Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories

A report from the APA/NIMH DSM-IV field trial

D. J. Buysse, C. F. Reynolds, D. J. Kupfer, Michael J. Thorpy, E. Bixler, R. Manfredi, A. Kales, A. Vgontzas, E. Stepanski, T. Roth, P. Hauri, D. Mesiano

Research output: Contribution to journalArticle

216 Citations (Scopus)

Abstract

Three diagnostic classifications for sleep disorders have been developed recently: the International Classification of Sleep Disorders (ICSD), the Diagnostic and Statistical Manual, 4th edition (DSM-IV), and the International Classification of Diseases, 10th edition (ICD-10). No data have yet been published regarding the frequency of specific diagnoses within these systems or how the diagnostic systems relate to each other. To address these issues, we examined clinical sleep disorder diagnoses (without polysomnography) in 257 patients (216 insomnia patients and 41 medical/psychiatric patients) evaluated at five sleep centers. A sleep specialist interviewed each patient and assigned clinical diagnoses using ICSD, DSM-IV and ICD-10 classifications. 'Sleep disorder associated with mood disorder' was the most frequent ICSD primary diagnosis (32.3% of cases), followed by 'Psychophysiological insomnia' (12.5% of cases). The most frequent DSM-IV primary diagnoses were 'Insomnia related to another mental disorder' (44% of cases) and 'Primary insomnia' (20.2% of cases), and the most frequent ICD-10 diagnoses were 'Insomnia due to emotional causes' (61.9% of cases) and 'Insomnia of organic origin' (8.9% of cases). When primary and secondary diagnoses were considered, insomnia related to psychiatric disorders was diagnosed in over 75% of patients. The more narrowly defined ICSD diagnoses nested logically within the broader DSM-IV and ICD-10 categories. We found substantial site-related differences in diagnostic patterns. These results confirm the importance of psychiatric and behavioral factors in clinicians' assessments of insomnia patients across all three diagnostic systems. ICSD and DSM-IV sleep disorder diagnoses have similar patterns of use by experienced clinicians.

Original languageEnglish (US)
Pages (from-to)630-637
Number of pages8
JournalSleep
Volume17
Issue number7
StatePublished - 1994
Externally publishedYes

Fingerprint

National Institute of Mental Health (U.S.)
Sleep Initiation and Maintenance Disorders
International Classification of Diseases
Diagnostic and Statistical Manual of Mental Disorders
Psychiatry
Sleep
Sleep Wake Disorders
Polysomnography
Mood Disorders
Mental Disorders

Keywords

  • DSM-IV
  • ICD-10
  • ICSD
  • Insomnia

ASJC Scopus subject areas

  • Physiology

Cite this

Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories : A report from the APA/NIMH DSM-IV field trial. / Buysse, D. J.; Reynolds, C. F.; Kupfer, D. J.; Thorpy, Michael J.; Bixler, E.; Manfredi, R.; Kales, A.; Vgontzas, A.; Stepanski, E.; Roth, T.; Hauri, P.; Mesiano, D.

In: Sleep, Vol. 17, No. 7, 1994, p. 630-637.

Research output: Contribution to journalArticle

Buysse, DJ, Reynolds, CF, Kupfer, DJ, Thorpy, MJ, Bixler, E, Manfredi, R, Kales, A, Vgontzas, A, Stepanski, E, Roth, T, Hauri, P & Mesiano, D 1994, 'Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories: A report from the APA/NIMH DSM-IV field trial', Sleep, vol. 17, no. 7, pp. 630-637.
Buysse, D. J. ; Reynolds, C. F. ; Kupfer, D. J. ; Thorpy, Michael J. ; Bixler, E. ; Manfredi, R. ; Kales, A. ; Vgontzas, A. ; Stepanski, E. ; Roth, T. ; Hauri, P. ; Mesiano, D. / Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories : A report from the APA/NIMH DSM-IV field trial. In: Sleep. 1994 ; Vol. 17, No. 7. pp. 630-637.
@article{2be63534ab3e47f299e7179eca14edf9,
title = "Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories: A report from the APA/NIMH DSM-IV field trial",
abstract = "Three diagnostic classifications for sleep disorders have been developed recently: the International Classification of Sleep Disorders (ICSD), the Diagnostic and Statistical Manual, 4th edition (DSM-IV), and the International Classification of Diseases, 10th edition (ICD-10). No data have yet been published regarding the frequency of specific diagnoses within these systems or how the diagnostic systems relate to each other. To address these issues, we examined clinical sleep disorder diagnoses (without polysomnography) in 257 patients (216 insomnia patients and 41 medical/psychiatric patients) evaluated at five sleep centers. A sleep specialist interviewed each patient and assigned clinical diagnoses using ICSD, DSM-IV and ICD-10 classifications. 'Sleep disorder associated with mood disorder' was the most frequent ICSD primary diagnosis (32.3{\%} of cases), followed by 'Psychophysiological insomnia' (12.5{\%} of cases). The most frequent DSM-IV primary diagnoses were 'Insomnia related to another mental disorder' (44{\%} of cases) and 'Primary insomnia' (20.2{\%} of cases), and the most frequent ICD-10 diagnoses were 'Insomnia due to emotional causes' (61.9{\%} of cases) and 'Insomnia of organic origin' (8.9{\%} of cases). When primary and secondary diagnoses were considered, insomnia related to psychiatric disorders was diagnosed in over 75{\%} of patients. The more narrowly defined ICSD diagnoses nested logically within the broader DSM-IV and ICD-10 categories. We found substantial site-related differences in diagnostic patterns. These results confirm the importance of psychiatric and behavioral factors in clinicians' assessments of insomnia patients across all three diagnostic systems. ICSD and DSM-IV sleep disorder diagnoses have similar patterns of use by experienced clinicians.",
keywords = "DSM-IV, ICD-10, ICSD, Insomnia",
author = "Buysse, {D. J.} and Reynolds, {C. F.} and Kupfer, {D. J.} and Thorpy, {Michael J.} and E. Bixler and R. Manfredi and A. Kales and A. Vgontzas and E. Stepanski and T. Roth and P. Hauri and D. Mesiano",
year = "1994",
language = "English (US)",
volume = "17",
pages = "630--637",
journal = "Sleep",
issn = "0161-8105",
publisher = "American Academy of Sleep Medicine",
number = "7",

