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Aspects of the Relationship Between Sleep and Nutrition: A Study of 375 Psychiatric Out-Patients

Published online by Cambridge University Press:  29 January 2018

A. H. Crisp  and
Edward Stonehill
A. H. Crisp
Affiliation:
St. George's Hospital Medical School, Tooting, London, S.W.17
Edward Stonehill
Affiliation:
Central Middlesex Hospital, Acton Lane, London, N.W.10 and Shenley Hospital, near Radlett, Herts; Department of Psychiatry, St. George's Hospital Medical School
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Extract

Weight change and sleep disturbance are well documented features of psychiatric illness. Complaint about difficulty in getting off to sleep is a common feature of neurotic illness, especially anxiety states. Early morning waking has for many years been regarded by some as a clinical feature—almost a diagnostic pointer—for ‘endogenous depression‘. Motor restlessness is also commonly described as a feature of this disorder. However, other clinicians have concluded that such depressive illness is merely one end of the spectrum of the depressive response. In particular, McGhie (1966) has shown that sleep disturbances of all kinds, as reported by the patients themselves, may occur in a variety of psychiatric illnesses. For instance he found that early morning waking was reported in 16 per cent of non-depressed psychiatric patients as distinct from 17 per cent of patients presenting with depression. Moreover, Hinton (1963) has shown that early morning waking when carefully measured does not specifically characterize those types of depressive illness described by others as ‘endogenous', but that it can occur in all types of depressive illness. He also reported his observation that sleep disturbance amongst depressed patients is mostly related to the phenomenon of agitation. Agitated patients lost more sleep, most apparent in the latter part of the night. On the other hand Carney et al. (1965), in their study of over 100 patients with depression, found that certain symptoms clustered into two groups reflecting the usual concepts of ‘endogenous' and ‘neurotic’ depression respectively. Early morning waking and weight loss were important characteristics of their group of patients designated ‘endogenous' depression, and were regarded as important indicators for them of the value of ECT. There was a positive inter-symptom correlation of 0.234 between weight loss (7 lb.+) and early waking. Most studies do not suggest a causal link between weight change and sleep disturbance, but by inference regard these features as being more integral aspects of an underlying biological factor which also promotes the disturbed mood.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 122 , Issue 569 , April 1973 , pp. 379 - 394
Copyright
Copyright © Royal College of Psychiatrists, 1973 

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