Sleep patterns, depression, physical activity levels, fatigue, and mental toughness in patients with multiple sclerosis (MS) : results from cross-sectional, longitudinal and intervention studies

Worldwide, multiple sclerosis (MS) is the most common chronic autoimmune demyelinating and inflammatory disease of the central nervous system, with long term effects on both physical and mental functioning. Individuals with MS might suffer from various combinations of physical and mental issues such as physical weakness, spasticity, motor and sensory dysfunction, fatigue, depression, sleep complaints, pain, cognitive dysfunction, and psychosocial and behavioral problems; these symptoms limit the individual’s capacity to function and participate at social life. In this PhD dissertation, the candidate investigated the impact of physical activity (PA) programs on depression, fatigue, paresthesia, objective and subjective sleep and mental toughness in patients with multiple sclerosis. She could show that PA positively improved symptoms of depression, fatigue, and paresthesia. Further, after a PA intervention, patients’ sleep improved subjectively and objectively. Additionally, Mental toughness (MT) as a psychological construct describing the capacity of a person to be consistently successful in facing difficulties in life, remained unchanged. From a developmental point of view the author showed that MT is routed in childhood. More specifically, childhood characteristics such as higher prosocial behavior, more positive peer relationships, and lower internalizing and externalizing problems at age five, could predict higher mental toughness at the age of fourteen years. The candidate underscored that MT is rather a trait than state, and that MT remained stable after PA interventions. Finally, in a cross sectional and longitudinal study on the same sample recruited since disease onset, the author showed that patients with MS did not differ in their sleep patterns and PA levels, compared to healthy samples. Additionally, two years after disease onset, patients are still as physically active as at onset, with slight changes in the pattern of their activity: Vigorous PA decreased, moderate PA and walking increased. Further, sleep patterns remained stable within the first two years of the disease. The PhD candidate had seven published and one submitted papers related to her project. In four papers, she was the first author and in four papers she is co-author

Further Evidence of the Zero-Association Between Symptoms of Insomnia and Facial Emotion Recognition—Results From a Sample of Adults in Their Late 30s

Background: Restoring sleep is associated with favorable cognitive, emotional, and behavioral adaptations. As regards the association between sleep duration and facial emotion recognition (FER), results are conflicting, and as regards the association between symptoms of insomnia and FER, no study has been performed so far. Accordingly, the aim of the present study was to investigate whether subjective sleep was associated with FER, along with perceived stress and mental toughness.Method: A total of 201 police officers (mean age = 38.5 years, 64.2% males) took part in the present cross-sectional study. They completed questionnaires covering socio-demographic data, subjective symptoms of insomnia, perceived stress, and mental toughness. Further, they underwent a computerized FER test, consisting of facial emotion labeling and facial emotion matching.Results: Performance of FER (accuracy, speed) was unrelated to subjective symptoms of insomnia. Lower FER was associated with higher age, but not to perceived stress or mental toughness. No gender differences were observed. Higher symptoms of insomnia were associated with higher stress scores and lower scores of mental toughness.Conclusions: The pattern of results suggests that FER was not associated with symptoms of insomnia, understood as a proxy of sleep quality, among adults. This observation replicates those studies showing a zero-association between sleep and FER

A Review on the Expression Pattern of Non-coding RNAs in Patients With Schizophrenia: With a Special Focus on Peripheral Blood as a Source of Expression Analysis

