Mood In Adults Research Articles

Development of an exercise program to improve sleep quality and mood in older adults with mild cognitive impairment

Development of an exercise program to improve sleep quality and mood in older adults with mild cognitive impairment

A Cross Sectional Study to Assess the Sleep Disturbance and Activities of Daily Living and Their Predictors among Older Adults Visiting Medical Out Patient Department of Selected Hospitals of Bagalkot

Background of the Study: Healthy aging according to the WHO is a continuous process of optimizing opportunities to maintain and improve physical and mental health, independence, and quality of life throughout the life course. Older adults may experience mobility problems due to age-related changes in muscles, bones, and joints. Depression, anxiety, and social isolation are prevalent among older adults. Sleep disturbances can significantly impact mood and emotional well-being in older adults. Mood swings, depression, and anxiety. This may result in difficulties with mobility, self-care tasks, and overall functional independence. Hence the investigator felt the need to conduct “A cross sectional study to assess the sleep disturbance and activities of daily living and their predictors among older adults visiting medical outpatient department of selected hospitals of Bagalkot.” Aim: To assess the sleep disturbance and activities of daily living among older adults. Methods: Quantitative non-experimental approach with Cross sectional descriptive survey research design was used for the study to accomplish the objectives. Sleep Quality Scale (SQS), The Lawton Instrumental Activities of Daily Living Scale were used to collect data. A sample of 100 older adults aged above 60 years and visiting medical OPD’s of selected hospitals of Bagalkot was selected by Non probability Purposive Sampling Technique. The data collected were analyzed using descriptive and Inferential Statistics. Results: Findings shows that, there was a significant negative correlation (r= -0.546, P<0.01) between sleep disturbance and activities of daily living of older adults. Sleep disturbance was significantly associated with Religion[χ2=9.09, P<0.0026], Marital Status[χ2=6.43, P<0.0112],Number of Children[χ2=10.77, P<0.001], Family Monthly Income[χ2=15.52, P<0.0001],Residential Status[χ2=10.39, P<0.0013],Type of Family[χ2=8.42, P<0.0037],Chronic Illness[χ2=15.2, P<0.0001],Exercise Habits[χ2=9.09, ...

The Impact of Spatial Light Patterns on Environmental Perception, Mood, and Preference of Older Adults in Assisted Living Facilities

ABSTRACT Previous studies show that electric light levels and temporal patterns significantly impact human perception, mood, and preference, however, there is a gap in existing studies that investigate the qualitative aspect of lighting design such as the spatial electric lighting patterns on older adults’ subjective impression. The main goal of this study is to examine the impact of different spatial electric lighting patterns on the perception, mood, and preference of older adults. The main research question is, “Are there any consistent and shared patterns of subjective impressions among the older adult population under exposure to the spatial electric lighting patterns in an environment?” The study utilized a multi-method research approach integrating systematic pictorial content analysis and a visual preference survey. Building upon a previously established spatial electric lighting pattern framework by authors, this research focused on evaluating the impact of these patterns on the perceptions and preferences of older adults. Sixty healthy older adult participants (aged 60 and above, 39 females, 21 males) from a US Pacific Northwest assisted living facility engaged in a survey research design employing sorting techniques and forced-choice questions. The study evaluated six distinct spatial electric lighting patterns based on criteria including visual preference, stressfulness, clarity, and spaciousness. The findings of this study show that different spatial electric lighting patterns have a substantial impact on older adults’ perceptions and preferences related to the environment. Findings revealed a clear preference for uniform lighting among older adults, as indicated by reduced visual preference when uniform lighting was absent. Additionally, older adults showed a preference for lighting environments that balanced direct and indirect lighting patterns in space. Interestingly, no significant differences in visual preferences were observed between peripheral and central lighting arrangements. Furthermore, the study identified significant associations between electric lighting spatial patterns and participants’ stress levels. It was observed that preference for uniform electric lighting patterns and perceived stress levels associated with these patterns are not mutually exclusive Environments lacking uniform electric lighting patterns were found to induce a more relaxed state. Moreover, the absence of both uniform and indirect lighting significantly enhanced perceived clarity. The study also explored the relationship between lighting uniformity, directionality, and perceived spaciousness. It found a significant correlation between uniform and directional lighting in enhancing the perceptions of the spaciousness of a space. The study concludes with the need to balance spatial electric lighting patterns to achieve a diversity of lighting scenes in older adults’ environments.

