Sleep habits and sleep problems associated with depressive symptoms in school-age children.

PROBLEM: Sleep disturbance is a characteristic symptom of depression, but it is also a problem in itself related to the severity of this illness. Hence, the objective of this study was to examine sleep habits and sleep problems associated with increased depressive symptoms in children. METHODS: The sample included 524 children equally distributed by gender (51.1% female), with an average age of 10.29 (SD = 1.34) years. The administered instruments were the Children's Depression Inventory (CDI; Cronbach α = 0.82) and a Sleep Habits and Sleep Problems Questionnaire (α = 0.91). FINDINGS: The mean score for the CDI was 12.51 (SD = 6.74) and 20% presented symptoms of depression. The linear regression model showed that sleep habits associated with the increase in symptoms of depression were: little sleep, hours of sleep during the week, and wake-up time on weekdays. In the same model, the associated sleep problems were: nocturnal awakenings, nightmares, and difficulty waking up. The presence of these sleep habits and sleep problems increased the score from 2.07 to 13.50 points on the CDI scale. CONCLUSIONS: Depressive symptoms increase with the presence of sleep habits related to sleep deprivation and sleep problems related to parasomnias in school-age children.

Estructura del sueño y funciones ejecutivas en niños con depresión / Sleep architecture and executive functions in children with depression

Sleep disturbance is a common complaint in depression. However, objective data in relation to the architecture of sleep associated with depression in childhood have been inconsistent. The objective measurement of sleepiness and executive functions is little known in depressive children. The objective of this study was to determine the differences in the sleep architecture, daytime sleepiness and executive functions in children with and without depression. Method The participants were 20 children with an average of 10.5 (SD=1.5) years old; nine were girls. Ten met the diagnostic criteria for major depression and ten were control. There were no differences by sex and age between groups with and without depression (p>.05). The instruments were: Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL), the Children Depression Inventory, and the Battery of Executive Frontal Functions. Also, there were two consecutive nights of polysomnographic recording and Multiple Sleep Latency Test (MSLT). Results No differences were found in the architecture of sleep, sleep efficiency was greater than 90% in both groups and the indexes of initiation and sleep maintenance did not show statistically significant differences. There were no differences in daytime sleepiness, sleep onset latency in the MSLT was 22.8 (SD=6.4) minutes for the group with depression and 23.7 (SD=4.1) for the control. The executive functions showed differences in tasks involving: visual-motor and impulse control, working memory and identification of the risk-benefit ratio. Conclusions The results suggest that prefrontal structures are more vulnerable to depression than the structures that regulate the circadian and homeostatic sleep.

La alteración del sueño es una queja común en la depresión. Sin embargo, los datos objetivos sobre las alteraciones en la estructura del sueño asociadas a la depresión infantil han sido inconsistentes. Por otro lado, el estudio objetivo de la somnolencia y las funciones ejecutivas en niños con depresión es poco conocida. El objetivo fue conocer si existen diferencias en la estructura del sueño, la somnolencia diurna y las funciones ejecutivas en niños con y sin depresión. Método Participaron 20 niños con promedio de 10.5 (DE=1.5) años de edad, de los cuales 45% fueron niñas. Diez cumplieron los criterios diagnósticos de depresión mayor y 10 fueron controles. No hubo diferencias por sexo y edad entre los grupos (p>.05). Los instrumentos fueron: La entrevista Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL), el Inventario de Depresión Infantil, y la Batería de Funciones Frontales y Ejecutivas. Asimismo, se realizaron dos noches consecutivas de registro polisomnográfico y la Prueba de Latencias Múltiples a Sueño (PLMS). Resultados No se encontraron diferencias en la estructura del sueño, la eficiencia del sueño fue mayor al 90% en ambos grupos y no hubo diferencias en los índices de inicio y continuidad del sueño, así como en las diferentes etapas de sueño. Tampoco se obtuvieron diferencias en la somnolencia diurna, la latencia al inicio de sueño en la PLMS fue de 22.8 (DE=6.4) minutos para el grupo con depresión y 23.7 (DE=4.1) para el control. Las funciones ejecutivas mostraron diferencias en tareas que implican: control visomotor y de impulsos, memoria de trabajo e identificación de la relación riesgo-beneficio. Conclusiones Los resultados sugieren que las estructuras prefrontales son más vulnerables a la depresión que las estructuras que regulan el ritmo circadiano y homeostático del sueño.

Técnicas psicoterapéuticas para proteger la confidencialidad y la responsabilidad legal: implicaciones del Biofeedback y Eeasp en el contexto jurídico / Psychotherapeutic techniques to protect the conidentiality and legalliability: implications of Biofeedback and Eeasp on the legal context

El Biofeedback a través del manejo de la temperatura periférica y la Escritura Emocional Autoreflexiva con Solución Propuesta (EEASP) son técnicas psicoterapéuticas que dan respuesta a las discusiones éticas jurídicas sobre la confidencialidad. El objetivo de la investigación fue conocer si existen diferencias en la temperatura periférica. La muestra fue de 42 adultos con un promedio de edad de 32.9 años, siendo 32 hombres y 10 mujeres, 16 fueron estudiantes y 26 trabajadores, quienes reportaron estar sometidos a niveles elevados de estrés. Los resultados mostraron un aumento estadísticamente significativo (t = 6.35, p = 0.001) del promedio de la temperatura (89.68 °F). Los resultados confirman que el Biofeedback y la EEASP son técnicas que tienen un impacto positivo sobre los procesos psicofisiológicos de los participantes y que pueden ser usadas sin violar la confidencialidad así como exonerar de responsabilidades legales.

The Biofeedback through peripheral temperature and emotional self-reflective writing with Solution Proposal (EEASP), are psychotherapeutic techniques in response to legal ethical discussions about confidentiality. The objective of this research was to determine whether there are differences in Peripheral temperature. The sample included 42 adults with mean age of 32.9 (± 9.0) years, 10 were female and 32 male, 16 were students and 26 workers who reported being subjected to high levels of stress. The results showed a significantly increase (t = 6.35, p = 0.001) of the average temperature (89.68 °F). The results confirm that the Biofeedback and EEASP are techniques that have a positive impact on psychophysiological processes of the participants and can be used without violating the confidentiality and exonerate from legal liability.