Chantal Kempenaers

Sleep EEG Variables in Young Schizophrenic and Depressive Patients

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EEG Sleep Studies in Patients With Generalized Anxiety Disorder

Sleep polygraphic recordings were performed during 3 consecutive nights in 12 inpatients with generalized anxiety disorder (GAD) in comparison with age- and sex-matched groups of patients with major depressive disorder (MDD) and normal subjects. GAD patients differed significantly from those with MDD. A lower number of awakenings and stage shifts in night 1 and the mean of the 3 nights and a shorter rapid eye movement (REM) duration in night 1 but longer REM latency in the mean of the 3 nights were observed in GAD in comparison to MDD. GAD patients also showed a significantly longer sleep onset latency and shorter duration of total sleep time and Stage 2 than control subjects. Electroencephalographic sleep recordings, as well as other laboratory tests, may help the clinician to differentiate anxiety from depressive disorders.

The Resilience Scale for Adults: Construct Validity and Measurement in a Belgian Sample

The Resilience Scale for Adults (RSA) was developed and has been extensively validated in Norwegian samples. The purpose of this study was to explore the construct validity of the Resilience Scale for Adults in a French-speaking Belgian sample and test measurement invariance between the Belgian and a Norwegian sample. A Belgian student sample (N = 363) completed the RSA, the Hopkins Symptom Checklist-25 (HSCL-25), and Sense of Coherence Scale (SOC-29). A Norwegian second sample (N = 315) was included in the analyses of invariance of the RSA. There were expected positive and negative significant correlations with SOC-29 and HSCL-25, respectively. The metric invariance was supported, with the exception of one of the six RSA factors. The findings demonstrate that the RSA may be a valid and reliable self-report measure of protective factors and further the results also indicated cross-cultural validity for the RSA in a French-speaking Belgian sample.

Multivariate study of sleep EEG in depression

ABSTRACT— The effects of four subtypes of major depressive disorder on four sleep EEG variables obtained in 153 depressed inpatients were analyzed taking into account the effects of age, gender. DST response and severity of depression. We have found that age significantly affected slow wave sleep. Sleep efficiency and total sleep time were shown to vary with age and severity of depression. Such effects were not detected for REM latency which was influenced by the endogenous subtype and the gender. Our data indicate that in depressed patients sleep EEG measures are influenced by multiple factors.

Sleep EEG recordings in generalized anxiety disorder with significant depression

After one accommodation night, sleep EEG recordings were performed during three consecutive nights in ten drug-free inpatients presenting generalized anxiety disorder (GAD) with significant depression, compared with a age- and sex-matched group of patients with GAD and a group of primary major depressive disorder (MDD) patients. GAD patients with depression did not differ from GAD patients in any sleep variable. Patients with MDD showed more stage shifts and a greater number of awakenings than patients with GAD. REM latency was significantly shorter in MDD patients than in the other groups, and may thus help to differentiate anxious from depressed patients.

Depression, anxiety and loss of resilience after multiple traumas: an illustration of a mediated moderation model of sensitization in a group of children who survived the Nazi Holocaust

BACKGROUND Depressive and anxiety disorders (DAD) have become a major public health problem. Multiple trauma is known to increase the risk of DAD through a sensitization mechanism. We investigate the hypothesis that resilience is a mediator of this mechanism. METHODS Former Hidden Children (FHC), the Jewish youths who spent World War II in various hideaway shelters across Nazi-occupied Europe, were compared with a control group. In each group, we measured the presence of multiple traumas, the resilience with the Resilience Scale for Adults, which has a six factors solution, and the DAD with the Hopkins Symptoms Checklist. We test a mediated moderation model with childhood trauma as the predictor; Later trauma as the moderator; Resilience as the mediator; and DAD as the outcome variable. RESULTS Results are consistent with a sensitization model of DAD mediated by resilience: confrontation with a primary trauma during childhood followed by secondary trauma(s) after childhood damages resilience, which, in turn, results in higher level of DAD. LIMITATIONS We are unable to differentiate if the sensitization process is a consequence of the nature of the trauma endured by FHC (long-standing exposure to extreme external events) or a consequence of the fact that this first trauma occurred during childhood. CONCLUSIONS Resilience construct is multi-factorial and a limited damaging of some of the factors is sufficient to lead to DAD even if other factors remain unaltered. Resilience can be altered by multiple traumas and, therefore, needs to be bolstered in therapy sessions.