Adherence to a telehealth program for older adults with dementia and their caregivers: A mixed-methods study.

The objectives were to analyze the association between the cognitive performance of older adults/caregivers, adherence to a telehealth program and investigate reasons for dropouts, retention and adherence. A mixed-methods study was conducted involving 41 older adults diagnosed with dementia who participated in a 12-week telehealth program that offered physical exercises for the older adults and psychoeducation for the caregivers. Cognitive performance, adherence rates, benefits and reasons for withdrawal, retention and adherence were determined with the aid of questionnaires, field records, and focus groups. No significant association was found between the adherence rate and cognitive performance. The main reason for dropouts was the occurrence of illness during the intervention. The reasons for adherence were the convenience of the online program and the fact that the program was free of cost. The benefits were improvements in the wellbeing, mood of the older adults and the mitigation of progressive symptoms of dementia.

Age-associated differences in FIRES: Characterizing prodromal presentation and long-term outcomes via the web-based NORSE/FIRES Family Registry.

Febrile infection-related epilepsy syndrome (FIRES) is a rare clinical presentation of refractory status epilepticus following a febrile infection. This study analyzes data from the NORSE/FIRES Family Registry, an international web-based registry available in six languages with data entered by patients, families, and clinicians to explore clinical presentations, survivorship, and long-term outcomes in adult and pediatric FIRES patients. We characterize and examine differences in demographics, prodromal symptoms, seizure frequency, anti-seizure medications (ASMs), quality of life, cognition, mood, and anxiety in adults vs pediatric populations with FIRES. Eighty-six participants were included in the study. Pediatric patients (n = 54) were predominantly male (77.8%) and experienced a significantly higher post-FIRES seizure burden than adult survivors (67.7% ≥12 seizures/month in pediatrics vs 11.8% in adults, p <.001). Adults (n = 32) were more likely to be female (59.4%) and have flu-like prodromal symptoms (90.6%). At ≥6 months post-FIRES, both groups exhibited high ASM use, with the majority (87.5%) taking three or more medications. Pediatric patients reported worse mood and anxiety outcomes compared to adults (p <.005). Self-reported quality of life and cognition were rated as moderate across in adults (5.2/10) and pediatric(4.7/10) patients, although pediatric patients indicated poorer cognition. Our findings highlight the challenges in managing post-FIRES outcomes across different age groups, particularly in pediatric patients who face a higher seizure burden and report worse cognitive outcomes.

The Effect of Virtual Intelligence Games Applied to Older Adults on Cognitive Skills

Objective: This study aimed to evaluate cognitive status, quality of life, and mood in older adults through intelligence games loaded onto smartphones. Methods: In this study, 60 older adults aged 65 and over, who voluntarily participated and visited the outpatient clinic of the Department of Physical Therapy and Rehabilitation at Kırıkkale University Faculty of Medicine, were evaluated. The sociodemographic information of the older adults such as age, height, weight, etc., was recorded. The cognitive statuses were assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), the quality of life was evaluated using the Nottingham Health Profile, and the depression statuses were assessed with the Geriatric Depression Scale (GDS). Those older adults meeting the inclusion criteria, with a MMSE score below 24, were included in the study, totaling 50 participants. Subsequently, the individuals were randomly divided into 2 groups: training and control, with each group consisting of 25 older adults. The training group was requested to play intelligence games developed by researchers and installed on their smartphones at least once a day for 8 weeks. Both the training and control groups were assessed using a questionnaire created before and after the training period. Results: According to the statistical analysis conducted, a significant difference was found between the training and control groups in the MMSE, MoCA, and GDS scores after the training. There was a significant difference found in the total score of sleep, emotional state, and overall quality of life (P &lt; .05), while no significant differences were detected among the other parameters (P &gt; .05). Conclusion: In conclusion, it was determined that technological advancements and the intelligence games loaded onto their smartphones, which they can access anytime and anywhere, improved the cognitive status of older adults in areas such as memory, attention, calculation, and shape matching and, it was observed that these activities enhanced their mood, sleep, and overall quality of life.

