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Eur Psychiatry. 2017 Sep;45:190-197. doi: 10.1016/j.eurpsy.2017.06.013. Epub 2017 Jul 16.

Sleep quality and emotional reactivity cluster in bipolar disorders and impact on functioning.

Author information

1
AP-HP, GH Saint-Louis-Lariboisière-Fernand-Widal, Département de Psychiatrie et de Médecine Addictologique, Pôle Neurosciences Tête et Cou, Paris, France; Université Paris Diderot, Inserm UMRS 1144, Paris, France; Fondation FondaMental, Créteil, France. Electronic address: bruno.etain@inserm.fr.
2
Fondation FondaMental, Créteil, France; Sorbonne Universités, UPMC Université Paris 06, UMR_S 1136, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, Inserm 75013, Paris, France.
3
Fondation FondaMental, Créteil, France; Université Paris-Est, UPEC, Inserm, U955, Équipe Psychiatrie Translationelle, AP-HP, Hôpitaux Universitaires Henri-Mondor, DHU PePsy, Pôle de Psychiatrie, 94000 Créteil, France.
4
Université Paris Diderot, Inserm UMRS 1144, Paris, France; Service de psychiatrie, Centre hospitalier Princesse-Grace, Avenue Pasteur, Monaco.
5
Fondation FondaMental, Créteil, France; Pôle de psychiatrie, Hôpital Sainte-Marguerite, Assistance Publique-Hôpitaux de Marseille, Marseille, France; Aix-Marseille Université, CNRS, CRN2M UMR7286, 13344 Marseille cedex15, France.
6
AP-HP, GH Saint-Louis-Lariboisière-Fernand-Widal, Département de Psychiatrie et de Médecine Addictologique, Pôle Neurosciences Tête et Cou, Paris, France; Université Paris Diderot, Inserm UMRS 1144, Paris, France; Fondation FondaMental, Créteil, France.
7
Fondation FondaMental, Créteil, France; Clinique Universitaire de Psychiatrie, CHU de Grenoble, Grenoble, France.
8
Fondation FondaMental, Créteil, France; Département d'Urgence et Post-Urgence Psychiatrique, CHRU Montpellier, INSERM U1061, Université Montpellier 1, Montpellier, France.
9
Fondation FondaMental, Créteil, France; Hôpital Charles-Perrens, Centre Expert Trouble Bipolaire, Service de psychiatrie adulte, Pôle 3-4-7, Bordeaux, France.
10
Fondation FondaMental, Créteil, France; Université de Lorraine, CHU de Nancy, Pôle 6 de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy, 1, rue du Docteur-Archambault, 54520 Laxou cedex, France.
11
Fondation FondaMental, Créteil, France; Université de Versailles Saint-Quentin, Centre Hospitalier de Versailles, Service de Psychiatrie Adulte, Le Chesnay, France.

Abstract

OBJECTIVE:

Bipolar disorders (BD) are characterized by sleep disturbances and emotional dysregulation both during acute episodes and remission periods. We hypothesized that sleep quality (SQ) and emotional reactivity (ER) defined clusters of patients with no or abnormal SQ and ER and we studied the association with functioning.

METHOD:

We performed a bi-dimensional cluster analysis using SQ and ER measures in a sample of 533 outpatients patients with BD (in remission or with subsyndromal mood symptoms). Clusters were compared for mood symptoms, sleep profile and functioning.

RESULTS:

We identified three clusters of patients: C1 (normal ER and SQ, 54%), C2 (hypo-ER and low SQ, 22%) and C3 (hyper-ER and low SQ, 24%). C1 was characterized by minimal mood symptoms, better sleep profile and higher functioning than other clusters. Although highly different for ER, C2 and C3 had similar levels of subsyndromal mood symptoms as assessed using classical mood scales. When exploring sleep domains, C2 showed poor sleep efficiency and a trend for longer sleep latency as compared to C3. Interestingly, alterations in functioning were similar in C2 and C3, with no difference in any of the sub-domains.

CONCLUSION:

Abnormalities in ER and SQ delineated three clusters of patients with BD and significantly impacted on functioning.

KEYWORDS:

Bipolar disorder; Cluster analysis; Emotional reactivity; Functioning; Sleep

PMID:
28957786
DOI:
10.1016/j.eurpsy.2017.06.013
[Indexed for MEDLINE]

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