Schizophrenia is a destructive neuropsychiatric disease with a median prevalence of 4.0 per 1,000 during the whole life. Genome-wide association studies have shown the role of copy number variants (generally deletions) and certain alleles of common single nucleotide polymorphisms in the pathogenesis of schizophrenia. This disorder predominantly follows the polygenic inheritance model. Schizophrenia has also been linked with various alterations in the transcript and protein content of the brain tissue. Recent studies indicate that alterations in non-coding RNAs (ncRNAs) signature underlie a proportion of this dysregulation. High throughput microarray investigations have demonstrated momentous alterations in the expression of long non-coding RNAs (lncRNA) and microRNAs (miRNAs) in the circulation or post-mortem brain tissues of patients with schizophrenia compared with control samples. While Gomafu, PINT, GAS5, TCONS_l2_00021339, IFNG-AS1, FAS-AS1, PVT1, and TUG1 are among down-regulated lncRNAs in schizophrenia, MEG3, THRIL, HOXA-AS2, Linc-ROR, SPRY4-IT1, UCA1, and MALAT1 have been up-regulated in these patients. Moreover, several miRNAs, such as miR-30e, miR-130b, hsa-miR-130b, miR-193a-3p, hsa-miR-193a-3p, hsa-miR-181b, hsa-miR-34a, hsa-miR-346, and hsa-miR-7 have been shown to be dysregulated in blood or brain samples of patients with schizophrenia. Dysregulation of these transcripts in schizophrenia not only provides insight into the pathogenic processes of this disorder, it also suggests these transcripts could serve as diagnostic markers for schizophrenia. In the present paper, we explore the changes in the expression of miRNAs and lncRNAs in patients with schizophrenia

Evaluation of Serum and Plasma Interleukin-6 Levels in Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression

Obstructive sleep apnea syndrome (OSAS) is considered a low-grade chronic inflammatory disease. Interleukin-6 (IL-6) is one of the most significant inflammatory markers and an excellent proxy for the inflammatory/immune system. The present meta-analysis and meta-regression aimed at comparing plasma and serum levels of IL-6 between individuals (children and adults) with OSAS and healthy controls. Four databases, PubMed/Medline, Scopus, Cochrane Library, and Web of Science, were comprehensively searched to retrieve articles published up to December, 2019, with no further restrictions. RevMan 5.3 software was used to calculate the crude mean difference (MD) and 95% confidence interval (CI). The results of funnel plots and meta-regression were analyzed by the CMA 2.0 software. Sixty-three studies (57 with adults; six with children) were included in the present meta-analysis. For adults, 37 studies reported significantly higher serum IL-6 levels and 20 reported significantly higher plasma IL-6 levels for those with OSAS than for healthy controls [pooled MD of 2.89 pg/ml (; P; < 0.00001) and pooled MD of 2.89 pg/ml (; P; < 0.00001), respectively]. The pooled analysis of serum and plasma IL-6 levels in children with OSAS compared with controls revealed that only the MD of plasma IL-6 levels was significant (MD = 0.84 pg/ml,; P; = 0.004). Results of the meta-regression showed that greater age was associated with higher serum IL-6 levels. Egger's test revealed a publication bias across the studies for serum and plasma IL-6 levels (; P; = 0.00044 and; P; = 0.01445, respectively). In summary, the meta-analysis and meta-regression confirmed that, compared to healthy controls, individuals with OSAS (children and adults) had higher serum/plasma IL-6 levels

Health Anxiety Predicts Postponing or Cancelling Routine Medical Health Care Appointments among Women in Perinatal Stage during the Covid-19 Lockdown

To avoid spreading the Corona Virus Disease 2019 (COVID-19), health authorities have forced people to reorganize their working and private lives and to avoid open and public spaces as much as possible. This has also been the case for women both during pregnancy and after delivery. Here, we investigated the associations between subjective beliefs in risk of infections and health anxiety, depression, stress, and other perinatal dimensions. To this end, we assessed 103 women (mean age: 28.57 years) during pregnancy and after delivery. They completed a series of questionnaires covering sociodemographic information, perinatal information, health anxiety, post-partum depression, and stress. Sixty-six participants (64.1%) were in the pre-partum stage, and 37 (35.9%) were post-partum. Health anxiety was unrelated to depression or stress. Knowing and being close to infected people was associated with higher health anxiety. Strict following of the safety recommendations was associated with greater health anxiety, depression, and stress. Postponing or cancelling routine medical check appointments was observed among participants with high health anxiety scores. Higher illness severity, overall health anxiety scores, and lower stress scores predicted those participants who postponed or cancelled their routine medical check appointments. Post-partum stage and a larger number of children were associated with higher stress scores, but not with depression or stress. The results are of practical and clinical importance; it appears that health anxiety, which is to say fear of getting infected with COVID-19 during pregnancy or at the post-partum stage, was associated with postponing or cancelling routine medical check appointments, but not with stress or depression

