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Can sleep disturbance be a cue of mood spectrum comorbidity? A preliminary study in panic disorder

Published online by Cambridge University Press:  11 April 2019

Mario Miniati ,
Laura Palagini Open the ORCID record for Laura Palagini [Opens in a new window] ,
Alessandra Maglio ,
Donatella Marazziti  and
Liliana Dell’Osso
Mario Miniati
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Laura Palagini*
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Alessandra Maglio
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Donatella Marazziti
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
Liliana Dell’Osso
Affiliation:
Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
*
*Address correspondence to: Laura Palagini, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100, Pisa, Italy. (Email: [email protected])
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Abstract

Objective.

To investigate if sleep disturbances may affect treatment outcomes of patients with panic disorder (PD).

Methods.

Eighty-five PD outpatients with no Axis I comorbidity for mood disorders completed a baseline assessment (T1) and were evaluated after 3 (T2), 6 (T3) and 12 months (T4), with the Panic Disorder Severity Scale (PDSS) total score as outcome measure during a 12-month naturalistic follow-up. Patients were assessed with the Mood Spectrum Self-Report (MOODS-SR, Lifetime Version), and the PDSS.

Results.

Forty-three patients (50.5%) met criteria for remission (PDSS<5) and 42 (49.5%) for no remission. In a logistic regression model with remission as the dependent variable, MOODS-SR sleep disturbances was the only determinant for a lower likelihood of PD remission. The items accounting for this result were the following: Repeated difficulty falling asleep (chi-square = 4.4; df = 1; p = 0.036), and Repeatedly waking up in the middle of the night (chi-square = 5.2; df = 1; p = 0.022).

Conclusion.

Lifetime sleep disturbances would represent a cue of mood spectrum (in absence of overt affective comorbidity) that may impair remission in PD.

Keywords

Mood spectrumpanic disordersleep disturbancestreatment outcomecomorbidity
Type
Original Research
Information
CNS Spectrums , Volume 25 , Issue 1 , February 2020 , pp. 32 - 37
Copyright
© Cambridge University Press 2019

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References

References:

