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Sleep-disorders quiz awakens interest.

An easily learned interview technique may enable mental health clinicians and researchers to diagnose sleep disorders more accurately and to distinguish primary sleep problems from those brought on by other psychiatric conditions, according to a study in the June AMERICAN JOURNAL OF PSYCHIATRY

A research team at Albert-Ludwigs University in Freiberg, Germany, developed the interview approach for sleep disorders based on the latest Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. Clinicians currently lack a standard interview method for identifying sleep disorders.

"Development of a structured interview for sleep disorders fills a critical gap in our field," write psychiatrist Charles F. Reynolds III of the University of Pittsburgh School of Medicine and his colleagues in an accompanying editorial. "It is potentially a useful clinical instrument for the office-based screening of patients with sleep disorders, as well as for sleep research."

Much controversy surrounds the definition of sleep disorders. The DSM divides these conditions into two general categories: disturbances in, the amount, quality, or timing of sleep, such as insomnia; and abnormal events that occur during sleep, such as repeated nightmares or sleepwalking. Many sleep-disorders specialists criticize DSM for ignoring physical ailments linked to sleep problems, and some prefer an alternative classification system that lists nearly 70 sleep disorders.

The German researchers, headed by psychologist Elisabeth Schramm, devised a 20- to 30-minute interview with questions covering physical health, drug use, mental health. and signs of sleep disorders adapted from DSM. Interviewers then fill out a symptom summary sheet.

A total of 68 people attending one of three sleep-disorders clinics participated in the study Twelve clinicians. 10 of whom specialize in sleep disorders, conducted the interviews. Volunteers were interviewed twice over a four-day period, each time by a different clinician.

Clinicians almost always agreed on diagnoses of sleep disorders, as well as on which participants suffered from sleep difficulties related to mental disorders such as depression.

For 27 of 30 volunteers attending one clinic, the researchers confirmed diagnoses of sleep disorders with overnight observations in a sleep laboratory and physiological measures -- including brain waves, respiration, and leg movements - obtained during sleep.

The German study contains several limitations, Reynolds and his coworkers assert. For instance. the ability of clinicians who do not specialize in sleep disorders to use the new interview successfully remains uncertain.

Moreover, the failure to gather physiological data on all participants raises the possibility that some were misdiagnosed and may have had an underlying, unrecognized problem, such as sleep apnea or leg twitching, the Pittsburgh scientists argue.
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Title Annotation:standard interview method developed for identifying sleep disorders
Author:Bower, Bruce
Publication:Science News
Date:Jun 26, 1993
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