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DSM-IV psychiatric comorbidity according to symptoms of insomnia: a nationwide sample of Korean adults

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Abstract

Purpose

The diagnosis of insomnia is based on the presence of four different symptoms: difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), early morning awakening (EMA), and non-restorative sleep (NRS). This study investigated the differences in sociodemographic correlates and psychiatric comorbidity between the four symptoms of insomnia in the general population of South Korea.

Methods

A sample of the population aged 18–64 (N = 6,510) was questioned using a face-to-face interview. Insomnia was defined as having at least one of the four following symptoms three or more times per week: DIS, DMS, EMA, and NRS. Psychiatric disorders were evaluated using the Korean version of Composite International Diagnostic Interview. Logistic regression analysis was used to test each of the sleep outcomes (DIS, DMS, EMA, or NRS) for an association with sociodemographic and clinical variables.

Results

The prevalence of DIS, DMS, EMA, and NRS were 7.9 % (95 % CI 6.6–9.5 %), 7.9 % (95 % CI 6.5–9.6 %), 4.9 % (95 % CI 3.9–6.0 %), and 14.8 % (95 % CI 12.6–17.4 %), respectively. The overall prevalence of insomnia was 19.0 % (95 % CI 16.1–22.2 %). Being separated, divorced, or widowed, being single, having a part-time job, having a psychiatric illness, and having a physical illness were all significantly related to insomnia. Older age also increased the risk of DMS and EMA, and younger age was a risk factor for NRS. The presence of most psychiatric disorders was significantly related to insomnia. However, the relationship between the psychiatric illness and each insomnia symptom varied and was dependent on the insomnia symptom.

Conclusions

Most psychiatric disorders were significantly associated with each insomnia symptom in different ways. Differences in sociodemographic and clinical correlates between the four insomnia symptoms implied the heterogeneous characteristics of insomnia as defined by the current diagnostic criteria.

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Acknowledgments

This study was supported by a research Grant from the Ministry of Health, Welfare, and Family Affairs of the Republic of Korea.

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Authors and Affiliations

  1. Department of Psychiatry, Bucheon Medical Center for the Elderly, Bucheon-si, South Korea

    Byung-Soo Kim

  2. Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Hong Jin Jeon

  3. Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Jin Pyo Hong

  4. Department of Psychiatry, Inha University College of Medicine, Incheon, South Korea

    Jae Nam Bae

  5. Department of Psychiatry and Behavioral Science, Boramae Hospital, Seoul National University College of Medicine, Seoul, South Korea

    Jun-Young Lee

  6. Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, South Korea

    Sung Man Chang

  7. Department of Medical Humanities and Social Medicine, School of Medicine, Ajou University, Suwon-si, Korea

    Young-Moon Lee

  8. Department of Neuropsychiatry, College of Medicine, Chungbuk National University, Cheongju-si, South Korea

    Jungwoo Son

  9. Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744, South Korea

    Maeng Je Cho

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  1. Byung-Soo Kim
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Correspondence to Maeng Je Cho.

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Kim, BS., Jeon, H.J., Hong, J.P. et al. DSM-IV psychiatric comorbidity according to symptoms of insomnia: a nationwide sample of Korean adults. Soc Psychiatry Psychiatr Epidemiol 47, 2019–2033 (2012). https://doi.org/10.1007/s00127-012-0502-0

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