Kong. A detailed sleep questionnaire was completed by 388 patients at baseline in May-June 2006. Relevant clinical information was extracted from clinical case notes from June 2007-October 2014. RESULTS: Prevalence of frequent insomnia and frequent nightmares was 19% and 9%, respectively. Baseline frequent insomnia was significantly associated with an increased incidence of suicide attempts during the follow-up period (adjusted hazard ratio = 4.63, 95% confidence interval 1.40-15.36, P < 0.05). Nightmare complaint alone did not predict the occurrence of suicide attempts, but the comorbidity of nightmares and insomnia was associated with the risk of suicide attempt over follow-up (adjusted HR = 11.10, 95% confidence interval: 1.68-73.43, P < 0.05). CONCLUSIONS: Sleep disturbances are common in patients with schizophrenia-spectrum disorders. The association between sleep disturbances and suicidal risk underscores the need for enhanced clinical attention and intervention on sleep disturbances in patients with schizophrenia.
Authors: Maurizio Pompili; David Lester; Alessandro Grispini; Marco Innamorati; Fulvia Calandro; Paolo Iliceto; Eleonora De Pisa; Roberto Tatarelli; Paolo Girardi Journal: Psychiatry Res Date: 2009-04-23 Impact factor: 3.222
Authors: Laura B Palmese; Pamela C DeGeorge; Joseph C Ratliff; Vinod H Srihari; Bruce E Wexler; Andrew D Krystal; Cenk Tek Journal: Schizophr Res Date: 2011-12 Impact factor: 4.939
Authors: Elizabeth C Thompson; Kara A Fox; Andrea Lapomardo; Jeffrey I Hunt; Jennifer C Wolff Journal: J Child Adolesc Psychopharmacol Date: 2020-02-13 Impact factor: 2.576
Authors: Elizabeth C Thompson; Samantha Y Jay; Nicole D Andorko; Zachary B Millman; Pamela Rakhshan Rouhakhtar; Kristin Sagun; Susan C Han; Bruce Herman; Jason Schiffman Journal: Psychiatry Res Date: 2021-01-02 Impact factor: 3.222
Authors: Nils Sandman; Katja Valli; Erkki Kronholm; Erkki Vartiainen; Tiina Laatikainen; Tiina Paunio Journal: Sci Rep Date: 2017-03-15 Impact factor: 4.379