Significance of sleep problems in the diagnosis of depressive and anxiety disorders

Abstract

To explore the significance of sleep problems in the diagnosis of depressive and anxiety disorders. A cross-sectional study was conducted through stratified convenient sampling in outpatients at our hospital from November 19, 2009 to January 19, 2010. A total of 203 outpatients (≥ 16 years old) were recruited from Department of Internal Medicine, Department of Surgery, Department of Obstetrics & Gynecology and other departments. Sleep Questionnaire was used as a screening tool for depressive and anxiety disorders. Composite international diagnostic interview (CIDI) was conducted by trained interviewers. According to diagnostic and statistical manual of mental disorders, Fourth Edition (DSM-IV) using the outcome from the logistic diagnostic procedure of CIDI as a golden standard for depressive and anxiety disorders, the validities of Sleep Questionnaire were calculated. According to the Sleep Questionnaire, the 12-month prevalence of any sleep problem was 31.0% (63/203). The Cronbach's α coefficient of the questionnaire was 0.764 and the area under the ROC (receiver operating characteristic) curve 0.741. With a cut-off point of 1, the sensitivity was 68.0% and the specificity 74.2% respectively. And it achieved the best composite diagnostic capacity. The positive predictive values were at least 27.0%. Sleep problem is a common complaint at a general hospital. When the duration and severity of sleep problem meet the standards of Sleep Questionnaire, a physician should be aware of possible depressive and anxiety disorders and more detailed information should be collected.