Ten percent to 40% of adults have intermittent insomnia, and 15% have long-term sleep difficulties. This article provides a review of the classification, differential diagnosis, and treatment options available for insomnia. We performed a MEDLINE search using OVID and the key words "insomnia," "sleeplessness," "behavior modification," "herbs," "medicinal," and "pharmacologic therapy." Articles were selected based on their relevance to the topic. Evaluation of insomnia includes a careful sleep history, review of medical history, review of medication use (including over-the-counter and herbal medications), family history, and screening for depression, anxiety, and substance abuse. Population-based studies estimate that 10% to 40% of American adults have intermittent insomnia; 10% to 15% have long-term sleep difficulties. 2Insomnia has been associated with decreases in work performance and increases in motor vehicle accidents and hospitalization rates.3 Cost estimates for lost productivity and insomnia-related accidents exceed $100 billion per year. 4 The purpose of this review is to provide a current review of the classification, the differential diagnosis, and treatment options for insomnia. We performed a MEDLINE search using OVID and the key words "insomnia," "sleeplessness," "behavior modification," "herbs," "medicinal," and "pharmacologic therapy." Abstracts were reviewed by 2 of the authors (ENR, SLP). Articles were then selected based on relevance to the topical review.
Introduction: Previous epidemiological studies clearly demonstrated gender differences in the patterns of mental illness. As a matter of fact, female suffer more from depressive and anxiety disorders, while male suffer more from addictive behaviour and psychotic disorders. Objectives/aims: The present study was elaborated by the Psychiatric Department Quality Commission of the Coimbra University Hospital in order to identify gender differences in socio-demographic and clinical characteristics of patients that were hospitalized from January to June 2011. Methods: We analyzed 417 clinical files and gathered socio-demographic information (gender, age, marital status and job) and clinical information (diagnosis and hospitalization's length). Statistical analysis was performed with SPSS program, using the chi-square's and Mann-Whitney's tests. Results: 53% of the inpatients were women. It was also observed that women were older (p = 0.021), more frequently married and widowed (p < 0.001), were less associated with compulsory admission (p < 0.001), had shorter hospitalizations (p = 0.024) and were more often diagnosed with adjustment reaction and bipolar disorder (p < 0.001), while men were younger (p < 0.001), more frequently single (p < 0.001), more frequently unemployed (p < 0.001), were more subject to compulsory admission (p < 0.001) and were more often diagnosed with addictive disorders and schizophrenia. Conclusions: These results are consistent with the existing literature and enable us to organize the services'conditions according to the needs of our psychiatric inpatient population.
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