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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2011; 11: 186.
Published online Nov 23, 2011. doi:  10.1186/1471-244X-11-186
PMCID: PMC3231868
Differences between patients' and clinicians' report of sleep disturbance: a field study in mental health care in Norway
Håvard Kallestad,corresponding author1,2 Bjarne Hansen,2,3 Knut Langsrud,2,3 Torleif Ruud,4,5 Gunnar Morken,2 Tore C Stiles,6 and Rolf W Gråwe7,8
1St. Olav's University Hospital, Division of Psychiatry, Department of Research and Development. Trondheim, Norway
2Norwegian University of Science and Technology, Faculty of Medicine, Department of Neuroscience. Trondheim, Norway
3St. Olav's University Hospital, Division of Psychiatry, Department of Østmarka. Trondheim, Norway
4Akershus University Hospital, Division of Mental Health Services. Norway
5University of Oslo, Faculty of Medicine, Institute of Clinical Medicine. Oslo, Norway
6Norwegian University of Science and Technology, Faculty of Social Sciences and Technology Management, Department of Psychology. Trondheim, Norway
7University of Oslo, Institute of Clinical Medicine, Norwegian Centre for Addiction Research, Oslo, Norway
8Drug and Alcohol Treatment Health Trust Central Norway. Department of Research and Development, Trondheim, Norway
corresponding authorCorresponding author.
Håvard Kallestad: havard.kallestad/at/ntnu.no; Bjarne Hansen: bjarne.hansen/at/ntnu.no; Knut Langsrud: knut.langsrud/at/ntnu.no; Torleif Ruud: torleif.ruud/at/medisin.uio.no; Gunnar Morken: gunnar.morken/at/ntnu.no; Tore C Stiles: tore.stiles/at/svt.ntnu.no; Rolf W Gråwe: rolf.w.grawe/at/rus-midt.no
Received April 14, 2011; Accepted November 23, 2011.
Abstract
Background
The aims of the study was to assess the prevalence of diagnosed insomnia and the agreement between patient- and clinician-reported sleep disturbance and use of prescribed hypnotic medication in patients in treatment for mental disorders.
Methods
We used three cross-sectional, multicenter data-sets from 2002, 2005, and 2008. Data-set 1 included diagnostic codes from 93% of all patients receiving treatment in mental health care in Norway (N = 40261). Data-sets 2 (N = 1065) and 3 (N = 1181) included diagnostic codes, patient- and clinician-reported sleep disturbance, and use of prescribed hypnotic medication from patients in 8 mental health care centers covering 10% of the Norwegian population.
Results
34 patients in data-set 1 and none in data-sets 2 and 3 had a diagnosis of insomnia as a primary or comorbid diagnosis. In data-sets 2 and 3, 42% and 40% of the patients reported sleep disturbance, whereas 24% and 13% had clinician-reported sleep disturbance, and 7% and 9% used hypnotics. Patients and clinicians agreed in 29% and 15% of the cases where the patient or the clinician or both had reported sleep disturbance. Positive predictive value (PPV) of clinicians' evaluations of patient sleep disturbance was 62% and 53%. When the patient reported sleep disturbance as one of their most prominent problems PPV was 36% and 37%. Of the patients who received hypnotic medication, 23% and 29% had neither patient nor clinician-rated sleep disturbance.
Conclusion
When patients meet the criteria for a mental disorder, insomnia is almost never diagnosed, and sleep disturbance is imprecisely recognized relative to the patients' experience of sleep disturbance.
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