Cavicchioli, FL, Maes, M, Roomruangwong, C, et al.Associations between severity of anxiety and clinical and biological features of major affective disorders. Psychiatry Res. 2018; 260: 17–23.Google Scholar
Troxel, WM, Kupfer, DJ, Reynolds, CF, et al.Insomnia and objectively measured sleep disturbances predict treatment outcome in depressed patients treated with psychotherapy or psychotherapy-pharmacotherapy combinations. J Clin Psychiatry. 2012;73: 478–485.Google Scholar
Harvey, AG.A transdiagnostic approach to treating sleep disturbance in psychiatric disorders. Cogn Behav Ther. 2009; 38: 35–42.Google Scholar
Baglioni, C, Battagliese, G, Feige, B, et al.Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. J Affect Disord. 2011; 135: 10–19.Google Scholar
Baglioni, C, Riemann, D.Is chronic insomnia a precursor to major depression? Epidemiological and biological findings. Curr Psychiatry Rep. 2012; 14: 511–518.Google Scholar
Sivertsen, B, Salo, P, Mykletun, A, et al.The bidirectional association between depression and insomnia: the HUNT study. Psychosom Med. 2012; 74: 758–765.Google Scholar
Nakamura, M, Sugiura, T, Nishida, S, et al.Is nocturnal panic a distinct disease category? Comparison of clinical characteristics among patients with primary nocturnal panic, daytime panic, and coexistence of nocturnal and daytime panic. J Clin Sleep Med. 2013; 9(5): 461–467.Google Scholar
Abad, VC, Guilleminault, C.Sleep and psychiatry. Dialogues Clin Neurosci. 2005; 7(4): 291–303.Google Scholar
Mellman, TA, Uhde, TW.Patients with frequent sleep panic: clinical findings and response to medication treatment. J Clin Psychiatry. 1990; 51(12): 513–516.Google Scholar
Ferini-Strambi, L, Bellodi, L, Oldani, A,et al.Cyclic alternating pattern of sleep electroencephalogram in patients with panic disorder. Biol Psychiatry. 1996; 40(3): 225–227.Google Scholar
Cervena, K, Matousek, M, Prasko, J,et al.Sleep disturbances in patients treated for panic disorder. Sleep Med. 2005; 6(2): 149–153.Google Scholar
Cousineau, H, Marchand, A, Bouchard, S, et al.Insomnia symptoms following treatment for comorbid panic disorder with agoraphobia and generalized anxiety disorder. J Nerv Ment Dis. 2016; 204(4): 267–273.Google Scholar
Cassano, GB, Dell’Osso, L, Frank, E, et al.The bipolar spectrum: a clinical reality in search of diagnostic criteria and an assessment methodology. J Affect Disord. 1999; 54(3): 319–328.Google Scholar
Dolsen, MR, Asarnow, LD, Harvey, AG.Insomnia as a transdiagnostic process in psychiatric disorders. Curr Psychiatry Rep. 2014; 16(9): 471.Google Scholar
Savino, M, Perugi, G, Simonini, E, et al.Affective comorbidity in panic disorder: is there a bipolar connection? J Affect Disord. 1993; 28(3): 155–163.Google Scholar
Fagiolini, A, Frank, E, Rucci, P,et al.Mood and anxiety spectrum as a means to identify clinically relevant subtypes of bipolar I disorder. Bipolar Disord. 2007; 9(5): 462–467.Google Scholar
Miniati, M, Benvenuti, A, Bologna, E, et al.Mood spectrum comorbidity in patients with anorexia and bulimia nervosa. Eat Weight Disord. 2018Jun; 23(3): 305–311.Google Scholar
Dell’Osso, L, Armani, A, Rucci, P, et al.Measuring mood spectrum: comparison of interview (SCI-MOODS) and self-report (MOODS-SR) instruments. Compr Psychiatry. 2002 Jan–Feb; 43(1): 69–73.Google Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed., text rev. Washington, DC: American Psychiatric Press; 2000.Google Scholar
Shear, MK, Rucci, P, Williams, J, et al.Reliability and validity of the Panic Disorder Severity Scale: replication and extension. J Psychiatry Res. 2001 Sept–Oct; 35(5): 293–296.Google Scholar
American Psychiatric Association (APA). Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatry. 2000 Apr; 157(4 Suppl): 1–45.Google Scholar
National Institute for Health and Care Excellence (NICE). Generalized anxiety disorder and panic disorder in adults: management. Clinical Guideline [CG113]. 2011; 1: 34–35.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, et al.Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P) New York: Biometrics Research, New York State Psychiatric Institute; 2002.Google Scholar
Furukawa, TA, Shear, MK, Barlow, DH, et al.Evidence-based guidelines for interpretation of the Panic Disorder Severity Scale. Depress Anxiety. 2009; 26(10): 922–929.Google Scholar
Keough, ME, Porter, E, Kredlow, MA, et al.Anchoring the Panic Disorder Severity Scale. Assessment. 2012 Jun; 19(2): 257–259.Google Scholar
Boylan, KR, Bieling, PJ, Marriott, M, et al.Impact of comorbid anxiety disorders on outcome in a cohort of patients with bipolar disorder. J Clin Psychiatry. 2004; 65(8): 1106–1113.Google Scholar
Cyranowski, JM, Endicott, J, Fagiolini, A, et al.Influence of panic-agoraphobic spectrum symptoms on treatment response in patients with recurrent major depression. Am J Psychiatry. 2000; 157(7): 1101–1107.Google Scholar
Frank, E, Cyranowski, JM, Rucci, P, et al.Clinical significance of lifetime panic spectrum symptoms in the treatment of patients with bipolar I disorder. Arch Gen Psychiatry. 2002; 59(10): 905–911.Google Scholar
Shear, MK, Cassano, GB, Frank, E, et al.The panic-agoraphobic spectrum: development, description, and clinical significance. Psychiatr Clin North Am. 2002Dec; 25(4): 739–756.Google Scholar
Berrocal, C, Ruiz Moreno, M, Merchán, P, et al.The mood spectrum self-report: validation and adaptation into Spanish. Depress Anxiety. 2006; 23: 220–235.Google Scholar
Miniati, M, Rucci, P, Frank, E, et al.Sensitivity to change and predictive validity of the MOODS-SR questionnaire, last-month version. Psychother Psychosom. 2009; 78(2): 116–124.Google Scholar
Cassano, GB, Mula, M, Rucci, P, et al.The structure of lifetime manic-hypomanic spectrum. J Affect Disord. 2009; 112: 59–70.Google Scholar
Rucci, P, Nimgaonkar, VL, Mansour, H, et al.Gender moderates the relationship between mania spectrum and serotonin transporter polymorphisms in depression. Am J Med Genet B Neuropsychiatr Genet. 2009 Oct 5; 150B(7): 907–913.Google Scholar
Calugi, S, Cassano, GB, Litta, A, et al.Does psychomotor retardation define a clinically relevant phenotype of unipolar depression? J Affect Disord. 2011; 129: 296–300.Google Scholar
Ghouse, AA, Sanches, M, Zunta-Soares, GB,et al.Lifetime mood spectrum symptoms among bipolar patients and healthy controls: a cross sectional study with the Mood Spectrum Self-Report questionnaire. J Affect Disord. 2014; 166: 165–167.Google Scholar
Batterham, PJ, Glozier, N, Christensen, H.Sleep disturbance, personality and the onset of depression and anxiety: prospective cohort study. Aust N Z J Psychiatry. 2012 Nov; 46(11): 1089–1098.Google Scholar