LEISURE ACTIVITY AND POSITIVE MOOD ACROSS ADULTHOOD: RESULTS FROM THE KOREAN TIME USE SURVEY

Abstract Adults in middle and later life may look forward to dedicating more time to outdoor leisure activities, which can contribute to their health and well-being. This study utilized 2-day time diaries from the 2019 Korean Time Use Survey (respondent N = 22,821; age 20−84) to examine how Korean adults engage in various outdoor activities (e.g., social visits, attending cultural events, and exercising) and whether their activity engagement (indicated by outdoor activity diversity and total hours of outdoor activity) is associated with positive mood. Further, we investigated whether these associations varied by age groups (age 20–39, 40–64, and 65–84), considering differences in family and work demands. We accounted for respondents’ total TV viewing hours, total “doing-nothing” hours, and sociodemographic characteristics as control variables in the models for positive mood. The findings showed that total hours of outdoor activities and watching TV were positively associated with a positive mood in younger adults, supporting the psychological benefits of detachment from work. Yet, for older individuals, diversity in outdoor activities was positively associated with positive mood, while total hours of outdoor activities were not significant—which indicates that engaging in various activities throughout the day can be beneficial for psychological well-being in later life. Notably, we found that total TV viewing hours were negatively associated with the positive mood of older adults. This study sheds light on the differential impacts of leisure activities based on life stages, underscoring the importance of diverse leisure activities for the psychological health of older individuals.

Immediate effects of exercise snacking on physical fatigue, mood, and pain in elderly adults with knee osteoarthritis

BackgroundExercise has been reported to be beneficial in reducing pain and fatigue, as well as improving mood, in patients with knee osteoarthritis (KOA). However, long bouts of exercise have been linked to an increase in fatigue and pain level in elderly adults. Currently, there are very few investigations into the immediate effects of breaking exercise into shorter and frequent bouts, otherwise known as exercise snacking on physical fatigue, mood, and pain in elderly adults with KOA. The aim of this study was to investigate the immediate impact of exercise snacking versus continuous exercise on physical fatigue, mood, and pain level in elderly adults with KOA.MethodsThis was a randomized experimental study, with 37 participants aged 60 years and above with KOA. Participants were recruited and randomly assigned into a five bouts of 2-min exercise snacking and 10-min continuous exercise groups, with the bicycle ergometer as the exercise mode. Physical fatigue, mood, and pain of participants were assessed at baseline and immediately after the exercise using Numerical Fatigue Rating Scale (NFRS), Visual Analog Mood Scale (VAMS), and Numerical Pain Rating Scale (NPRS) respectively. Descriptive statistics and inferential statistics of Wilcoxon Rank test, Mann–Whitney U, and ANCOVA were used to analyze the data with p value set at 0.05.ResultsThere were significant differences (p < 0.001) in physical fatigue, mood, and pain between baseline and post-intervention values within groups. Between-group comparisons revealed significant reductions in physical fatigue (p < 0.001) and pain levels (p = 0.048) in the exercise snacking group compared to the continuous exercise group. However, no significant between-group differences were found for mood.ConclusionExercise snacking yielded significant improvements in physical fatigue and pain in elderly with KOA. However, both exercise snacking and continuous aerobic exercise were comparable in their immediate effects on mood in elderly adults with KOA.Trial registrationPACTR202308724795310 Registered 28th September 2023, https://www.edctp.org/pan-african-clinical-trials-registry/.

