Sleep health differs between resident and outpatient schizophrenic patients

patient schizophrenia spectrum disorder A new study found that they had longer total sleep and rest times and lower activity levels than healthy controls.¹

New data from a multinational team of researchers show that abnormal sleep rhythms in home-based patients with schizophrenia, which may contribute to more serious symptoms associated with psychiatric illness, may contribute to more serious symptoms in outpatients or healthy controls. The findings suggest that the impact of improved sleep on schizophrenia symptoms and the overall quality of life of patients should be investigated.

The researchers, led by Ahmad Mayeli, Ph.D., a postdoctoral fellow at the University of Pittsburgh, and Alice D. LaGoy, Ph.D., a postdoctoral fellow at the Naval Health Research Center, examined sleep and rest-activity rhythm (RAR) patterns in residential and outpatient patients. I was. Compare patients with schizophrenia to healthy controls and other patients. In addition, we investigated whether schizophrenia symptoms and their severity differed between patient groups based on sleep and RAR.

“Alterations in sleep and RAR parameters have been found to be associated with clinical manifestations of[schizophrenia],” the researchers wrote. Negative symptoms, which contribute significantly to reduced functioning, reduced work capacity, reduced goal-directed activity, and ultimately reduced quality of life, are associated with longer total sleep duration and lower motor activity patterns. These patients.”

The team recruited patients aged 18-56 years diagnosed with a DSM-5-defined schizophrenia spectrum disorder. He is currently undergoing treatment in one of ten residential or outpatient facilities at Italy’s Ministry of Mental Health (DMH) and has a good knowledge of the Italian language. .

A psychiatrist or psychologist collected individual information about the current patient diagnosis, duration of illness, and lifetime duration of psychiatric hospitalization. Psychopathological severity was assessed by the 24-item Brief Psychiatric Rating Scale (BPRS), and psychosocial functioning was measured by the 43-item Specific Function Rating Scale (SLOF).

Negative symptom severity was assessed by the 13-item Brief Negative Symptom Scale (BNSS), and RAR and sleep health were assessed by indices determined by 7-day assessments with the actigraphy watch. .

The final evaluation included 230 patients, including 122 schizophrenia patients and 108 health care workers. Among the schizophrenia patients, 68 (55.7%) were residents and 54 (44.3%) were outpatients.

Total sleep time (TST) per actigraphy was longer in both schizophrenia groups compared to healthy controls (P. <.001); both patient groups additionally showed the longest resting and most active 10 h (M10) per RAR.

Resident patients with schizophrenia reported higher circadian variation (IV) than healthy controls, indicating daily rhythm fragmentation.

Among the two schizophrenia patient groups, residential patients reported a lower M10 than outpatients, whereas the opposite was true for IV (P. <.001).

Residential patients reported higher scores than outpatients in terms of severity of negative symptoms. Daily stability (IS) was significantly associated with residential schizophrenia patient status for negative symptom severity, but not with outpatient status.

There were no significant correlations between sleep and RAR variables, BPRS total scores, and positive symptoms.

In a press release accompanying the data, Fabio Ferrarelli, MD, PhD, senior author of the study and associate professor of psychiatry at the University of Pittsburgh, said home-based patients with schizophrenia had more stable daily lives than outpatients. He pointed out research results that emphasized that²

“We tend to think that stable routines are a good thing, but when these routines get too rigid, they can cause problems,” he said. “In our study, this daily rhythm rigidity was strongly correlated with the severity of negative mental health symptoms in residential patients with schizophrenia.”

In general, the findings support strategies for improving mental health, such as variations in daily life and more routine movement.

“Especially as people get older, they tend to get deeper into their daily lives,” says Ferrarelli. “Routines give us a sense of control over our lives and are very beneficial. But if the routine is too rigid, it can backfire.”

The researchers concluded that their study demonstrated shared and unique properties of sleep and RAR measures among schizophrenia patients in residential and outpatient care settings.

“Based on these findings, future studies will help establish whether improving some of these measures improves quality of life and clinical symptoms in patients with schizophrenia spectrum disorders.” I will,” they wrote.

References

1. ^{Mayeli, A., LaGoy, AD, Smagula, SF, etc. Shared distinct abnormalities in sleep-wake patterns in patients with schizophrenia spectrum disorder and their relationship to negative symptoms. Mole Psychiatry (2023). https://doi.org/10.1038/s41380-023-02050-x}
2. ^{University of Pittsburgh. Disturbed rest-wake rhythms exacerbate symptoms in schizophrenics. press release. newswise. Published April 19, 2023. Accessed April 23, 2023. ta=home}