López-Torres Hidalgo Jesús, avarro Bravo Beatriz N, Párraga Martínez Ignacio, Andrés Pretel Fernando, Rabanales Sotos Joseba, Simarro Herráez María José
Unidad de Investigación de la Gerencia de Atención Primaria de Albacete, Servicio de Salud de Castilla-La Mancha, España.
Gac Sanit. 2013 Jan-Feb;27(1):47-52. doi: 10.1016/j.gaceta.2011.11.014. Epub 2012 Mar 7.
To evaluate the perceived health status of elderly patients with insomnia, whether primary, secondary to a medical illness, or associated with another mental disorder.
We conducted a cross-sectional study in a representative sample of 926 persons aged over 65 years. A psychiatric interview was used to verify the presence of insomnia (DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, fourth ed., revised text). Interviews were conducted by health professionals to assess perceived health status (EuroQol-5D), health problems, and socio-demographic characteristics.
The prevalence of primary insomnia was 8.9% (95% CI: 7.1-11.0), that of insomnia associated with another mental disorder was 9.3% (95% CI: 7.5-11.4) and that of insomnia secondary to medical illness was 7.0% (95% CI: 5.4-8.9). Patients with insomnia who used hypnotics/sedatives scored lower in self-reported health (57.6; 95% CI: 53.7-61.4), significantly lower (p<0.05) than participants with insomnia not taking these drugs (65.1; 95% CI: 53.7-61.4). The mean health status score in individuals without insomnia was 0.87 and was significantly lower (p<0.05) in persons with any type of insomnia: 0.80 in primary insomnia, 0.73 in insomnia secondary to a mental disorder and 0.76 in insomnia associated with medical illness.
Health status was worse in older people with insomnia, whether primary, secondary to other mental illnesses or organic, and when the elderly patients consumed hypnotics/sedatives. Limitations were less severe in primary insomnia.
评估原发性失眠、继发于躯体疾病的失眠或与其他精神障碍相关的失眠的老年患者的健康状况。
我们对926名65岁以上的具有代表性的样本进行了横断面研究。采用精神科访谈来核实失眠的存在（《精神疾病诊断与统计手册》第四版，修订文本，DSM-IV-TR）。由健康专业人员进行访谈，以评估健康状况（欧洲五维健康量表）、健康问题和社会人口学特征。
原发性失眠的患病率为8.9%（95%可信区间：7.1 - 11.0），与其他精神障碍相关的失眠患病率为9.3%（95%可信区间：7.5 - 11.4），继发于躯体疾病的失眠患病率为7.0%（95%可信区间：5.4 - 8.9）。使用催眠药/镇静剂的失眠患者自我报告的健康得分较低（57.6；95%可信区间：53.7 - 61.4），显著低于未服用这些药物的失眠参与者（65.1；95%可信区间：53.7 - 61.4）。无失眠者的平均健康状况评分为0.87，在任何类型的失眠患者中均显著较低（p<0.05）：原发性失眠患者为0.80，继发于精神障碍的失眠患者为0.73，与躯体疾病相关的失眠患者为0.76。
失眠的老年人，无论原发性、继发于其他精神疾病或器质性疾病，以及服用催眠药/镇静剂时，健康状况较差。原发性失眠的局限性相对较轻。