Psychological distress and diagnosed mood and anxiety disorders in Pacific adults: a pooled analysis of five consecutive New Zealand Health Survey years

ABSTRACT This article examines psychological distress and diagnosed mood and anxiety disorders in Pacific adults, comparing against non-Māori non-Pacific (nMnP) adults, and between Pacific subgroups. A sample of adults aged 15 years and over was pooled from five consecutive New Zealand Health Survey years spanning 2014/15–2018/19. Prevalence estimates of psychological distress and doctor-diagnosed mood and/or anxiety disorders were calculated for Pacific and nMnP adults, and Pacific subgroups defined by two sociodemographic factors: multiple ethnic affiliation (‘multi-ethnicity’) and years since migration to Aotearoa New Zealand. Risk ratios for comparative analyses were generated using log-binomial regression modelling. Mental health inequities were evident in Pacific adults (n = 4,335) as they were more likely than nMnP (n = 50,397) to experience psychological distress, but less likely to have ever had a diagnosed mood and/or anxiety disorder. Within-Pacific differences were also visible, with higher rates of diagnosed mood and/or anxiety disorders seen in both multi-ethnic and New Zealand-born Pacific adults, and lower rates in Pacific migrants. Living for a longer time in Aotearoa New Zealand appeared to be associated with an increased risk of diagnosed mood and anxiety disorders.

The Temporal Relationship Between Physical Activity, Mood, and Sleep in Older Adults: Lead‐Lag Discovery and Replication Analyses

The Temporal Relationship Between Physical Activity, Mood, and Sleep in Older Adults: Lead‐Lag Discovery and Replication Analyses

The psychosocial effects of the COVID-19 pandemic on Turkish older adults: is there a difference between males and females?

BackgroundThe COVID-19 pandemic has seriously affected older adults’ social lives, physical activity, and cognitive functions. Additionally, the lockdowns have disrupted regular healthcare for patients with chronic illnesses or needing acute care. Furthermore, the pandemic has negatively affected different psychosocial influences in each country due to the various cultural characteristics, technology, health system, and financial opportunities. This study aimed to investigate the effects of COVID-19 on mood, social participation, and healthcare use in older adults living in Turkey.MethodsA cross-sectional study was conducted during the third wave of the COVID-19 pandemic (March-December 2021) in three medical centers in Turkey. Patients aged 60 + years without significant cognitive impairment were recruited by mail or at hospital admissions. Information on demographics, pandemic-related distancing measures, healthcare use, lifestyle, symptoms of anxiety, depression, and social participation were assessed.ResultsA total of 343 participants were included in the study. Women had a higher rate of hypertension, symptoms of anxiety, depression, and fatigue compared to men (p < 0.05). Since the start of the pandemic, only 22.4% of non-acute healthcare appointments were conducted face-to-face. Time spent with family and friends, hope for the future, and physical activity decreased. At the same time, the experience of loneliness, the number of meals and unhealthy snacks, and the use of digital services increased. Women were also more concerned about getting coronavirus infection, transmitting the virus to others, and being discriminated against because of the infection (p < 0.05).ConclusionsThese pandemic days have had a significant psychosocial impact on Turkish older adults, especially women. As a strategy of the health care policy, easy access and follow-up to the health system should be provided, and the necessary support should be procured to minimize the detrimental effects of the pandemic on older people.

Overweight/obesity and depressed mood in Chinese adults: A stratified test

This study investigated the relationship between overweight/obesity and depressed mood in Chinese adults, examining the influence of factors such as age, gender, and place of residence. We conducted statistical tests on data from 10,833 participants of the 2018 Chinese General Social Survey (CGSS), using multiple linear regression analysis and stratified linear regression analysis. The results showed a significant and negative association between overweight/obesity and depressed mood, in which those who were overweight/obese had fewer instances of depressed mood. We found the negative correlation between overweight/obesity and depressed mood to be more significant in the Fortunate Generation cohort group and the urban group, and there was also a significant and negative association between overweight/obesity and depressed mood for men. These findings clarify the association between overweight/obesity and depressed mood as well as provide guidance for the development of relevant policies that target prevention and control.

Safety and Efficacy of Ashwagandha Root Extract on Cognition, Energy and Mood Problems in Adults: Prospective, Randomized, Placebo-Controlled Study.