}

TY - JOUR

T1 - Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories

T2 - A report from the APA/NIMH DSM-IV field trial

AU - Buysse, D. J.

AU - Reynolds, C. F.

AU - Kupfer, D. J.

AU - Thorpy, Michael J.

AU - Bixler, E.

AU - Manfredi, R.

AU - Kales, A.

AU - Vgontzas, A.

AU - Stepanski, E.

AU - Roth, T.

AU - Hauri, P.

AU - Mesiano, D.

PY - 1994

Y1 - 1994

N2 - Three diagnostic classifications for sleep disorders have been developed recently: the International Classification of Sleep Disorders (ICSD), the Diagnostic and Statistical Manual, 4th edition (DSM-IV), and the International Classification of Diseases, 10th edition (ICD-10). No data have yet been published regarding the frequency of specific diagnoses within these systems or how the diagnostic systems relate to each other. To address these issues, we examined clinical sleep disorder diagnoses (without polysomnography) in 257 patients (216 insomnia patients and 41 medical/psychiatric patients) evaluated at five sleep centers. A sleep specialist interviewed each patient and assigned clinical diagnoses using ICSD, DSM-IV and ICD-10 classifications. 'Sleep disorder associated with mood disorder' was the most frequent ICSD primary diagnosis (32.3% of cases), followed by 'Psychophysiological insomnia' (12.5% of cases). The most frequent DSM-IV primary diagnoses were 'Insomnia related to another mental disorder' (44% of cases) and 'Primary insomnia' (20.2% of cases), and the most frequent ICD-10 diagnoses were 'Insomnia due to emotional causes' (61.9% of cases) and 'Insomnia of organic origin' (8.9% of cases). When primary and secondary diagnoses were considered, insomnia related to psychiatric disorders was diagnosed in over 75% of patients. The more narrowly defined ICSD diagnoses nested logically within the broader DSM-IV and ICD-10 categories. We found substantial site-related differences in diagnostic patterns. These results confirm the importance of psychiatric and behavioral factors in clinicians' assessments of insomnia patients across all three diagnostic systems. ICSD and DSM-IV sleep disorder diagnoses have similar patterns of use by experienced clinicians.

AB - Three diagnostic classifications for sleep disorders have been developed recently: the International Classification of Sleep Disorders (ICSD), the Diagnostic and Statistical Manual, 4th edition (DSM-IV), and the International Classification of Diseases, 10th edition (ICD-10). No data have yet been published regarding the frequency of specific diagnoses within these systems or how the diagnostic systems relate to each other. To address these issues, we examined clinical sleep disorder diagnoses (without polysomnography) in 257 patients (216 insomnia patients and 41 medical/psychiatric patients) evaluated at five sleep centers. A sleep specialist interviewed each patient and assigned clinical diagnoses using ICSD, DSM-IV and ICD-10 classifications. 'Sleep disorder associated with mood disorder' was the most frequent ICSD primary diagnosis (32.3% of cases), followed by 'Psychophysiological insomnia' (12.5% of cases). The most frequent DSM-IV primary diagnoses were 'Insomnia related to another mental disorder' (44% of cases) and 'Primary insomnia' (20.2% of cases), and the most frequent ICD-10 diagnoses were 'Insomnia due to emotional causes' (61.9% of cases) and 'Insomnia of organic origin' (8.9% of cases). When primary and secondary diagnoses were considered, insomnia related to psychiatric disorders was diagnosed in over 75% of patients. The more narrowly defined ICSD diagnoses nested logically within the broader DSM-IV and ICD-10 categories. We found substantial site-related differences in diagnostic patterns. These results confirm the importance of psychiatric and behavioral factors in clinicians' assessments of insomnia patients across all three diagnostic systems. ICSD and DSM-IV sleep disorder diagnoses have similar patterns of use by experienced clinicians.

KW - DSM-IV

KW - ICD-10

KW - ICSD

KW - Insomnia

UR - http://www.scopus.com/inward/record.url?scp=0028007228&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028007228&partnerID=8YFLogxK

M3 - Article

VL - 17

SP - 630

EP - 637

JO - Sleep

JF - Sleep

SN - 0161-8105

IS - 7

ER -