Insomnia and depression during protective isolation in patients with hematological disorders.
OBJECTIVE
Patients treated in a protective isolation unit (PIU) often experience loneliness and increased feelings of seclusion, leading to elevated levels of distress, but the relationship between psychiatric distress and environmental factors is unclear. Therefore, we retrospectively compared the impact of environmental factors on insomnia and depression between patients in the PIU and those in a standard ward (SW).


METHODS
Subjects were 246 patients with hematological disorders hospitalized in Meitetsu Hospital between April 1, 2007 and July 31, 2008 (62 PIU patients and 184 SW patients). We assessed insomnia and depression, as well as concomitant corticosteroid (CS) administration, stem cell transplantation (SCT) therapy, and complications resulting from these therapies. Details of medical history and patient information were retrospectively extracted from patients' charts, medical records and the electronic laboratory database at the hospital.


RESULTS
Patients in the PIU tended to be complicated by insomnia or depression more than those in the SW, but the stay in the PIU was not significantly related to the incidence of insomnia or depression. Our findings indicated that use of CS was a risk factor for insomnia. The prevalence of depression was higher in patients with therapeutic complications. All PIU patients with depression also received SCT.


CONCLUSIONS
Our findings suggest an increased potential for insomnia after administration of CS and depression in cases with complications after SCT, which is important to keep in mind for patients with hematological disorders.
Kunitomi
Akane
A
Department of Hematology, Meitetsu Hospital, Nagoya, Japan. akunitom@mx5.suisui-w.ne.jp
Iida
Hiroatsu
H
Kamiya
Yoshikazu
Y
Hayashi
Mayuko
M
Suwa
Taro
T
Kanda
Junya
J
Sao
Hiroshi
H
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D003863:Depression / Q000209:etiology*; D005260:Female; D006402:Hematologic Diseases / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010356:Patient Isolation / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology*; D033581:Stem Cell Transplantation / Q000523:psychology; D055815:Young Adult
D000305:Adrenal Cortex Hormones