Psychiatric morbidity in patients referred to an insomnia clinic

Mahendran R, Subramaniam M, Chan YH
Correspondence: Dr R Mahendran, rathi_mahendran@imh.com.sg

ABSTRACT
Introduction Insomnia is a common complaint associated with psychiatric disorders. Detection and diagnosis of insomnia can be a challenge at the primary care level. Patients often present with various kinds of psychological symptoms. Therefore, a high index of suspicion and careful assessments are crucial in eliciting signs and symptoms and making an accurate diagnosis of primary insomnia or a psychiatric disorder.
Methods This study was undertaken at the end of 2005, and is a retrospective review of all patients referred to the Insomnia Clinic and seen by the principal author in a three-year period between 2002 and 2005. Relevant data was collected from the medical records of patients who attended the clinic during this period.
Results In this study of 141 patients seen at an Insomnia Clinic, 47.5 percent had primary insomnia, while 52.5 percent had a primary diagnosis of a psychiatric disorder. 41.1 percent of those diagnosed with a primary psychiatric disorder had comorbid psychiatric disorders and 4.3 percent had substance abuse problems.
Conclusion The various psychiatric disorders present in this group of patients highlight the need for careful assessment and recognition of these associations.

Keywords: insomnia, insomnia clinic, psychiatric disorders, sleep disorders
Singapore Med J 2007; 48(2): 163–165