In Patients With Multiple Sclerosis, Both Objective and Subjective Sleep, Depression, Fatigue, and Paresthesia Improved After 3 Weeks of Regular Exercise

Background: Multiple sclerosis (MS) patients suffer from various difficulties including sleep complaints, symptoms of depression and fatigue, paresthesia, and cognitive impairments. There is growing evidence that regular physical activity has a positive effect on both sleep and psychological functioning, though there is limited evidence of this kind for MS patients. The aim of the present study was therefore to investigate the impact on this patient group of a regular exercise program with respect to subjective and objective sleep, depression, paresthesia, fatigue, and cognitive performance.Methods: A total of 46 patients [mean age: 50.74 years; Expanded Disability Status Scale (EDSS): mean: 5.3, 78.4% females] completed this 3-week intervention study. At baseline and 3 weeks later, they answered questionnaires covering sociodemographic information, subjective sleep, depression, fatigue, paresthesia, and subjective physical activity. Objective sleep [sleep electroencephalogram (EEG) recordings] and cognitive performance were also assessed at both time points. Patients participated in a regular exercise activity every weekday for about 60 min.Results: Compared to the baseline, by the end of the study, objective sleep had significantly improved (sleep efficiency, sleep onset latency, and wake time after sleep onset), and symptoms of sleep complaints, depression, fatigue, and paresthesia were significantly reduced. Subjective physical activity (moderate and vigorous) and cognitive performance also increased over the course of the intervention.Conclusions: In patients with MS, participation in regular exercise impacted positively on their objective and subjective sleep, depression, paresthesia, fatigue, and cognitive performance

Associations between morning salivary cortisol and blood cortisol in individuals with Obstructive Sleep Apnea Syndrome: A meta-analysis

Background: Obstructive sleep apnea syndrome (OSAS) may be associated with an increase in hypothalamic-pituitary-adrenocortical axis activity (HPA AA). We reviewed research comparing morning salivary and blood (serum and plasma) cortisol concentrations of individuals with OSAS to those of healthy controls. Methods: We made a systematic search without any restrictions of the PubMed/Medline, Scopus, Cochrane Library, and Web of Science databases for relevant articles published up to August 25, 2019. Results: Sixteen studies were analyzed in this meta-analysis; five studies compared morning salivary concentrations, five compared serum concentrations, four compared plasma cortisol concentrations, and two compared both salivary and plasma concentrations. In pediatric samples, compared to healthy controls, those with OSAS had significantly lower saliva morning cortisol concentrations (MD = -0.13 µg/dl; 95% CI: 0.21, -0.04; P = 0.003). In contrast, no significant differences were observed for serum cortisol concentrations, plasma cortisol concentrations, or salivary morning cortisol concentrations between adults with and without OSAS (p = 0.61, p = 0.17, p = 0.17). Conclusion: Cortisol concentrations did not differ between adults with OSAS and healthy controls. In contrast, morning salivary cortisol concentrations were lower in children with OSAS, compared to healthy controls. Given that a reduced HPA AA is observed among individuals with chronic stress, it is conceivable that children with OSAS are experiencing chronic psychophysiological stress

Examining the Effects of Mindfulness-Acceptance-Commitment Training on Self-Compassion and Grit among Elite Female Athletes

