Self-reported sleep quality, strain and health in relation to perceived working conditions in females The aims of this study were to examine self-reported sleep quality, perceived strain and health in relation to working conditions; the prevalence and severity of sleep disturbances and daytime distress arising from poor sleep in women on different work shifts. Furthermore, to see whether females with gastrointestinal symptoms, joint-, back- or muscle-pain and who are dissatisfied with working hours differ with regard to the above aspects. Finally, degree of strain-related symptoms and sleep difficulties were tested as predictors of sleep quality and general health outcome. Important research questions are whether registered nurses and those on rotating work shifts have greater sleep problems than others. A total of 156 females, aged 20-59 years, working at three different casualty departments, answered structured questionnaires. The results showed a persistently high rate of psycho-physiological long-term effects of stress related to working conditions. Thirty-four per cent were dissatisfied with their working hours, and exhibited significantly more mental strain, fatigue/excessive tiredness and inability to relax after work because of involuntary thoughts, in relation to working conditions than others did. Sixty-two females (39.7%) complained of insufficient sleep. The sleep quality outcome was significantly predicted by difficulty falling asleep (odds ratio 8.4), difficulty in falling asleep after nocturnal awakening (odds ratio 3.4) and perceived exhaustion (odds ratio 2.6). Females suffering from gastrointestinal symptoms and joint-, back- and muscle symptoms for several days in a week or even everyday were especially sensitive to worse sleep quality. Independent of work shifts, registered nurses exhibited a higher degree of mental strain and prolonged recovery in comparison with others. In conclusions, sleep initiation difficulties, troubled sleep and exhaustion significantly predicted reduced sleep quality outcome with decreased resilience to stress and vulnerability to psycho-physiological disorders in females working within the health care system.
BackgroundAccumulating evidence suggests that the brain's nitric oxide (NO) signalling system may be involved in the pathophysiology of schizophrenia and could thus constitute a novel treatment target. The study was designed to investigate the benefit of L-lysine, an amino acid that interferes with NO production, as an add-on treatment for schizophrenia.MethodsL-lysine, 6 g/day, was administered to 10 patients with schizophrenia as an adjunctive to their conventional antipsychotic medication. The study was designed as a single-blinded, cross-over study where patients were randomly assigned to initial treatment with either L-lysine or placebo and screened at baseline, after four weeks when treatment was crossed over, and after eight weeks.ResultsL-lysine treatment caused a significant increase in blood concentration of L-lysine and was well tolerated. A significant decrease in positive symptom severity, measured by the Positive And Negative Syndrome Scale (PANSS), was detected. A certain decrease in score was also observed during placebo treatment and the effects on PANSS could not unequivocally be assigned to the L-lysine treatment. Furthermore, performance on the Wisconsin Card Sorting Test was significantly improved compared to baseline, an effect probably biased by training. Subjective reports from three of the patients indicated decreased symptom severity and enhanced cognitive functioning.ConclusionsFour-week L-lysine treatment of 6 g/day caused a significant increase in blood concentration of L-lysine that was well tolerated. Patients showed a significant decrease in positive symptoms as assessed by PANSS in addition to self-reported symptom improvement by three patients. The NO-signalling pathway is an interesting, potentially new treatment target for schizophrenia; however, the effects of L-lysine need further evaluation to decide the amino acid's potentially beneficial effects on symptom severity in schizophrenia.Trial registrationNCT00996242
Electrodermal activity was registered during examination with the Defense Mechanism Test of 21 patients diagnosed with anxiety disorder, affective disorder, or schizophrenic disorder. The test can be interpreted as a model situation of how a person defends himself against a threat to avoid anxiety. We used Andersson's modified version of the test and tested the hypothesis that electrodermal activity should increase when there were responses categorised as Anxiety and decrease when there were responses categorised as defences or when the threat was correctly identified. We found significant increase in all electrodermal variables in connection with responses categorised as Anxiety. After exposures with responses categorised as Isolation, the maximal skin conductance level and the magnitude of late nonspecific responses were significantly decreased. After exposures when the threat was identified and thus no longer subliminal, the electrodermal activity was significantly decreased. All these findings support our hypothesis. After exposures with significantly decreased. All these findings support our hypothesis. After exposures with responses categorised as Denial all electrodermal variables were significantly increased. Similarly in responses categorised as Repression, Introaggression, and Disavowal or denial of hero's sex the frequency of late nonspecific responses were significantly increased. The increased electrodermal activity could be due to insufficient defence strategies as categorised in the Defense Mechanism Test.
In this sample consisting mainly of out-patients, there were few relationships between impairment in backward masking and high threshold values in DMTm. Their visual information processing was not as disturbed as expected. Most previous studies on both backward masking and the DMT in patients with schizophrenia have been conducted among in-patients, who could be expected to be more disturbed than the out-patients in the present study. The results of studies on in-patients with schizophrenia must not be generalized to include out-patients, and vice versa.
The aim was to study defence categories according to the modified version of the Defence Mechanism Test (DMTm) and to see if there was a relationship between DMTm and severity of illness. The material consists of 23 patients with panic disorder according to DSM-III-R who participated in a long-term follow-up of two clinical trials. The most common defence categories were repression, denial, disavowal or denial of the threat relation or of the identity of the peripheral person. The patients with denial or polymorphous identification had more severe symptoms and the latter group also were more handicapped by their symptoms. Denial and disavowal or denial of the threat relation may be defence categories, which are not so effective in preventing the individual from experiencing anxiety. Polymorphous identification, although not so common, does not seem to be an appropriate defence among patients with panic disorder.
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