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The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure identifies high levels of coexistent psychiatric symptomatology in patients referred for insomnia treatment

Authors Meaklim H, Swieca J, Junge M, Laska I, Kelly D, Joyce R, Cunnington D

Received 7 May 2018

Accepted for publication 10 August 2018

Published 5 November 2018 Volume 2018:10 Pages 377—383

DOI https://doi.org/10.2147/NSS.S173381

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Steven A Shea


Video abstract presented by Hailey Meaklim.

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Hailey Meaklim,1,2 John Swieca,1 Moira Junge,1 Irena Laska,1 Danielle Kelly,1,3 Rosemarie Joyce,1,3 David Cunnington1

1Melbourne Sleep Disorders Centre, East Melbourne, VIC, Australia; 2Discipline of Psychology, RMIT University, Bundoora, VIC, Australia; 3Sleep Disorders Unit, St Vincent’s Private Hospital, East Melbourne and Werribee, VIC Australia

Purpose: Referrals to sleep psychology services, even for a perceived single problem such as insomnia, can present with complex, coexistent psychiatric symptoms and comorbid disorders. This study aimed to assess the feasibility of implementing the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure (CCSM) into a sleep psychology clinic to identify coexistent psychiatric symptomatology in insomnia referrals.
Patients and methods: Patients were 50 consecutive referrals to a private sleep psychology service within a sleep disorders center in Melbourne, Australia. Patients who attended sleep psychology services between June 2015 and January 2017 had their clinical records reviewed. Basic demographic information, comorbidities, and responses to the Insomnia Severity Index were gathered. The Diagnostic and Statistical Manual of Mental Disorders Ed. 5 Task Force and Work Groups created the CCSM in 2013 to deal with the issue of coexistent psychiatric symptomatology across mental health conditions, and this measure was included into the sleep psychology intake procedure and patient responses were reviewed.
Results: The CCSM was simple and quick to administer and score and revealed high levels of psychiatric symptomatology in sleep psychology referrals. Sleep problems were the most common domain of psychiatric symptomatology reported (86%). Anxiety (66%), depression (64%), anger (64%), and somatic symptoms (50%) were also very common. Suicidal ideation was acknowledged by 26% of patients. In addition, 82% of patients had at least one diagnosed comorbidity upon referral (eg, psychiatric, physical health, or other sleep disorder).
Conclusion: The findings support the CCSM as a feasible measure for identifying the high levels of coexistent psychiatric symptomatology in patients presenting for insomnia treatment at sleep psychology services.

Keywords: comorbidity, sleep, mental health, insomnia, assessment

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