Search

Circadian dysregulation causes sleep disturbance and impacts quality of life and functioning. Some interventions target circadian entrainment through modifying light exposure, but existing reviews of light interventions for sleep improvement include few studies in psychiatric populations. We examined effect of light interventions on sleep quality, duration and timing, and effect moderators. We included controlled studies in intrinsic circadian rhythm disorders (such as advanced or delayed sleep) and in neuropsychiatric disorders with assumed high prevalence of circadian dysregulation (such as affective and psychotic disorders). Articles were identified through database searching: 40 studies reporting 49 relevant intervention comparisons met inclusion criteria. Meta-analysis showed improvements in sleep continuity (ES = -0.23, p = 0.000), self-reported sleep disturbance (ES = -0.32, p = 0.014), and advancement of delayed sleep timing (ES = -0.34, p = 0.010). Although the small number of studies limited meta-regression, evening light avoidance was associated with greater increase in total sleep time. Effects of light on sleep and circadian outcomes have received limited attention in studies in psychiatric disorders, but results were promising in these groups. These findings invite further refinement and testing of light interventions to improve sleep in psychiatric disorders, with improved assessment and specification of problems, and the development and implementation of light schedule interventions for delayed sleep. [ABSTRACT FROM AUTHOR]

Abstract: Intervening to shorten the pre-psychotic and pre-treatment phases has been attractive as a possible way to improve long-term outcome. Several types of prodrome to schizophrenia have been identified and there is evidence that treating them prevents transition to psychosis during medium-term follow-up. These experimental treatments include antipsychotics and cognitive-behavioural therapy (CBT). New services to treat psychosis earlier and more effectively have been springing up, though evidence for their relative benefits is not yet unequivocal. They rely on characteristic antipsychotic regimes and psychosocial interventions. [Copyright &y& Elsevier]

Schizophrenia is associated with a more than doubled risk of death from cardiovascular disease (CVD). Risk factors for CVD include low levels of physical activity, sedentary behaviour and sleep problems. These risk factors are not systematically assessed by health services. Examine the feasibility, acceptability, validity and reliability of tools measuring physical activity, sedentary behaviour and sleep. Thirty participants with schizophrenia measured their physical activity, sedentary behaviour and sleep by wearing ActiGraph wGT3X-BT accelerometers on their wrist and waist, and recorded their sleep using the SleepBot smartphone app for 7 days. After 7 days they completed the 5-item Simple Physical Activity Questionnaire (SIMPAQ) to retrospectively measure their physical activity and sedentary behaviour over the study period. Concurrent SIMPAQ and SleepBot validity and inter-rater reliability were assessed against accelerometer-derived measures of physical activity, sedentary behaviour and sleep. A qualitative interview was conducted at the end of the study to assess acceptability. The tools were feasible: 93% of participants provided valid wear-time accelerometry data and 83% provided SleepBot data. The SIMPAQ showed moderate concurrent validity but poor agreement for moderate-vigorous physical activity (MVPA) and moderate validity and agreement as a measure of sedentary behaviour. The SleepBot app showed poor concurrent validity and agreement for measures of sleep. The qualitative interviews demonstrated the tools were acceptable. Monitoring physical activity, sedentary behaviour and sleep by accelerometry, smartphone and questionnaire was feasible and acceptable to people with schizophrenia. The SIMPAQ could be a valid and appropriate tool for routine clinical use. • Low physical activity, sedentary behaviour and sleep problems are common in schizophrenia • Measuring these lifestyle behaviours using accelerometry, a mobile phone app, and questionnaire is feasible and acceptable to people with schizophrenia • The Simple Physical Activity Questionnaire (SIMPAQ) may provide a valid measure of moderate-vigorous physical activity and a valid and reliable measure of sedentary behaviour • The SleepBot app did not demonstrate validity or agreement as a measure of sleep problems [ABSTRACT FROM AUTHOR]

We used UK CUtLASS RCT data to establish that patients’ rating of mental health improvement (baseline to week 12) correlated significantly with percentage symptom improvement (PANSS). In a regression analysis predictors of the patient’s week 12 mental health rating were percentage change in positive symptoms (PANSS), DAI score and the patient's rating of side effects. Patients in an RCT were able to subjectively rate their mental health status, validated by objective improvement on the PANSS. [ABSTRACT FROM AUTHOR]

Dysfunctional metacognitive beliefs are common among people with psychosis. In this meta-analysis we examined whether these are also present in people meeting at-risk mental state (ARMS) criteria. We also explored the relationship between metacognitive beliefs and symptoms in the ARMS group. An electronic database search of Ovid MEDLINE, PsycINFO and Embase from inception until August 2016 was conducted using keyword search terms synonymous with ARMS and metacognition. Eligible studies were original research articles that examined metacognitive beliefs using the Metacognitions Questionnaire (MCQ) among people meeting ARMS criteria. Studies included in the meta-analyses also reported comparison MCQ data acquired from healthy controls, help-seeking individuals, or people with psychotic disorders. Eleven eligible studies were identified, reporting data from six unique ARMS samples. People with ARMS did not differ from those with established psychotic disorders on any MCQ subscale, but they reported significantly more dysfunctional metacognitive beliefs than healthy or help-seeking controls. Maladaptive metacognitive beliefs were associated with a range of symptoms in ARMS individuals, but evidence for associations with specific subthreshold psychotic phenomena was inconsistent. This evidence indicates how valuable assessment and treatment of dysfunctional metacognitive beliefs may be but suggests that specific aspects of methodology should be addressed. [ABSTRACT FROM AUTHOR]