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20 results

  • Suicidal risk among adolescent psychiatric inpatients: the role of insomnia, depression, and social-personal factors

  • Valentina Baldini, Martina Gnazzo, Martina Maragno, Rebecca Biagetti, Camilla Stefanini, Francesco Canulli, Giorgia Varallo, Cristina Donati, Giovanni Neri, Andrea Fiorillo, Giuseppe Plazzi
  • Journal:
    European Psychiatry / Volume 68 / Issue 1 / 2025
    Published online by Cambridge University Press:
    28 February 2025, e42
    • Article
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  • Background

    Adolescents with psychiatric disorders are at increased risk of suicide, with insomnia, depression, and social-personal factors playing pivotal roles. This study investigates the interplay between these factors in a sample of adolescent psychiatric inpatients in Italy, with a particular focus on their association with suicide attempts.

    Methods

    We conducted a cross-sectional study on 95 adolescent inpatients (54 suicide attempters, 41 non-attempters) to explore their sociodemographic and clinical variables, including insomnia, depression, and social-personal factors as history of bullying. Logistic regression analyses and Pearson’s correlations were used to identify significant predictors of suicide attempts and their interrelations.

    Results

    Suicide attempters were predominantly female (90% vs. 75%, p = 0.04) and more likely to have a family psychiatric history (83% vs. 63%, p = 0.04), a history of bullying (26% vs. 9%, p = 0.01), and insomnia (79% vs. 53%, p = 0.01). Depression was strongly associated with suicide attempts (96% vs. 70%, p = 0.01), while physically active adolescents were significantly less likely to attempt suicide (27% vs. 53%, p = 0.01). Insomnia and depression were highly correlated (r = 0.94, p = 0.02), emphasizing the critical role of the former in emotional dysregulation. Behavioral factors, such as physical inactivity and bullying, emerged as additional key contributors to suicidal behavior.

    Conclusion

    This study highlights the multifaceted nature of suicide risk in adolescent psychiatric inpatients, with sleep disturbances, depression, and behavioral factors playing central roles. These findings underscore the need for integrated interventions targeting sleep, emotional regulation, and behavioral vulnerabilities to mitigate suicide risk.

  • Chapter 34 - Genetics of autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE)

  • from Section 9 - Psychiatricand medical disorders
  • Edited by Paul Shaw, Mehdi Tafti, Michael J. Thorpy
  • Book:
    The Genetic Basis of Sleep and Sleep Disorders
    Published online:
    05 November 2013
    Print publication:
    24 October 2013, pp 365-374

  • Summary

    Nocturnal frontal lobe epilepsy (NFLE) displays a strong familial trait for parasomnias. NFLE is often misdiagnosed as an arousal disorder, especially in children, or, commonly, as various parasomnias and psychiatric disorders, including non-rapid eye movement (NREM) arousal disorders and conversion disorders. NFLE patients show a strong positive family history for epilepsy, up to one-fourth of patients in a big series had an affected relative. In summary, autosomal dominant NFLE (ADNFLE) is a genetic heterogeneous epileptic syndrome that can be incidental to different mutations in different genes. Given the high intra-familial variability and the overlapping features of the clinical manifestations, ADNFLE patients do not seem to show a clear distinction from sporadic NFLE cases, except for some specific mutations. The mechanisms whereby mutations cause ADNFLE are still poorly understood, and new insights in the pathophysiology of the disease are needed.

The Parasomnias and Other Sleep-Related Movement Disorders
  • Edited by Michael J. Thorpy, Giuseppe Plazzi
  • Published online:
    10 November 2010
    Print publication:
    10 June 2010
  • The first authoritative review on the parasomnias - disorders that cause abnormal behavior during sleep - this book contains many topics never before covered in detail. The behaviors associated with parasomnias may lead to injury of the patient or bed-partner, and may have forensic implications. These phenomena are common but often unrecognized, misdiagnosed, or ignored in clinical practice. With increasing awareness of abnormal behaviors in sleep, the book fulfils the need for in-depth descriptions of clinical and research aspects of these disorders, including differential diagnosis, pathophysiology, morbidity, and functional consequences of each condition, where known. Appropriate behavioral and pharmacological treatments are addressed in detail. There are authoritative sections on disorders of arousal, parasomnias usually associated with REM sleep, sleep-related movement disorders and other variants, and therapy of parasomnias. Sleep specialists, neurologists, psychiatrists, psychologists and other healthcare professionals with an interest in sleep disorders will find this book essential reading.

  • Chapter 27 - Propriospinal myoclonus

  • from Section 5 - Sleep-related movement disorders and other variants
  • Edited by Michael J. Thorpy, Giuseppe Plazzi, Università di Bologna
  • Book:
    The Parasomnias and Other Sleep-Related Movement Disorders
    Published online:
    10 November 2010
    Print publication:
    10 June 2010, pp 261-269

  • Summary

    This chapter presents the history, clinical findings, pathology, differential diagnosis and management of propriospinal myoclonus. Propriospinal myoclonus at sleep onset consists of sudden axial jerks arousing during drowsiness preceding falling asleep and during intra-sleep relaxed wakefulness and upon awakening in the morning. The jerks may be variable in frequency, recurring in clusters separated by long gaps of time or quasi-periodically every 10-20 sec during transition from wakefulness to sleep. For patients with suspected propriospinal myoclonus, multiple muscle EMGs from cranial, axial and limb muscles are essentials at polysomnographic investigation. According to the evidence available, propriospinal myoclonus at sleep onset must originate at the spinal level, but it must be set into motion by neurophysiological mechanisms specific to the transitional period between wake and sleep. Propriospinal myoclonus at wake-sleep transitions remains idiopathic condition, often lifelong one, in which no structural abnormality of the brain or spinal cord has been demonstrated.

  • Chapter 19 - Catathrenia (sleep-related groaning)

  • from Section 4 - Other parasomnias
  • Edited by Michael J. Thorpy, Giuseppe Plazzi, Università di Bologna
  • Book:
    The Parasomnias and Other Sleep-Related Movement Disorders
    Published online:
    10 November 2010
    Print publication:
    10 June 2010, pp 184-193

  • Summary

    Four patients had a positive personal history for parasomnias and two- a positive family history. Personal history was positive for parasomnias in two patients. Family history was positive for parasomnias in two patients, for nocturnal groaning in one patient, and for sudden infant death syndrome in one patient. Eight patients were reporting a family history positive for parasomnias and three for nocturnal groaning. Catathrenia is associated with a positive personal or familial history for other parasomnias. There is no drug medication available for catathrenia. Empirical pharmacological treatments with dosulepine, trazodone, clonazepam, paroxetine, carbamazepine, gabapentin, and pramipexole have been unsuccessful or refused. The efficacy of the nCPAP ventilation is still debated. In particular, nCPAP treatment seems effective only when noisy breathing during sleep, diagnosed as catathrenia, is related to the co-existence of expiratory and inspiratory flow limitation with obstructive apneas or hypopneas and consequent intermittent hypoxia.