title: Presence and persistence of sleep-related symptoms and suicidal ideation in psychiatric inpatients.
abstract: BACKGROUND
  Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment.
  
  
  OBJECTIVE
  To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve.
  
  
  METHODS
  The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination.
  
  
  RESULTS
  Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission.
  
  
  CONCLUSIONS
  These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.
authors.affiliation: <location>Baylor College of Medicine, Houston, TX, USA</location> <location>Department of Psychology, Mississippi State University, Mississippi State, MS, USA</location>
authors.forename: Michael R
authors.initials: MR
authors.lastname: Nadorff
authors.affiliation: <location>Baylor College of Medicine, Houston, TX, USA</location> <location>The Menninger Clinic, Houston, TX, USA</location>
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Ellis
authors.affiliation: <location>Baylor College of Medicine, Houston, TX, USA</location> <location>The Menninger Clinic, Houston, TX, USA</location>
authors.forename: Jon G
authors.initials: JG
authors.lastname: Allen
authors.affiliation: <location>Department of Psychology, Mississippi State University, Mississippi State, MS, USA</location>
authors.forename: E Samuel
authors.initials: ES
authors.lastname: Winer
authors.affiliation: <location>The Menninger Clinic, Houston, TX, USA</location>
authors.forename: Steve
authors.initials: S
authors.lastname: Herrera
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D019964:Mood Disorders / Q000150:complications / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000150:complications* / Q000453:epidemiology; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires
keywords: inpatient sample; insomnia symptoms; sleep-related symptoms; suicidal ideation