Nofzinger E A, Buysse D J, Reynolds C F, Kupfer D J
Sleep and Chronobiology Center, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, PA 15213.
J Clin Psychiatry. 1993 Jul;54(7):244-55; discussion 256-9.
Disturbances of the sleep/wake cycle are fundamental clinical symptoms for patients with many of the mental disorders. This review of the literature on research in sleep and mental disorders from 1966 to 1991 highlights the major developments and findings that are central to the development of a DSM-IV diagnosis of sleep disorders related to another mental disorder (nonsubstance/primary).
As a framework, the review discusses the classification criteria listed in the International Classification of Sleep Disorders (ICSD, 1990) for sleep disorders associated with mental disorders. Research relevant to the classification system is reviewed and the merits of modifying the DSM-III-R criteria based on the accumulated research are discussed.
Overall, the review supports the notion of consistent biological alterations in the sleep/wake cycle for patients with many of the mental disorders.
On the basis of this evidence, sleep disorders related to another mental disorder warrant separate diagnostic classification within a nosology for sleep disorders. The review also reveals the historical development of sleep research as a tool within the field of psychiatry for characterizing the biological bases of mental disorders.
睡眠/觉醒周期紊乱是许多精神障碍患者的基本临床症状。这篇对1966年至1991年期间睡眠与精神障碍研究文献的综述突出了对与另一种精神障碍（非物质/原发性）相关的睡眠障碍进行《精神疾病诊断与统计手册》第四版（DSM-IV）诊断的核心主要进展和研究结果。
作为一个框架，该综述讨论了《国际睡眠障碍分类》（ICSD，1990）中列出的与精神障碍相关的睡眠障碍的分类标准。对与该分类系统相关的研究进行了综述，并讨论了根据积累的研究修改《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）标准的优点。
总体而言，该综述支持许多精神障碍患者在睡眠/觉醒周期中存在一致的生物学改变这一观点。
基于这一证据，与另一种精神障碍相关的睡眠障碍在睡眠障碍分类学中应有单独的诊断分类。该综述还揭示了睡眠研究作为精神病学领域内用于描述精神障碍生物学基础的一种工具的历史发展。
