Clinical factors contributing to the differential diagnosis of primary insomnia and insomnia related to mental disorders

The results support the face validity of clinical factors used by sleep specialists to distinguish primary insomnia from insomnia related to mental disorders and suggest the need for studies on the validity of negative conditioning and sleep hygiene in the etiology of primary insomnia.

Abstract

While neither sleep hygiene nor negative conditioning is a diagnostic criterion in DSM-IV, these results support the face validity of these clinical factors distinguishing between primary insomnia and insomnia related to mental disorders. The use of a psychiatric disorder as an inclusion criterion for insomnia related to mental disorders and an exclusion criterion for primary insomnia reinforces a categorical distinction between the two diagnoses, but the contribution of psychiatric symptoms in primary insomnia appears to be a clinically relevant one. These findings suggest the need for studies on the validity of negative conditioning and sleep hygiene in the etiology of primary insomnia, as well as on the significance of psychiatric disorders, especially depression, in primary insomnia.