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Randomized Controlled Trial
. 2012 Dec 30;200(2-3):265-71.
doi: 10.1016/j.psychres.2012.07.037. Epub 2012 Aug 9.

Sleep impairment, mood symptoms, and psychosocial functioning in adolescent bipolar disorder

Jessica R Lunsford-Avery  1 , Charles M Judd, David A Axelson, David J Miklowitz
Affiliations
Randomized Controlled Trial

Sleep impairment, mood symptoms, and psychosocial functioning in adolescent bipolar disorder

Jessica R Lunsford-Avery et al. Psychiatry Res. .

Abstract

Few empirical studies have investigated the role of sleep impairment in the course of adolescent bipolar spectrum disorders (BSD). The present study examined the longitudinal associations between sleep disruption, mood symptom severity, and psychosocial functioning in a 2-year follow-up of patients with adolescent BSD. Fifty-three adolescents with BSD (mean [S.D.] age: 14.6 [1.6]) participated in a two-site randomized trial of family focused treatment for adolescents (FFT-A) or enhanced care, a briefer psychoeducational treatment; both treatments were administered with pharmacotherapy. Sleep disturbance was assessed with the Adolescent Sleep Habits Questionnaire (ASHQ) filled out by patients every 6 weeks in the first study year and every 3 months in the second year. Main outcomes included clinician-rated measures of mania, depression and psychosocial impairment over 2 years. Sleep impairment was significantly associated with mania and depression severity scores and psychosocial impairment ratings across the 2-year follow-up. Despite its efficaciousness in reducing mood symptoms, FFT-A was not more effective than enhanced care in improving sleep habits. Sleep impairment may play a substantial role in the course of adolescent BSD. Youth with BSDs may benefit from targeted psychosocial interventions that emphasize sleep regularity.

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Figures

Figure 1
Figure 1
Relationship of ASHQ and MRS scores over time Abbreviations: ASHQ, Adolescent Sleep Habits Questionnaire; MRS, Mania Rating Scale. For ease of illustration, the graphs present the unadjusted ASHQ scores.
Figure 2
Figure 2
Relationship of ASHQ and DRS Scores over Time Abbreviations: ASHQ, Adolescent Sleep Habits Questionnaire; DRS, Depression Rating Scale. For ease of illustration, the graphs present the unadjusted ASHQ scores.
Figure 3
Figure 3
Relationship of ASHQ and A-LIFE global psychosocial functioning over time Abbreviations: ASHQ, Adolescent Sleep Habits Questionnaire; A-LIFE, Adolescent Longitudinal Interval Follow-up Evaluation. For ease of illustration, the graphs present the unadjusted ASHQ scores.
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