MENTAL COMORBIDITY OF CHRONIC INSOMNIA IN GENERAL-PRACTICE ATTENDERS USING DSM-III-R

The major aim of this study was to investigate links between chronic i nsomnia and mental and personality disorders using the DSM-III-R class ification. Of a sample of 2512 general practice attenders, 105 with a chronic insomnia complaint over a 4-month period were evaluated for me ntal and personality disorders. In addition, the significance of other factors such as personality traits, social functioning and the patien t's own estimation of sleep quality was studied. Sixty-six patients go t a diagnosis of a current insomnia using a structured interview for D SM-III-R. Fifty percent of them had at least one additional current Ax is I or II diagnosis. Affective disorders were most common as principa l psychiatric diagnosis followed by substance use disorders. The gener al practitioners were poor in recognizing their patients' chronic inso mnia complaints and the high percentage of substance abusers among the m. The important role of psychopathology in chronic insomnia sufferers was indicated by the high number of patients who displayed prominent personality traits. The predominant personality pattern was characteri zed by a pattern of internalization of problems combined with an anxio us-depressive reaction style. In summary, strong associations between chronic insomnia, mental disorders and psychopathology were confirmed by this investigation.