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《精神疾病诊断与统计手册》第5版自评一级交叉症状量表显示,在因失眠接受治疗的患者中,并存的精神症状水平较高。

The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure identifies high levels of coexistent psychiatric symptomatology in patients referred for insomnia treatment.

作者信息

Meaklim Hailey, Swieca John, Junge Moira, Laska Irena, Kelly Danielle, Joyce Rosemarie, Cunnington David

机构信息

Melbourne Sleep Disorders Centre, East Melbourne, VIC, Australia,

Discipline of Psychology, RMIT University, Bundoora, VIC, Australia.

出版信息

Nat Sci Sleep. 2018 Nov 5;10:377-383. doi: 10.2147/NSS.S173381. eCollection 2018.

Abstract

PURPOSE

Referrals to sleep psychology services, even for a perceived single problem such as insomnia, can present with complex, coexistent psychiatric symptoms and comorbid disorders. This study aimed to assess the feasibility of implementing the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure (CCSM) into a sleep psychology clinic to identify coexistent psychiatric symptomatology in insomnia referrals.

PATIENTS AND METHODS

Patients were 50 consecutive referrals to a private sleep psychology service within a sleep disorders center in Melbourne, Australia. Patients who attended sleep psychology services between June 2015 and January 2017 had their clinical records reviewed. Basic demographic information, comorbidities, and responses to the Insomnia Severity Index were gathered. Task Force and Work Groups created the CCSM in 2013 to deal with the issue of coexistent psychiatric symptomatology across mental health conditions, and this measure was included into the sleep psychology intake procedure and patient responses were reviewed.

RESULTS

The CCSM was simple and quick to administer and score and revealed high levels of psychiatric symptomatology in sleep psychology referrals. Sleep problems were the most common domain of psychiatric symptomatology reported (86%). Anxiety (66%), depression (64%), anger (64%), and somatic symptoms (50%) were also very common. Suicidal ideation was acknowledged by 26% of patients. In addition, 82% of patients had at least one diagnosed comorbidity upon referral (eg, psychiatric, physical health, or other sleep disorder).

CONCLUSION

The findings support the CCSM as a feasible measure for identifying the high levels of coexistent psychiatric symptomatology in patients presenting for insomnia treatment at sleep psychology services.

摘要

目的

转介至睡眠心理服务机构的患者,即便被认为仅存在单一问题,如失眠,也可能伴有复杂的、并存的精神症状及共病。本研究旨在评估将《精神疾病诊断与统计手册》第五版自评一级交叉症状测量表(CCSM)应用于睡眠心理诊所,以识别失眠转诊患者中并存的精神症状的可行性。

患者与方法

连续纳入澳大利亚墨尔本一家睡眠障碍中心内一家私立睡眠心理服务机构的50例转诊患者。对2015年6月至2017年1月期间接受睡眠心理服务的患者的临床记录进行回顾。收集基本人口统计学信息、共病情况以及对失眠严重程度指数的反应。工作组于2013年制定了CCSM,以处理心理健康状况中并存的精神症状问题,该测量表被纳入睡眠心理接诊流程,并对患者的反应进行了回顾。

结果

CCSM实施和评分简单快捷,显示睡眠心理转诊患者中存在高水平的精神症状。睡眠问题是报告的最常见的精神症状领域(86%)。焦虑(66%)、抑郁(64%)、愤怒(64%)和躯体症状(50%)也很常见。26%的患者承认有自杀意念。此外,82%的患者在转诊时至少有一种已确诊的共病(如精神疾病、身体健康问题或其他睡眠障碍)。

结论

研究结果支持CCSM作为一种可行的测量方法,用于识别在睡眠心理服务机构接受失眠治疗的患者中高水平的并存精神症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d30/6223387/71334d1df311/nss-10-377Fig1.jpg

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