Form, frequency and burden of sleep problems in general health care: a report from the WHO Collaborative Study on Psychological Problems in General Health Care

Abstract

The WHO Collaborative Study on Psychol og ical Problems in General Health Care examined the frequency. form , course and outcome of psychological probl ems in general health c are senings. A total of 25.916 general heal th care anenders at 15 sites In 14 countries were scre en ed using the 12-item General Health Questionnaire (GHQ-12). Of those sc reened. 5,438 were asses sed in de tail using a Prim ary Health Care version of the Composite International Diagnostic Interview (CIDI-PHC) In conjunction with the Brief Disability Questionnaire. the Social Disability Schedules. a self rated overall health status fonn and the 28• nem General Health Que stionnaire. The analysis has shown that sleep problems were common at all sites with : 26 .8% of all pat ients ha ving some form of sleep problem and '5% of the patients examined had trouble failing or staying asleep.Ofthose with sleep problems. 51 .5% had a well-defined International Classification of Diseases 10th Revision (ICD-IO) mental disorder (such as depression. anxiety, sornatoform disorders or alcohol problems) and 48.5% of those with sleep problems for at least two weeks or more did not fulfil the criteria for any well defined ICD•I 0 diagnosis. Persons with sleep problems reported a degree of disability in the performance of their da ily activities and social roles even when they had no symptoms of psychological disorders. When such symptoms were present the disab ility was significantly increased. insomnia I general health care} ICD•I0 I Cross-cultural comparisons I sleep problems

Nonorganic Insomnia in Generalized Anxiety Disorder

“…Indeed, in a recent study on the diagnosis of patients coming to the Sleep Outpatient Clinic o f the Department of Psychiatry, University of Vienna, 70% suffered from a non-organic and 30% from an organic sleep disorder [8]. In a non-specialized sleep laboratory, 52% of the patients exhibited psychic disorders [9], which is interestingly almost exactly in agreement with the W H O collaborative study on psychological problems in 25.916 general health care patients in 14 countries [10], in which 26.8% had sleep problems; of these 51.5% had a well-defined ICD-10 diagnosis for mental disorders) such as depression, anxiety, somatoform disorders or alcohol problems. Mental disorders are the leading causes for sleep disturbances, which may also be seen from the fact that one fifth of patients in a general practice report sleep disorders, while this is the case for one third of the patients in offices of neuropsychiatric specialists and in three quarters of patients in psychiatric clinics [11,12], Indeed, in a recent epidemiological study of 700 patients attending 24 general practices in Switzerland.…”

Placebo-Controlled Sleep Laboratory Studies on the Acute Effects of Zolpidem on Objective and Subjective Sleep and Awakening Quality in Nonorganic Insomnia Related to Neurotic and Stress-Related Disorder

“…Indeed, in a recent study on the diagnoses of patients coming to the Sleep Outpatient Clinic of the Department of Psychiatry, University of Vienna, 70% were suffering from nonorganic and 30% from organic sleep disorders [8]. In a nonspecialized sleep laboratory, 52% of the patients exhibited psychic disorders [9], which interestingly is almost exactly in agreement with the WHO collaborative study on psychological problems in 25,916 general health care patients in 14 countries [10], in which 26.8% were suffering from sleep problems. Of these, 51.5% had a well-defined ICD-10 diagnosis of mental disorder such as depression, anxiety, somatoform disorders or alcohol problems.…”

A review of signals used in sleep analysis

“…Up to 40% of the United States (US) adult population experience problems with falling asleep or daytime sleepiness, which are largely assumed to be due to disturbed sleep patterns (Hossain & Shapiro 2002). It is difficult to quantify the impact of poor sleep structure in a broad sense as it is often considered a symptom of other diseases, although it is intricately connected to many of the dominant burdens of disease (Üstün et al 1996). In fact, the health effects of sleep disorders span a wide range: from the apparently simple daytime sleepiness, which is a non-specific symptom common to other disorders (Pagel 2009), to the more severe effects of increased risk of cardiovascular disease and stroke (Young et al 2002).…”