ECT is associated with a significant reduction of symptoms of PTSD and MDD, as well as reduction in risk of suicidality, cardiovascular, and all-cause mortality in MDD and PTSD, an effect more robust than antidepressant-therapy alone.
Anxiety and its disorders cause distress that interferes with sleep and wakefulness. Insomnia appears to be the most common sleep disturbance associated with anxiety disorders. Nocturnal enuresis and sleep terrors tend to be more common in childhood anxiety disorders, such as separation anxiety disorder and selective mutism. Poor sleep quality is seen in adults with anxiety disorders such as specific phobia, social phobia, panic disorder, and generalized anxiety disorder. Objective data obtained from polysomnograms support this claim in many instances. Nocturnal panic occurs frequently in patients with sleep apnea and may predispose to the development of panic disorder. Insomnia is a trait marker for depression, and may also be one for anxiety disorders. A thorough assessment of sleep difficulties should form an important part of the clinical evaluation of patients with anxiety symptoms.
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Psychiatr Ann
. 2016;46(7):396–400.]
PURPOSE: Positive Airway Pressure (PAP) therapy is the most common modality of treatment for obstructive sleep apnea (OSA) but adherence remains a significant problem. Personality traits may be some of the most important factors for non-adherence. Aim of this study to find the relationship between adherence and patient personality traits. METHODS: This was a cross sectional prospective clinical study. Patients were recruited during their visit in sleep clinic. Their personal characteristics, Polysomnography (PSG) results were collected from the electronic chart. Behavioral inhibition system/ behavioral activation system (BIS/BAS) scales, short measure of five factor model personality traits (mini-IPIP), Positive and Negative Affect Score (PANAS) tests were used for personality trait measurement. Data from the PAP device was obtained to measure adherence. Pearson correlation, T-test, Kruskal-Wallis test, Chi-square test or Fisher's exact test were used in the univariate analyses. Logistic regression was used in the multivariate analyses. RESULTS: A total 400 patients were recruited. 77 cases were excluded from the study due to incomplete data. Two patients withdrew from the study. As a result, 321 patients had all data for evaluation. Most of them (307) were male and only 14 were female. The mean age was 60.6 years with a standard deviation of 12.7. Among the 321 evaluated patients, 160 were classified as compliant. In the univariate analyses, older age (>65), profession, PAP type, side effect, efficiency and Behavioral Activation System Fun Seeking (BAS FS), BMI, Apnea-Hypopnea Index (AHI) were significantly associated with PAP adherence. A multivariate analysis revealed that profession, PAP type, efficiency, age, BAS FS are still significant predictors after adjusting for other covariates. A further analysis with total usage time and days without usage also showed significant association with adherence for Intellect Imagination and Negative Affect respectively by Pearson correlation.
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