Transgenerational transmission of trauma in families of Holocaust survivors: The consequences of extreme family functioning on resilience, Sense of Coherence, anxiety and depression

BACKGROUND The psychological transmission of the noxious effects of a major trauma from one generation to the next remains unclear. The present study aims to identify possible mechanisms explaining this transmission among families of Holocaust Survivors (HS). We hypothesized that the high level of depressive and anxiety disorders (DAD) among HS impairs family systems, which results in damaging coping strategies of their children (CHS) yielding a higher level of DAD. METHODS 49 CHS completed the Resilience Scale for Adults, the Hopkins Symptom Check List-25, the 13-Item Sense of Coherence (SOC) scale, and the Family Adaptability and Cohesion Scale. We test a mediation model with Family types as the predictor; coping strategies (i.e. Resilience or SOC) as the mediator; and DAD as the outcome variable. RESULTS Results confirm that the CHS׳ family types are more often damaged than in general population. Moreover, growing in a damaged family seems to impede development of coping strategies and, therefore, enhances the occurrence of DAD. LIMITATIONS The present investigation is correlational and should be confirmed by other prospective investigations. CONCLUSIONS At a theoretical level we propose a mechanism of transmission of the noxious effects of a major trauma from one generation to the next through family structure and coping strategies. At a clinical level, our results suggest to investigate the occurrence of trauma among parents of patients consulting for DAD and to reinforce their coping strategies.

Disentangling Sense of Coherence and Resilience in case of multiple traumas

BACKGROUND Depressive and anxiety disorders (DAD) are a major public health problem. Trauma endured during childhood is known to increase the risk of DAD in adulthood. We investigate the hypothesis that Sense of Coherence (SOC) is a mediator between childhood trauma and depressive and anxious symptoms (DAD) in adulthood. We also explore the nature (personality trait or aptitude) of SOC and attempt to disentangle the concepts of resilience and SOC. METHOD Former hidden children (FHC), the Jewish youths who spent World War II in various hideaway shelters across Nazi-occupied Europe, were compared with a control group. In each group we measured the presence of multiple traumas, the resilience with the Resilience Scale for Adults, the DAD with the Hopkins Symptoms Checklist and the SOC with the SOC-13 self-report questionnaire. We tested a mediated moderation model with childhood Trauma as the predictor; Adulthood trauma as the moderator; SOC as the mediator; and DAD as the outcome variable. RESULTS Results were consistent with a sensitization model of DAD partially mediated by SOC. A first component of SOC was similar to an aptitude and another part of SOC was more similar to a personality trait. LIMITATIONS We are unable to differentiate if the sensitization process is a consequence of the nature of the trauma endured by FHC (long-standing exposure to extreme external events) or a consequence of the fact that this first trauma occurred during childhood. CONCLUSION Our results could account for the controversial debate regarding the life time stability of SOC.

Altered interaction between cardiac vagal influence and delta sleep EEG suggests an altered neuroplasticity in patients suffering from major depressive disorder.

Jurysta F, Kempenaers C, Lancini J, Lanquart J‐P, van de Borne P, Linkowski P. Altered interaction between cardiac vagal influence and delta sleep EEG suggests an altered neuroplasticity in patients suffering from major depressive disorder.

Long-term CPAP treatment partially improves the link between cardiac vagal influence and delta sleep

BackgroundContinuous positive airway pressure (CPAP) treatment improves the risk of cardiovascular events in patients suffering from severe sleep apnea-hypopnea syndrome (SAHS) but its effect on the link between delta power band that is related to deep sleep and the relative cardiac vagal component of heart rate variability, HFnu of HRV, is unknown. Therefore, we tested the hypothesis that CPAP restores the link between cardiac autonomic activity and delta sleep across the night.MethodsEight patients suffering from severe SAHS before and after 4 ± 3 years of nasal CPAP treatment were matched with fourteen healthy controls. Sleep EEG and ECG were analysed to obtain spectral sleep and HRV components. Coherence analysis was applied between HFnu and delta power bands across the first three sleep cycles.ResultsSleep characteristics and spectral HRV components were similar between untreated patients, treated patients and controls, with the exception of decreased Rapid Eye Movement duration in untreated patients. Coherence and gain values between HFnu and delta EEG variability were decreased in untreated patients while gain values normalized in treated patients. In patients before and during long-term CPAP treatment, phase shift and delay between modifications in HFnu and delta EEG variability did not differ from controls but were not different from zero. In healthy men, changes in cardiac vagal activity appeared 9 ± 7 minutes before modifications in delta sleep.ConclusionsLong-term nasal CPAP restored, in severe SAHS, the information between cardiovascular and sleep brainstem structures by increasing gain, but did not improve its tightness or time shift.