This prospective, randomized, placebo-controlled study assessed the effects of Ashwagandha root extract (ARE) on cognition, energy, and mood in adults with self-reported cognitive and energy problems. Healthy subjects aged 30-75 years were randomized to receive ashwagandha (Withania somnifera) root extract (ARE) 600 mg/day (n = 60)/identical placebo (n = 60) orally for 8 weeks. Cognitive function was assessed at baseline and week 8 using a Computerized Mental Performance Assessment System (COMPASS). Secondary outcomes were Profile of Mood States Abbreviated Version (POMS-A), Mental Fatigue Scale (MFS) and Behavior Rating Inventory of Executive Function-Adult (BRIEF-A) for effects on mood, mental fatigue and executive function, respectively, assessed at baseline, week 4 and 8. Greater improvement (p < .05) from baseline scores were seen with ARE as against placebo for COMPASS items episodic memory, working memory and accuracy of attention. ARE also improved the POMS-A, MFS and BRIEF-A scores from baseline suggesting an improvement in mood, vigor, and an increase in the executive functioning respectively with ARE. The herb was well tolerated and had a good patient compliance with no serious adverse events reported in either of the groups. This study suggests that a dose of 600 mg a day can improve cognition, energy, and mood in adults with self-reported cognitive and energy problems.

A controlled trial comparing the impact of guided forest bathing or a mindful urban walk on heart rate, blood pressure, and mood in young Thai adults

Abstract In Thailand, cardiovascular disease and mental health cause a large health and economic burden, with 10% of Thai adults and 32% of adolescents reporting depression. Forest bathing (FB) (mindful nature walking) is growing in popularity globally as a preventative health intervention. Most FB research compares FB with a non‐active control of unguided urban walking, finding improved health and well‐being in FB but not the urban condition. This controlled trial offers a unique and robust comparison of guided FB with an active control of guided mindful urban walking. This is also the first study testing the acceptability and effectiveness of guided FB in Thailand. In a crossover design, heart rate, heart rate variability, blood pressure, and mood in 30 participants were compared before and after 1 h of guided FB and a guided mindful urban walk. MANOVA and t‐test analyses revealed that heart rate and blood pressure reduced in both conditions, but more in the mindful urban condition. Whilst negative mood was reduced in the FB condition but increased in the mindful urban condition. The study offers evidence for the promising health and well‐being benefits of both guided FB and mindful urban walking. Poor mental health and health inequalities are of increasing global concern, hence further research into the effectiveness of alleviating these difficulties through inexpensive interventions such as guided FB and mindful walking are encouraged. The study also offers the first data indicating that FB was acceptable and effective in a Thai population. Read the free Plain Language Summary for this article on the Journal blog.

Walking and talking for well‐being: Exploring the effectiveness of walk and talk therapy

AbstractDespite the rising trend of integrating nature and movement into talking therapy, the extent of empirical support remains limited. This study explored the effects of a walk and talk intervention on adult mood and well‐being using a multiple baseline design with pre, post and follow‐up assessments. Five adults (3 males and 2 females) from a technology company took part in a walk and talk intervention lasting approximately 6–8 sessions. They completed self‐report measures at baseline, post‐intervention and follow‐up, with semi‐structured interviews conducted at follow‐up. Results showed a reduction in psychological distress and an increase in well‐being for all participants from baseline to follow‐up. Qualitative data from a thematic analysis supported these findings: participants found the natural, calming effect of the outdoors, combined with the movement of walking, facilitated a sense of freedom to express themselves and, in doing so, maximise the benefits of the therapeutic space. These included gaining a broader perspective, heightened self‐awareness and greater acceptance of oneself, others and life's challenges. This study offers real‐world evidence supporting walk and talk therapy as an effective intervention for adult well‐being and mood.

The Effect of Two Somatic-Based Practices Dance and Martial Arts on Irisin, BDNF Levels and Cognitive and Physical Fitness in Older Adults: A Randomized Control Trial.

