Jacobs E A, Reynolds C F, Kupfer D J, Lovin P A, Ehrenpreis A B
Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA 15213.
Am J Psychiatry. 1988 Mar;145(3):346-9. doi: 10.1176/ajp.145.3.346.
The authors examined the accuracy of the differential diagnosis of chronic insomnia with and without sleep laboratory studies in a consecutive series of 123 patients. All patients were evaluated by means of a sleep/wake log, a sleep habits questionnaire, structured psychiatric and clinical interviews, and a minimum of two consecutive nights of polysomnography. Notwithstanding a high rate of Research Diagnostic Criteria (RDC)-diagnosed psychopathology (63%) in this sample, the major finding was that in 49% of the patients laboratory results added to, refuted, and/or failed to support the clinical impression. This resulted in substantial modification of the initial diagnostic formulation and therefore in increased specificity of diagnosis.
作者对连续123例患者进行了研究，探讨有无睡眠实验室检查时慢性失眠症鉴别诊断的准确性。所有患者均通过睡眠/觉醒日志、睡眠习惯问卷、结构化精神科和临床访谈以及至少连续两晚的多导睡眠图进行评估。尽管该样本中研究诊断标准（RDC）诊断的精神病理学发生率很高（63%），但主要发现是，49%的患者实验室结果补充、反驳和/或未支持临床印象。这导致了初始诊断公式的实质性修改，从而提高了诊断的特异性。
