title: Insomnia in alcohol dependence: predictors of symptoms in a sample of veterans referred from primary care.
abstract: OBJECTIVE
  Patients with alcohol dependence presenting for treatment may have multiple associated co-morbid conditions and limited social supports, which complicate treatment. Each of these factors has been independently associated with complaints of insomnia. In this preliminary study, we investigated the relations between insomnia complaints and socio-demographic factors and psychiatric co-morbidity in treatment-seeking patients with alcohol dependence.
  
  
  METHODS
  We conducted a retrospective chart review on 84 consecutive patients referred to the Behavioral Health Laboratory of the Philadelphia Veterans Affairs Medical Center for evaluation of psychiatric and substance use disorders. Patients met DSM-IV diagnostic criteria for alcohol dependence and completed a series of self-assessments of sleep. Univariate and multivariable analyses were used to examine the relations amongst the variables of interest.
  
  
  RESULTS
  In multivariable models, Sleep Latency was significantly greater in individuals without partners (p = .01), those with psychiatric disorders (p = .03) and smokers (p = .01), with a non-significant trend for those with past-year suicidal ideation. No significant predictor of Wake Time After Sleep Onset was seen. Poor Sleep Quality was predicted by younger age (OR = .93 [.88, .98], p = .004) and the presence of a psychiatric disorder (OR = 20.80 [4, 102], p = .0002), with a non-significant trend for suicidal ideation.
  
  
  CONCLUSIONS
  Insomnia symptoms in treatment-seeking alcohol dependent patients should prompt consideration of the individuals' psychiatric and psychosocial features.
authors.affiliation: MIRECC VISN-4, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA 19104, USA. subhajit.chakravorty@uphs.upenn.edu
authors.forename: Subhajit
authors.initials: S
authors.lastname: Chakravorty
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grandner
authors.forename: Henry R
authors.initials: HR
authors.lastname: Kranzler
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Mavandadi
authors.forename: Mitchel A
authors.initials: MA
authors.lastname: Kling
authors.forename: Michael L
authors.initials: ML
authors.lastname: Perlis
authors.forename: David W
authors.initials: DW
authors.lastname: Oslin
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications*; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology*; D012907:Smoking; D019966:Substance-Related Disorders / Q000175:diagnosis; D059020:Suicidal Ideation; D014728:Veterans / Q000523:psychology*