Mata Ruiz I, Ortiz Lobo A, Hernándex Monsalve M, Gervás J
Servicio Salut Mental del Area, CESCA, Madrid.
Aten Primaria. 1995 Sep 30;16(5):271-4.
Although insomnia is a common complaint in Primary Care, the patient's perception of the problem and the variables which affect his/her visit to the doctor have been little studied. In this study the Subjective Complaint of Insomnia (SCI) was evaluated. These data were then compared with those found in the clinical records and those contributed by the doctors at a Health Centre.
An observational crossover study, using a structured personal interview based on Goldberg's Clinical Interview Schedule, was carried out. The clinical records of those interviewed were reviewed and a questionnaire aimed at the doctors was designed to determine their perception of insomnia from their consultations.
The prevalence of SCI in the preceding week was 45.45%. 45.7% of patients with SCI attended for this reason. Those patients who did not declare SCI to their doctor often lacked psychiatric antecedents, attended because of acute (rather than chronic) pathology and scored lower on the subjective evaluation scale of the intensity of the insomnia. Quality of sleep was recorded in 58.7% of the clinical records, with 20.6% prevalence of insomnia. All the doctors interviewed thought that the prevalence of insomnia among their patients was below 40%.
The prevalence of insomnia in Primary Care is greater than doctors believe and than that recorded in the clinical notes. Patients who do not mention their problems are those who are less seriously ill.
尽管失眠是初级保健中常见的主诉，但患者对该问题的认知以及影响其就医的因素鲜有研究。本研究对失眠主观主诉（SCI）进行了评估。然后将这些数据与临床记录中的数据以及某健康中心医生提供的数据进行比较。
采用基于戈德堡临床访谈量表的结构化个人访谈进行了一项观察性交叉研究。对接受访谈者的临床记录进行了审查，并设计了一份针对医生的问卷，以确定他们在会诊中对失眠的认知。
前一周SCI的患病率为45.45%。45.7%的SCI患者因此前来就诊。那些未向医生声明SCI的患者通常没有精神病史，因急性（而非慢性）疾病前来就诊，且在失眠强度主观评估量表上得分较低。58.7%的临床记录记录了睡眠质量，失眠患病率为20.6%。所有接受访谈的医生都认为他们的患者中失眠患病率低于40%。
初级保健中失眠的患病率高于医生的认知以及临床记录中的记录。未提及自身问题的患者病情较轻。
