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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This interview study investigated nonspecific psychological distress in the general population. A probability sample of 200 adults was drawn from heterogenous sex, class, and ethnic groups in New York City. Twenty-five scales were developed. Eight reflect a single dimension of nonspecific distress (eg, Poor Self-esteem, Sadness, and Perceived Physical Health) and 17 are distinct from these and from each other (eg, False Beliefs and Perceptions, Manic Characteristics, Insomnia, Antisocial History, and illness-linked Somatic Problems). Both sets of scales have become part of a new interview instrument, the Psychiatric Epidemiology Research Interview (PERI). Questions are raised about the nature of nonspecific distress in relation to Frank's construct of "demoralization," the value of the measured dimensions of psychopathology that contrast with it, and the relation of PERI, which uses a self-report format, to diagnostic interviews developed here and abroad.
Arch Gen Psychiatry 1980 Nov
PMID:Nonspecific psychological distress and other dimensions of psychopathology. Measures for use in the general population. 743 85

In a double-blind crossover study the beta-adrenergic blocking drug propranolol hydrochloride reduced symptoms in 17 of 26 patients with chronic anxiety disorders. Both somatic and psychic symptoms improved as judged by patient and observer ratings. The most frequent side effects (dizziness, fatigue, and insomnia) were difficult to distinguish from anxiety symptoms and were, for the most part, mild. The therapeutic and side effects observed suggested CNS activity of the drug. Although propranolol is of benefit to patients with anxiety, its efficacy, compared with that of other antianxiety drugs, has not been established.
Arch Gen Psychiatry 1980 Dec
PMID:Propranolol in chronic anxiety disorders. A controlled study. 744 18

Despite the vast literature on drug dependence, little has been written about patients who become addicted while taking medically prescribed drugs for organic pathology. Observations from a psychiatric consultation-liaison service reveal that these patients are frequently middle-aged with no history of drug abuse before the onset of a chronic medical condition. Associated with their medical condition is a dependence on narcotics and/or psychotropic medications for such complaints as pain, headache, insomnia, and anxiety. Thea addiction may persist for years without acknowledgement by a patient, doctor, or family, although there is usually a progressive constriction of social and occupational functioning. The primary physician is highly valued by the patient; this manifest appreciation trends to facilitate the primary physician's continued prescription of large doses of addicting drugs. Treatment involving detoxification typically goes through a series of stages, each of which has characteristic hazards and pitfalls that can lead to failure of treatment.
Gen Hosp Psychiatry 1980 Dec
PMID:Treatment of iatrogenic drug dependence in the general hospital. 746 45

Insomnia in elderly people has traditionally been regarded as inevitable and trivial. A longitudinal study was undertaken to examine the prevalence of sleep disturbance among elderly people in an inner London community and its association with demographic variables, depression, dementia and disability. Those aged 65 years and over living at home were interviewed using a validated and reliable semi-structured interview schedule. A total of 705 people were interviewed in 1987-88 and 524 were re-interviewed in 1990. Subjective sleep disturbance was found to be common (33% and 43%, respectively). Sleep disturbance was associated with being a woman, being unmarried, living alone, disability, and current and future depression, but not with dementia or older age. The best predictor of future depression in elderly people who were not depressed was current sleep disturbance. In the presence of current sleep disturbance, the traditional predictors of depression--being a woman, having a disability, being unmarried, living alone and being older--did not contribute further. This study has shown that sleep disorder is associated with pathology. Insomnia in elderly people requires assessment and this must be accompanied by the treatment of underlying disorders and monitoring of future health.
Br J Gen Pract 1993 Nov
PMID:Does sleep disturbance predict depression in elderly people? A study in inner London. 820 44

Delayed sleep phase syndrome (DSPS) is a common but little reported cause of severe insomnia. Affected individuals complain of difficulty falling asleep and difficulty awaking at socially acceptable hours. It results from a dysregulation of the circadian sleep-wake cycle. DSPS presents in clinically heterogenous ways as modulated by motivation, psychopathology, drug status, and treatment compliance factors. Patients respond variably to the range of possible treatments. Bright light treatment potentially corrects the circadian abnormality of DSPS. Other treatments reported to relieve some DSPS patients include schedule shifts, drugs, and vitamin and hormone treatments. The safety and efficacy of light treatment have not been conventionally defined, but available information suggests that it is ophthalmologically safe. At present, DSPS must be managed empirically by various methods.
Gen Hosp Psychiatry 1995 Sep
PMID:Treatment of delayed sleep phase syndrome. 852 48

Single photon emission tomography (SPET) permits the in vivo measurements of regional cerebral radioactivity in the human brain following the administration of compounds labeled with photon-emitting isotopes. According to our SPET findings of a reduced binding of [123I]labeled (S)-2-hydroxy-3-iodo-6-methoxy-([1-ethyl-2-pyrrolidinyl]methyl) benzamide (IBZM) (a highly selective CNS D2 dopamine receptor ligand) to D2 dopamine receptors in striatal structures in untreated patients with nocturnal myoclonus syndrome (NMS) it seemed to be of interest to investigate whether there are changes in D2 receptor binding under dopamine replacement therapy or not. We studied the uptake and distribution of [123I]IBZM before and in the course of dopamine replacement therapy in four patients with severe insomnia caused by a nocturnal myoclonus syndrome (NMS). We found an increase of the IBZM binding to D2 receptors in the course of treatment, which was associated with an improvement of sleep quality. Reasons for this are discussed. The [123I]IBZM SPET technique in conclusion offers an intersting tool for in vivo investigations of functional changes in the dopaminergic neurotransmitter system in longitudinal studies.
J Neural Transm Gen Sect 1995
PMID:Single photon emission tomography (SPET) imaging of dopamine D2 receptors in the course of dopamine replacement therapy in patients with nocturnal myoclonus syndrome (NMS). 857 4

