DSM-IV Classification of Sleep Disorders
Sleep disorders have been included in the Diagnostic and Statistical Manual of Mental Disorders since 1987. DSM-III-R (American Psychiatric Association 1987) classified patients first according to their primary complaint of “dyssomnia” (including insomnia, hypersomnia, and circadian rhythm disorder) or “parasomnia.” The DSM-III-R sleep disorder system was the first psychiatric sleep classification to demonstrated diagnostic interrater reliability by the use of a structured interview (Schramm et al. 1993). In DSM-IV (American Psychiatric Association 1994), patients are classified at the first level by presumed pathophysiology rather than by presenting symptom.
Thus, DSM-IV includes major sections of primary sleep disorders, sleep disorders related to another mental disorder, secondary sleep disorders due to an Axis III condition, and substance-induced sleep disorders (
Table 89-1). The number of specific sleep diagnoses in DSM-IV is greater than that in DSM-III-R but far smaller than that in the International Classification of Sleep Disorders (ICSD), the classification used by most sleep specialists (Diagnostic Classification Steering Committee 1990). DSM-IV sleep disorders characterized by insomnia have moderately good interrater reliability in clinical practice, with mean kappa values in the range of 0.30-0.57 (Buysse et al. 1994). Specific diagnoses have also been shown to result in different treatment recommendations (Buysse et al. 1997b).
Revision date: June 20, 2011
Last revised: by Amalia K. Gagarina, M.S., R.D.
We are pleased to let readers post comments about an article. Please increase the credibility of your post by including your full name and email.
All comments are reviewed by our editors before they are posted on the site. Just keep it clean, kids. Commenting is not available in this weblog entry.