Comparability of sleep disorders diagnoses using DSM-IV and ICSD classifications with adolescents

Study Objectives: The use of diagnostic classifications to define sleep dis orders is still unusual in epidemiological studies assessing the prevalence of sleep disorders in an adolescent population. Design: Cross-sectional study. Representative samples of general population s in United Kingdom, Germany and Italy were selected and interviewed by tel ephone about their sleep habits, sleep and mental disorder diagnoses. Overa ll, 724 adolescents ages 15-18 years and 1447 young adults ages 19 to 24 ye ars were interviewed. ICSD-90 and DSM-IV diagnoses provided by the Sleep-EV AL expert system were used for the comparisons. Setting: N/A Participants: N/A Interventions: N/A Measurements and Results: 8% of the adolescents and 12.6% of the young adul ts had ICSD dyssomnia or sleep disturbances associated with a mental disord er. According to the DSM-IV classification, 5.7% of the adolescents and 8.1 % of the young adults had a dyssomnia. diagnosis. The comparison between th e two classifications show that 73.2% of adolescents and young adults with a DSM-IV dyssomnia diagnosis also had similar ICSD diagnosis. The reverse c omparison, ICSD vs. DSM-IV, shows that 39.8% of the subjects with an ICSD d iagnosis had a DSM-IV diagnosis. DSM-IV primary insomnia was the most frequ ent diagnosis. Subjects with such a diagnosis were found in about 10 differ ent ICSD diagnoses, mainly inadequate sleep hygiene, psychophysiological or idiopathic insomnia and insufficient sleep syndrome. Conclusions: ICSD-90 classification provided higher prevalence of sleep dis order diagnoses than the DSM-IV classification. In adolescents and young ad ults, DSM-IV primary insomnia is two times more often associated with ICSD inadequate sleep hygiene than with ICSD psychophysiological or idiopathic i nsomnia.