Majumdar Anindo, Ramya S, Ramakrishnan Jayalakshmy
Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India.
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
J Family Med Prim Care. 2019 Mar;8(3):1182-1188. doi: 10.4103/jfmpc.jfmpc_118_19.
Sleep disorders and mental health problems are common diagnoses in primary care settings. The objective of this study was to estimate the magnitude of poor sleep, depression, and anxiety through opportunistic screening and to find out the independent predictors of poor sleep quality among female participants.
A hospital-based study was conducted in the outpatient department (OPD) of an urban primary health center of Puducherry. Patients and accompanying healthy attendants ≥ 18 years of age who visited the OPD for any reason were included. Those with serious acute illness, previously diagnosed mental illness, pregnant women, and women in postpartum period (upto 6 weeks) were excluded. Systematic random sampling was used to select the participants. A semi-structured questionnaire was used to collect sociodemographic and clinical details along with the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale. Height and weight were also measured.
A total of 301 participants were recruited. Mean age of the participants was 49.4 (standard deviation 15.2) years. Magnitude of poor sleep (PSQI score > 5), abnormal anxiety, and abnormal depression were 118 (39.2%), 60 (19.9%), and 28 (9.3%) respectively. Multivariate logistic regression analysis showed that history of pain [odds ratio (OR) 3.2 (1.6-6.5), = 0.001], abnormal anxiety [OR 2.5 (1.2-5.6), = 0.021], and abnormal depression [OR 4.3 (1.4-13.2), = 0.01] independently predicted poor sleep quality among females.
OPD-based opportunistic screening for sleep and mental health problems should be routinely conducted by primary care and family physicians.
睡眠障碍和心理健康问题是基层医疗环境中常见的诊断。本研究的目的是通过机会性筛查评估睡眠不佳、抑郁和焦虑的程度，并找出女性参与者中睡眠质量差的独立预测因素。
在本地治里市一家城市初级卫生中心的门诊部进行了一项基于医院的研究。纳入因任何原因前往门诊部就诊的年龄≥18岁的患者及陪同的健康家属。排除患有严重急性疾病、先前诊断为精神疾病的患者、孕妇及产后（至6周）女性。采用系统随机抽样选择参与者。使用半结构化问卷收集社会人口学和临床细节，以及匹兹堡睡眠质量指数（PSQI）和医院焦虑抑郁量表。还测量了身高和体重。
共招募了301名参与者。参与者的平均年龄为49.4（标准差15.2）岁。睡眠不佳（PSQI评分>5）、焦虑异常和抑郁异常的比例分别为118（39.2%）、60（19.9%）和28（9.3%）。多因素逻辑回归分析显示，疼痛史[比值比（OR）3.2（1.6 - 6.5），P = 0.001]、焦虑异常[OR 2.5（1.2 - 5.6），P = 0.021]和抑郁异常[OR 4.3（1.4 - 13.2），P = 0.01]独立预测女性睡眠质量差。
基层医疗和家庭医生应常规开展基于门诊部的睡眠和心理健康问题机会性筛查。