Maintaining healthy brain function during ageing is of great importance, especially for the self-sufficiency of older adults. The main aim of this study was to determine the effects of dance and martial arts on exerkines Brain Derived Neurotrophic Factor (BDNF) and irisin blood serum levels. This randomized controlled trial examined the effects of dance and martial arts on serum Brain-Derived Neurotrophic Factor (BDNF) and irisin levels, as well as cognitive function, mood, and physical measures in older adults. Seventy-seven independently living older adults (mean age 70.3±3.8 years) were randomized into three groups: dance (DG), martial arts (MaG), and control (CG), followed over 12weeks. Generalized linear models were used to assess the interventions' effects. There was a significant increase in BDNF levels in both the DG (1.8 ± 4.9, p < 0.05) and MaG (3.5 ± 6.3, p < 0.05), while CG experienced a decrease (-4.9 ± 8.2, p < 0.05). Between-group effects were significant for BDNF, with DG and MaG showing higher levels than CG (p < 0.05). No significant changes in irisin levels were found. Cognitive performance, particularly attention and mental flexibility (measured by the Trail Making Test A and B), significantly improved in the DG compared to CG (p < 0.05). Additionally, participants in DG showed improved mood based on the Geriatric Depression Scale (p < 0.05) compared to CG. Anthropometric T-scores were significantly associated with changes in irisin levels (p < 0.05) after intervention. The study found that dance and martial arts upregulated BDNF levels, with dance showing notable improvements in cognitive function and mood in older adults. Changes in anthropometric measures were linked to increased irisin levels. These findings suggest that both dance and martial arts may promote healthy brain function in aging populations. NCT05363228.

The effects of a short-term Mediterranean diet intervention on mood and mental wellbeing in adults

Emerging evidence suggests protective properties of a Mediterranean diet (MD) in relation to prevention and management of mood disorders(1). However, there is paucity of dietary interventions investigating adherence to MD and effects on mood and wellbeing in individuals without a clinical diagnosis. The present study aimed to investigate the effects of adherence to a short-term MD on mood and wellbeing in healthy adults.A controlled crossover design randomly assigned 18 adults (Age(yrs) 53.74 ( ± 7.10), BMI(kg.m2)26.62 ( ± 5.45)) to follow a MD or their habitual diet (control) for 7-days, before switching to the alternate condition (following a 7-day washout). At baseline, an Educational Group Session familiarised participants with MD principles through informal presentation and interactive explanation of participant resource booklets to use at home throughout the MD condition only. Anthropometric characteristics, self-reported mood (Profile of Mood States (POMS), Lader Visual Analogue Scale(VAS)) and wellbeing (Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) were assessed at baseline and upon completion of each diet condition. The MD Adherence Screener (MEDAS) assessed adherence to the interventions.A significant difference was found in MD adherence scores between MD (M = 11.3, SD = 1.8) and Control Diet (CD) (M = 2.5, SD = 1.5); t(17) = 16.1, p&lt;0.001). Main effects analysis using a general linear model controlling changes in body mass index showed significant effects of MD intervention versus the CD on the change in total mood disturbance (M(MD) = −15, SD = 12), M(CD) = −3, SD = 9), F(1,31) = 4.9, p = 0.034); feelings of calm (VAS) (M(MD) = 9, SD = 14), M (CD) = −2, SD = 6), F(1,31) = 8.5, p = 0.006); wellbeing (M(MD) = 6, SD = 5), M(CD) = −2, SD = 6), (F(1,31) = 6.6, p = 0.015).These findings suggest that a short-term dietary change towards a MD can improve mood, feelings of calm and overall wellbeing in middle aged adults.

Mood, Quality of Life, and Immune Fitness During the COVID-19 Pandemic of Young Adults in Germany.

