Sleep quality impairments in schizophrenia and bipolar affective disorder patients continue during periods of remission: a case-controlled study.

Objective: Bipolar disorder (BD) and schizophrenia are chronic psychiatric disorders in which sleep disorders are commonly seen. In mental disorders, residual symptoms may persist even if symptoms are greatly reduced overall. The aim of this study was to compare the sleep quality of schizophrenia and BD patients in remission with that of healthy controls. Methods: Forty-three patients with schizophrenia, 46 BD patients in remission for at least 3 months, and 51 healthy controls were included the study. The Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Young Mania Rating Scale (YMRS) and Pittsburgh Sleep Quality Index (PSQI) were administered to all participants and the Positive and Negative Syndrome Scale (PANSS) was administered to patients with schizophrenia. Results: Poor sleep quality was more frequent in the patient groups than the control group (p=0.009). PSQI score was positively correlated with duration of disease (r=0.236; p=0.026), number of cigarettes smoked per day (r=0.430; p<0.001), body mass index (r=0.189; p=0.025), and negatively correlated with duration of remission (r=-0.224; p=0.0359). Conclusion: Schizophrenia and BD patients in remission had worse sleep quality than a control group. Sleep quality was worst in the patients with schizophrenia. The severity of sleep disorder symptoms was positively associated with disease duration and negatively associated with duration of remission. Schizophrenia and BD patients should be carefully evaluated for symptoms of sleep disorders even when they are in clinical remission and should be offered additional treatment for sleep disorder symptoms when necessary.

Comorbid Anxiety Increases Suicidal Risk in Bipolar Depression: Analysis of 9720 Adolescent Inpatients.

OBJECTIVE: To evaluate the risk of association between suicidal behaviors and comorbid anxiety disorders in adolescents with bipolar depression. METHODS: We conducted a cross-sectional study using the nationwide inpatient sample (NIS) from the United States. This study included 9720 adolescent inpatients with bipolar depression and further grouped by co-diagnosis of anxiety disorders. Logistic regression analysis was used to evaluate the odds ratio (OR) of suicidal behaviors due to comorbid anxiety after controlling demographic confounders and psychiatric comorbidities. RESULTS: Out of total inpatients, 34.8% (n = 3385) had comorbid anxiety disorders with a predominance in females (70.3%) and White patients (67.7%). About 54.1% of inpatients with comorbid anxiety had suicidal behaviors versus 44.6% in the non-anxiety cohort (p < 0.001). Comorbid anxiety disorders were associated with 1.35 times higher odds (95% CI 1.23-1.47, p < 0.001) for suicidal behaviors. CONCLUSION: Suicidal behaviors are significantly prevalent in bipolar depression adolescents with comorbid anxiety disorders. Anxiety disorders are an independent risk factor in bipolar depression that increase the risk of suicidal behaviors by 35%. This necessitates careful assessment and management of comorbid anxiety disorders in bipolar youth to mitigate suicidality.

Late-onset polyglucosan body myopathy in five patients with a homozygous mutation in GYG1.

Five Sardinian patients presented in their 5th or 6th decade with progressive limb girdle muscle weakness but their muscle biopsies showed vacuolar myopathy. The more or less abundant subsarcolemmal and intermyofibrillar vacuoles showed intense, partially α-amylase resistant, PAS-positive deposits consistent with polyglucosan. The recent description of late-onset polyglucosan myopathy has prompted us to find new genetic defects in the gene (GYG1) encoding glycogenin-1, the crucial primer enzyme of glycogen synthesis in muscle. We found a single homozygous intronic mutation harbored by five patients, who, except for two siblings, appear to be unrelated but all five live in central or south Sardinian villages.

Motor afferents from the cerebellum, zona incerta and substantia nigra to the mediodorsal thalamic nucleus in the rat.

The mediodorsal (MD) thalamic nucleus provides information from subcortical structures to the prefrontal cortex. The human MD thalamic nucleus has been implicated in a great variety of different clinical conditions and normal functions ranging from schizophrenia, Parkinsonism and epilepsy to many cognitive functions. In the rat the MD thalamic nucleus is divided into three cytoarchitectonic sectors whereas in the primates it is divided into two; medial one-third (magnocellular) and lateral two-thirds further the lateral sector is divided into pars parvocellularis pars multiformis, pars fasciculosa and pars caudalis. In this study we used a retrograde tracer, fluoro-gold (FG) to evaluate some of the afferents reaching the lateral sector of the MD (MDl) thalamic nucleus. The results of the present study have shown that MDl receives afferent connections from the lateral cerebellar nucleus (dentate nucleus), substantia nigra pars reticulata (SNR) and zona incerta (ZI). Subsequent to FG injections into the MDl, labeled cells were observed mainly bilaterally but were sparser on the contralateral side than ipsilaterally from each of the three structures listed. All three afferents showed a topographical organization. The labeled neurons were localized at the dorsomedial aspect of the lateral cerebellar nucleus, the dorsoventral aspect of the SNR and in the dorsal sector of the ZI. The lateral cerebellar nucleus reached the MDl via the superior cerebellar peduncle. No other deep cerebellar nuclei showed labeled cells. There were no labeled cells in the substantia nigra pars compacta (SNC). Although the three regions identified here are recognized as having motor functions, the connections to MD suggest that their outputs also play a role in cognitive or other higher cortical functions.