Shannen R van der Kruk, Kate M Gunn, Hamish MacDougall, Donna Milne, Katherine Smith, Rob Zielinski
Feasibility and preliminary effectiveness of virtual reality as a patient education tool for people with cancer undergoing immunotherapy: a protocol for a randomised controlled pilot study in a regional setting
BMJ open
link insomniac symptoms suicidality long suspected deserves specific attention examine current evidence relationship epidemiology neurobiology order propose targeted management clinical example selective medlineliterature research insomnia symptoms suicidality epidemiological data statistical analysis show symptoms insomnia independent risk factors suicidality neurobiological factors associated combined insomnia symptoms suicidality serotonergic dysfunction circadian rhythm disorder leading hypofrontality reduced problem solving capacity impaired emotional impulsecontrol social isolation recurrent rumination comorbid psychiatric disorders access potentially lethal drugs weapons need urgent evaluation patients combination suicidality symptoms insomnia patients insomnia risk factors suicide need treated resolutely early stage modern sleeppromoting antidepressants low toxicity antipsychotics must preferred treatment patients insomniac sleep disorders suicidality multimodal antiinsomnia antidepressive therapy adapted circadian rhythm exert favorable influence depressivesuicidal insomnia symptoms inherent risks