Aims and method: To assess clinicians’ views about their understanding and treatment of sleep problems in people with non-affective psychosis. An online survey was emailed to adult mental health teams in two NHS trusts. Results: One hundred and eleven clinicians completed the survey. All clinicians reported disrupted sleep in their patients, and endorsed the view that sleep and psychotic experiences each exacerbate the other. However, most clinicians (n = 92, 82%) assessed sleep problems informally, rather than using standard assessment measures. There was infrequent use of the recommended cognitive-behavioural treatments for sleep problems such as persistent insomnia, with the approaches typically used being sleep hygiene and medications instead. Clinical implications: Clinicians recognise the importance of sleep in psychosis, but the use of formal assessments and recommended treatments is limited. Barriers to treatment implementation identified by the clinicians related to services (e.g. lack of time), patients (e.g. their lifestyle) and environmental features of inpatient settings.
Summary Background Patient education forms a cornerstone of management of inflammatory bowel disease (IBD). The Internet has opened new avenues for information gathering. Aim To determine the relationship between different information sources and patient knowledge and anxiety in patients with IBD. Methods The use of information sources in patients with IBD was examined via questionnaire. Anxiety was assessed with the hospital anxiety and depression scale and disease‐related patient knowledge with the Crohn's and colitis knowledge score questionnaires. Associations between these outcomes and demographics, disease‐related factors, and use of different information sources were analysed using linear regression analysis. Results Of 307 patients (165 Crohn's disease, 142 ulcerative colitis) 60.6% were female. Participants used the hospital IBD team (82.3%), official leaflets (59.5%), and official websites (53.5%) most frequently in contrast to alternative health websites (9%). University education (P < 0.001), use of immunosuppressants (P = 0.025), Crohn's and Colitis UK membership (P = 0.001), frequent use of the hospital IBD team (P = 0.032), and frequent use of official information websites (P = 0.005) were associated with higher disease‐related patient knowledge. Female sex (P = 0.004), clinically active disease (P < 0.001), frequent use of general practitioners (P = 0.014), alternative health websites (homoeopathy, nutritionists, etc.) (P = 0.004) and random links (P = 0.016) were independently associated with higher anxiety. Conclusions Different patient information sources are associated with better knowledge or worse anxiety levels. Face‐to‐face education and written information materials remain the first line of patient education. Patients should be guided towards official information websites and warned about the association between the use of alternative health websites or random links and anxiety.
Sonography provides dynamic high-resolution imaging for the diagnosis and grading of injuries to the pectoralis muscles.
A B S T R A C TRecent evidence suggests that sleep problems are associated with psychotic like experiences including paranoia. However, the mechanisms underpinning this association are not well understood and thus studies modelling hypothesised mediating factors are required. Alexithymia, the inability to recognise and describe emotions within the self may be an important candidate. In two separate studies we sought to investigate factors mediating the relationship between sleep quality and paranoia using a cross-sectional design. Healthy volunteers without a mental health diagnosis were recruited (study 1, N = 401, study 2, N = 402). Participants completed a series of measures assessing paranoia, negative emotions, alexithymia and perceptual anomalies in an online survey. In study 1, regression and mediation analyses showed that the relationship between sleep quality and paranoia was partially mediated by alexithymia, perceptual anomalies and negative affect. In contrast, study 2 found that the relationship between sleep quality and paranoia was fully mediated by negative affect, alexithymia and perceptual anomalies. The link between sleep quality and paranoia is unclear and reasons for discrepant results are discussed. Novel findings in this study include the link between alexithymia and paranoia.
Study objectives: To examine the role of sleep reactivity as a predictor of insomnia in patients diagnosed with breast cancer.Methods: One hundred and seventy three women with breast cancer participated and were followed up over a period of 9 months. At baseline participants were assigned to a high (n=114) or low (n=59) sleep reactivity group, based on their responses to the Ford Insomnia Response to Stress Test (FIRST). We assessed whether these FIRST groupings (high / low sleep reactivity) predicted changes in insomnia over time using the Insomnia Severity Index (ISI). We also tested if these FIRST groupings predicted insomnia disorder (using ISI index cut-offs) at three different time points (T3, T6 and T9).Results: Individuals with high sleep reactivity were more likely to experience a worsening of insomnia.Using logistic regression we also found that FIRST grouping predicted insomnia disorder. Results remained significant after controlling for estimated pre-morbid sleep, age and whether someone had chemotherapy.Conclusions: Our study shows that sleep reactivity may be a robust predictor of insomnia within breast cancer populations. Sleep reactivity should be considered in routine clinical assessments as a reliable way to identify patients at risk of developing insomnia. This would facilitate early sleep intervention for those patients who are considered high risk.
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