title: Impact of sleep disturbance on patients in treatment for mental disorders.
abstract: BACKGROUND
  In clinical practice, sleep disturbance is often regarded as an epiphenomenon of the primary mental disorder. The aim of this study was to test if sleep disturbance, independently of primary mental disorders, is associated with current clinical state and benefit from treatment in a sample representative of public mental health care clinics.
  
  
  METHODS
  2246 patients receiving treatment for mental disorders in eight public mental health care centers in Norway were evaluated in a cross-sectional study using patient and clinician reported measures. Patients reported quality of life, symptom severity, and benefit from treatment. Clinicians reported disorder severity, level of functioning, symptom severity and benefit from treatment. The hypothesis was tested using multiple hierarchical regression analyses.
  
  
  RESULTS
  Sleep disturbance was, adjusted for age, gender, time in treatment, type of care, and the presence of any primary mental disorder, associated with lower quality of life, higher symptom severity, higher disorder severity, lower levels of functioning, and less benefit from treatment.
  
  
  CONCLUSIONS
  Sleep disturbance ought to be considered a stand-alone therapeutic entity rather than an epiphenomenon of existing diagnoses for patients receiving treatment in mental health care.
authors.affiliation: Division of Psychiatry, Department of Research and Development, St Olav's University Hospital, Trondheim, Norway. havard.kallestad@ntnu.no
authors.forename: Håvard
authors.initials: H
authors.lastname: Kallestad
authors.forename: Bjarne
authors.initials: B
authors.lastname: Hansen
authors.forename: Knut
authors.initials: K
authors.lastname: Langsrud
authors.forename: Torleif
authors.initials: T
authors.lastname: Ruud
authors.forename: Gunnar
authors.initials: G
authors.lastname: Morken
authors.forename: Tore C
authors.initials: TC
authors.lastname: Stiles
authors.forename: Rolf W
authors.initials: RW
authors.lastname: Gråwe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000150:complications / Q000523:psychology*; D016896:Treatment Outcome