Background: Mindfulness-based interventions are well-established in the field of psychotherapy, and such interventions have also gained increased attention in the field of sport psychology, either to cope with psychological pressure or to improve an athlete’s performance. The goal of the present study was to examine whether a Mindfulness–Acceptance–Commitment (MAC) program could increase self-compassion and grit among elite female athletes compared to an active control condition. To this end, we performed a randomized trial among female adult athletes. Methods: Forty female adult athletes (M(age) = 22.22, SD = 2.40) were randomly assigned either to the Mindfulness–Acceptance–Commitment group (n = 20; 7 group sessions, 60 min each) or the active control group (n = 20; 7 group sessions, 60 min each). At baseline, seven weeks later at the end of the study and again four weeks later at follow-up, participants completed a series of self-rating questionnaires on mindfulness, self-compassion and grit. Results: Dimensions of mindfulness, self-compassion and grit improved over time, but more so in the Mindfulness–Acceptance–Commitment condition compared to the active control condition. Improvements remained stable from the study end to follow-up. Conclusions: While the active control condition improved dimensions of mindfulness, self-compassion and grit among female adult athletes, improvements were much stronger in the Mindfulness–Acceptance–Commitment condition. Importantly, improvements in the Mindfulness–Acceptance–Commitment condition remained stable over a time lapse of four weeks at follow-up after study completion, suggesting that the Mindfulness–Acceptance–Commitment intervention appeared to improve cognitive–emotional learning processes

Polymorphisms of ATP-binding cassette, sub-family A, member 4 (rs560426 and rs481931) and non-syndromic cleft lip/palate: A meta-analysis

Background: A number of genes are associated with the incidence of non-syndromic cleft lip/palate (NSCL/P). Studies have shown a significant association between polymorphisms of ATP-binding cassette, sub-family A, member 4 (ABCA4) with the risk of NSCL/P. The present meta-analysis assessed the association between ABCA4 polymorphisms (rs560426 and rs481931) and the NSCL/P risk by reviewing case-control studies. Methods: Four databases (Scopus; Cochrane Library; Web of Science; and PubMed) were searched for articles published up to June 2020. The Review Manager 5.3 software was used to calculate the crude odds ratio (OR) and 95% confidence interval (CI). Both subgroup analyses for ethnicity and source of controls and a meta-regression related to publication year were conducted. Results: Of 94 retrieved studies, 12 were analyzed in this meta-analysis (2859 NSCL/P patients and 3792 controls for ABCA4 rs560426 polymorphism and 1333 NSCL/P patients and 1884 controls for ABCA4 rs481931 polymorphism). Overall, there was no significant association between both polymorphisms and the risk of NSCL/P. However, subgroup analysis demonstrated that there was a higher risk of NSCL/P for specific models: the allelic model (OR = 1.13; p = 0.03), the homozygote model (OR = 1.53; p = 0.04), and the recessive model (OR = 1.30; p = 0.03) in the Asian ethnicity for the rs560426 polymorphism. Conclusion: The findings confirmed that the NSCL/P risk was significantly associated with the G allele and GG genotype of rs560426 polymorphism but not for rs481931 polymorphism. There were no associations between both polymorphisms (rs560426 and rs481931) and the NSCL/P risk in those of European descent and the mixed ethnicitie

A Mixed-Method Modified Delphi Study toward Identifying Key Elements of Psychotherapy in Iran

In Iran, psychotherapy is regarded as an effective treatment for psychiatric disorders. However, no previous research has identified the key elements of psychotherapy that may be specific to Iranian society. The current study was conducted in an attempt to identify these elements.; A mixed-method modified Delphi approach was used, taking place over several stages during 2017-2018. The first stage involved interviewing 12 experts in psychotherapy to identify key elements of psychotherapy in Iran by thematic analysis. Then, successive Delphi rounds were conducted to obtain consensus (75% agreement) from 70 psychotherapy experts on these key elements.; Key elements of psychotherapy were grouped into the following themes: (1) systematic education/training; (2) psychotherapist competency; (3) psychotherapy reflective of Iranian societal needs; and (4) the substrate (scientific/ethical principles) of psychotherapy. Consensus was reached during two Delphi rounds. In Delphi round 1, 52.8% of the statements reached consensus, and all remaining statements reached consensus in round 2.; The key elements of psychotherapy in Iran are a set of conditions for the education and training of competent psychotherapists who can perform psychiatric interventions appropriate to Iranian society under supervised rules. These should serve as a framework for improving the current delivery of psychotherapy in Iran