Somatic symptoms often complicate the diagnosis and psychopharmacological treatment of depression in HIV illness. We treated 33 depressed HIV-positive men and women with medically symptomatic HIV or AIDS (CDC stages 2B, 2C, 3B, or 3C) in a 6 week open-label trial with sertraline, paroxetine, or fluoxetine, to assess their effectiveness and tolerability. We further assessed whether treatment of depression resulted in a reduction in both affective and somatic symptoms in this medically ill population. Twenty-four subjects (73%) completed the trial (7 on sertraline, 7 on paroxetine, 10 on fluoxetine), 20 (83%) of whom were clinical responders. Nine dropped out within 1-3 weeks of treatment because of adverse effects, mostly agitation, anxiety, and insomnia. Subjects who completed 6 weeks of SSRI treatment experienced significant reductions in both affective and somatic symptoms, many of the latter having been attributed to HIV rather than depression. These results suggest that, even in later stages of HIV illness, the contribution of depression to perceived somatic symptoms may be significant, and that these symptoms may improve with antidepressant treatment.
Gen Hosp Psychiatry 1997 Mar
PMID:Selective serotonin reuptake inhibitor treatment of depression in symptomatic HIV infection and AIDS. Improvements in affective and somatic symptoms. 909 63

The morbidity of sleep problems has been well documented; however, they are frequently associated with and are symptomatic of several psychiatric disorders. It is unclear how much of the morbidity can be accounted for by the associated psychiatric and substance abuse disorders and medical problems, and how much by the sleep problems per se. Sleep problems may also be an early sign of a psychiatric problem. This paper reports data from an epidemiologic community survey of over 10,000 adults living in three U.S. communities. A structured diagnostic assessment of psychiatric disorders as well as assessment of the presence of insomnia not due to medical conditions, medication, drug or alcohol abuse, and a 1-year follow-up were completed. Persons with insomnia in the past year without any psychiatric disorders ever (uncomplicated insomnia); with a psychiatric disorder in the past year (complicated insomnia); and with neither insomnia nor psychiatric disorders ever were compared on treatment utilization and the first onset of a psychiatric disorder in the subsequent year. Eight percent of those with uncomplicated as compared with 14.9% with complicated insomnia and 2.5% with neither had sought treatment from the general medical sector for emotional problems in the 6 months prior to the interview. The rates of treatment sought from the psychiatric specialty sector were 3.8%, 9.4%, and 1.2%, respectively. These differences were significant after controlling for sociodemographic characteristics and were sustained when the persons were interviewed 1 year later. Uncomplicated insomnia was also associated with an increase in risk for first onset of major depression, panic disorder, and alcohol abuse over the following year. Insomnia, even in the absence of psychiatric disorders, is associated with increased use of general medical and mental health treatment for emotional problems and for the subsequent first onset in the following year of some psychiatric disorders. Early diagnosis and treatment of uncomplicated insomnia may be useful.
Gen Hosp Psychiatry 1997 Jul
PMID:The morbidity of insomnia uncomplicated by psychiatric disorders. 932 53

We investigated the withdrawal of temazepam in a single general practice using two alternative prescribing policies: an alternative benzodiazepine; or an alternative group of drugs recommended for short-term management of insomnia, including sedative antihistamines and chloral hydrate. The study showed that temazepam prescribing in general practice can be reduced or stopped by using a simple intervention. An alternative benzodiazepine is useful in helping patients to stop their use of hypnotic agents. The use of antihistamines as substitute hypnotics is not advocated on the basis of our findings.
Br J Gen Pract 1998 Sep
PMID:What happens when doctors stop prescribing temazepam? Use of alternative therapies. 1062 27

This pilot study was undertaken to identify practical problems in studying the effects of teenage motherhood, and compare the assessments of perceived health status and social networks of teenage mothers with those of their nulliparous peers. A total of 55 teenage mothers with one child were matched with the control group of nulliparous teenagers with no history of pregnancy concerning the date of birth, type of house, and postcode. Different results between the groups were manifested despite the comparable characteristics. Upon initial analysis, Vitality and Mental Health sub-scales of the short form 36 mean scores on mothers were significantly lower than the control. Mean scores on the B subscales were significantly higher in the General Health Questionnaire, showing high levels of insomnia/anxiety. With regard to self-assessed health status, the number of people providing support or the degree of satisfaction felt with the support in both groups did not have any significant differences. Although findings in this study highlights some practical problems related to teenage motherhood, detailed screening interviews of a large number of respondents is required to obtain a closely match in the control group.
Br J Gen Pract 1998 Oct
PMID:Teenage mothers and their peers: a research challenge. 1095 51


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