Wong Mark Lawrence, Lau Kristy Nga Ting, Espie Colin A, Luik Annemarie I, Kyle Simon D, Lau Esther Yuet Ying
Department of Clinical Psychology, Pamela Youde Nethersole Eastern Hospital, Hospital Authority, Hong Kong.
Department of Psychology, The University of Hong Kong, Hong Kong.
Sleep Med. 2017 May;33:76-81. doi: 10.1016/j.sleep.2016.05.019. Epub 2016 Oct 22.
The Sleep Condition Indicator (SCI) and Insomnia Severity Index (ISI) are commonly used instruments to assess insomnia. We evaluated their psychometric properties, particularly their discriminant validity against structured clinical interview (according to DSM-5 and ICSD-3), and their concurrent validity with measures of sleep and daytime functioning.
A total of 158 young adults, 16% of whom were diagnosed with DSM-5 insomnia disorder and 13% with ICSD-3 Chronic Insomnia by structured interview, completed the ISI and SCI twice in 7-14 days, in addition to measures of sleep and daytime function.
The Chinese version of the SCI was validated with good psychometric properties (ICC = 0.882). A cutoff of ≥8 on the ISI, ≤5 on the SCI short form, and ≤21 on the SCI achieved high discriminant validity (AUC > 0.85) in identifying individuals with insomnia based on both DSM-5 and ICSD-3 criteria. The SCI and ISI had comparable associations with subjective (0.18 < r < 0.51) and actigraphic sleep (0.31 < r < 0.43) and daytime functioning (0.34 < r < 0.53).
The SCI, SCI short form, and ISI were found to correctly identify individuals with DSM-5- and ICSD-3-defined insomnia disorder. Moreover, they showed good concordance with measures of daytime dysfunction, as well as subjective and objective sleep. The SCI and ISI are recommended for use in clinical and research settings.
睡眠状况指标（SCI）和失眠严重程度指数（ISI）是常用的评估失眠的工具。我们评估了它们的心理测量特性，特别是它们相对于结构化临床访谈（根据《精神疾病诊断与统计手册》第5版和《国际睡眠障碍分类》第3版）的区分效度，以及它们与睡眠和日间功能测量指标的同时效度。
共有158名年轻人，其中16%经结构化访谈被诊断为符合《精神疾病诊断与统计手册》第5版的失眠症，13%符合《国际睡眠障碍分类》第3版的慢性失眠症，他们在7至14天内完成了两次ISI和SCI测试，此外还进行了睡眠和日间功能测量。
中文版SCI经验证具有良好的心理测量特性（组内相关系数=0.882）。ISI评分≥8、SCI简表评分≤5以及SCI评分≤21时，在根据《精神疾病诊断与统计手册》第5版和《国际睡眠障碍分类》第3版标准识别失眠个体方面具有较高的区分效度（曲线下面积>0.85）。SCI和ISI与主观睡眠（0.18<r<0.51）、活动记录仪监测的睡眠（0.31<r<0.43）以及日间功能（0.34<r<0.53）具有相似的相关性。
发现SCI、SCI简表和ISI能够正确识别符合《精神疾病诊断与统计手册》第5版和《国际睡眠障碍分类》第3版定义的失眠症个体。此外，它们与日间功能障碍测量指标以及主观和客观睡眠指标显示出良好的一致性。推荐在临床和研究环境中使用SCI和ISI。