Background: The COVID-19 pandemic has profoundly affected young adults' lives globally, including those in Germany. This study investigated mental health and quality of life during the pandemic, with a particular focus on mood. Immune fitness, the body's capacity to respond to health challenges (such as infections) by activating an appropriate immune response, was assessed as a physical health indicator. Methods: Data were collected from 317 participants, aged 18 to 35, via an online survey conducted between November 2021 and March 2022. Participants included 103 men (32.5%) and 214 women (67.5%), with a mean age of 25.5 years (SD = 4.1). Results: Compared to pre-pandemic levels, significant declines in mood, quality of life, immune fitness, and sleep quality were observed during the lockdown periods of the COVID-19 pandemic (p < 0.0125). The most pronounced effects were observed during the second lockdown, with declines extending into the second no-lockdown period for fatigue, depression, happiness, optimism, and immune fitness (p < 0.0125). Significant sex differences were found for the magnitude of mood effects (anxiety, depression, stress). No significant differences were found according to age or occupational status (student vs. work). Conclusions: The COVID-19 pandemic and associated lockdown periods had a significant negative effect on the mood, immune fitness, and well-being of young adults living in Germany.

Enhancing sleep and mood in depressed adolescents: A randomized trial on nurse-led digital cognitive behavioral therapy for insomnia

BackgroundDespite the effectiveness of digital cognitive behavior therapy for insomnia (dCBT-I) in treating comorbid insomnia and depression, its accessibility and high dropout rates among adolescents and young adults remain significant limitations. A potential solution could be nurse-led dCBT-I. This study evaluates the feasibility and efficacy of nurse-led dCBT-I in reducing insomnia symptoms and improving mood in adolescents and young adults with depression. AimsOur objective was to evaluate the feasibility and effectiveness of a nurse-led dCBT-I in reducing insomnia severity among adolescents and young adults with depression. MethodsA parallel-group randomized controlled trial involved 40 adolescents and young adults aged 14 to 24 with major depressive disorder and insomnia. They were assigned to receive either a nurse-led 6-week dCBT-I or usual care. The study evaluated outcomes such as insomnia severity, depression severity, and sleep parameters. Measurements were taken at baseline, immediately after the intervention (6 weeks), and during a follow-up at 18 weeks. ResultsThe intention-to-treat analysis was performed using a generalized linear mixed model (GLMM). Results indicated that, compared to the control group, participants in the intervention group exhibited a significant reduction in insomnia severity at the 18-week follow-up, with a large effect size (Cohen's d = −0.965, p < 0.001). Additionally, the intervention group demonstrated a significant decrease in depression severity both at the end of the intervention (Cohen's d = −0.686, p = 0.001) and at the 18-week follow-up (Cohen's d = −0.508, p = 0.011), indicating a medium effect size. ConclusionsNurse-led dCBT-I is an effective treatment for adolescents and young adults with depression and insomnia.

Suspected Pseudobulbar Affect in Neurodegenerative Disease.

To investigate the association between suspected pseudobulbar affect (PBA), clinical diagnosis, cognitive testing, and self-reported mood in older adults presenting for evaluation of dementia. Patients presenting to an outpatient memory disorders clinic (N=311). We used traditional and novel network modeling approaches to examine associations between neuropsychological (NP) tests, patient and clinician rating scales, and the Center for Neurological Study-Lability Scale (CNS-LS) among patients with suspected AD (n=133) and other neurocognitive diagnosis (n=178). We then examined differences in test performance between patients with and without suspected PBA (CNS-LS cut-off of ≥ 13), while accounting for demographic and psychiatric covariates with propensity score matching. Group differences were assessed with Bayesian models. Prevalence of suspected PBA in AD was slightly less than half (44.4%) and at a similar rate in other dementias (e.g., 46.9% in CVD and 45.5% in LBD). In network models, the CNS-LS was associated with higher anxiety and better word list recall. After accounting for covariates, AD patients with suspected PBA performed better on word list recall βM=0.40, 95% CI [0.15, 0.66], and committed fewer false positive errors on recognition βM=-1.51, 95% CI [-2.34, -0.59] than AD patients without suspected PBA. There were no differences in patients with any other diagnostic impression, nor group differences on other NP measures. Patients with suspected PBA and AD diagnosis had better memory recall and recognition than those without suspected PBA, suggesting that impaired emotional regulation may be an early sign of AD in patients with less prominent memory decline. Better understanding PBA in neurodegenerative diseases, including prevalence and comorbidity with psychiatric conditions, could help with early identification, education, and initiation of treatment.