Laura Palagini1, Giada Cipollone2, Isabella Masci2, Danila Caruso2, Francescoluigi Paolilli2, Giulio Perugi2, Dieter Riemann3. 1. Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy. Electronic address: lpalagini@tiscali.it. 2. Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy. 3. Department of Clinical Psychology and Psychophysiology/ Sleep Medicine, Center for Mental Disorders, University of Freiburg, Freiburg, Germany.
Abstract
INTRODUCTION: Insomnia symptoms are very common in Bipolar Disorder. Our aim was to assess the potential association between insomnia, emotion dysregulation and suicidality in subjects with Bipolar Disorder. METHODS: Seventy-seven subjects with Bipolar Disorder type II with a depressive episode with mixed features were recruited. Patients were assessed with SCID-DSM-5, the Insomnia Severity Index (ISI), the Difficulties in Emotion Regulation Scale (DERS), the Scale for Suicide Ideation (SSI) while evaluating manic and depressive symptoms. RESULTS: Subjects with insomnia symptoms compared to those without showed higher scores in the DERS scale and subscales, including impulsivity, and in the SSI scale. Insomnia symptoms significantly predicted the severity of depressive symptoms, emotion dysregulation, and suicidality in subjects with bipolar disorder. In particular, insomnia was related to difficulties in some areas of emotion regulation including impulsivity. Emotion dysregulation significantly mediated the association between insomnia and depressive symptoms (Z = 2.9, p = 0.004). Furthermore, emotional impulsivity mediated the association between insomnia symptoms and suicidality (Z = 2.2, p = 0.03). CONCLUSION: In our study, subjects with bipolar disorder suffering from insomnia experienced a greater severity of depressive symptoms and suicidality compared to subjects without insomnia. Insomnia was associated with emotion dysregulation, impulsivity and suicidality. Further research is necessary to investigate if these latter features may benefit from early insomnia treatment in subjects with bipolar disorder.
INTRODUCTION:Insomnia symptoms are very common in Bipolar Disorder. Our aim was to assess the potential association between insomnia, emotion dysregulation and suicidality in subjects with Bipolar Disorder. METHODS: Seventy-seven subjects with Bipolar Disorder type II with a depressive episode with mixed features were recruited. Patients were assessed with SCID-DSM-5, the Insomnia Severity Index (ISI), the Difficulties in Emotion Regulation Scale (DERS), the Scale for Suicide Ideation (SSI) while evaluating manic and depressive symptoms. RESULTS: Subjects with insomnia symptoms compared to those without showed higher scores in the DERS scale and subscales, including impulsivity, and in the SSI scale. Insomnia symptoms significantly predicted the severity of depressive symptoms, emotion dysregulation, and suicidality in subjects with bipolar disorder. In particular, insomnia was related to difficulties in some areas of emotion regulation including impulsivity. Emotion dysregulation significantly mediated the association between insomnia and depressive symptoms (Z = 2.9, p = 0.004). Furthermore, emotional impulsivity mediated the association between insomnia symptoms and suicidality (Z = 2.2, p = 0.03). CONCLUSION: In our study, subjects with bipolar disorder suffering from insomnia experienced a greater severity of depressive symptoms and suicidality compared to subjects without insomnia. Insomnia was associated with emotion dysregulation, impulsivity and suicidality. Further research is necessary to investigate if these latter features may benefit from early insomnia treatment in subjects with bipolar disorder.
Authors: Laura Palagini; Raffaele Manni; Eugenio Aguglia; Mario Amore; Roberto Brugnoli; Paolo Girardi; Luigi Grassi; Claudio Mencacci; Giuseppe Plazzi; Antonino Minervino; Lino Nobili; Giovanni Biggio Journal: Front Psychiatry Date: 2020-06-26 Impact factor: 4.157
Authors: Laura Palagini; Raffaele Manni; Eugenio Aguglia; Mario Amore; Roberto Brugnoli; Stéphanie Bioulac; Patrice Bourgin; Jean-Arthur Micoulaud Franchi; Paolo Girardi; Luigi Grassi; Régis Lopez; Claudio Mencacci; Giuseppe Plazzi; Julia Maruani; Antonino Minervino; Pierre Philip; Sylvie Royant Parola; Isabelle Poirot; Lino Nobili; Giovanni Biggio; Carmen M Schroder; Pierre A Geoffroy Journal: Front Psychiatry Date: 2021-06-10 Impact factor: 4.157
Authors: Dorota Wołyńczyk-Gmaj; Andrzej Jakubczyk; Elisa M Trucco; Paweł Kobyliński; Justyna Zaorska; Bartłomiej Gmaj; Maciej Kopera Journal: Int J Environ Res Public Health Date: 2022-02-25 Impact factor: 3.390