title: Sleep disturbances in a clinical forensic psychiatric population.
abstract: OBJECTIVE
  Poor sleep is known to cause detrimental effects on the course of diverse psychiatric disorders and is a putative risk factor for hostility and aggression. Thus, sleep may be crucial in forensic psychiatric practice. However, little is known about the prevalence of sleep disturbances in these complex psychiatric patients.
  
  
  METHODS
  In this study we investigated the presence of sleep disorders and subjective sleep quality using the Sleep Diagnosis List (SDL), the Pittsburgh Sleep Quality Index (PSQI), interviews addressing the causes of sleep complaints, and file information on sleep medications in 110 patients admitted to a forensic psychiatric hospital.
  
  
  RESULTS
  Almost 30% of the participants suffered from one or more sleep disorders, especially insomnia. An even larger proportion of the participants (49.1%) experienced poor sleep quality. Interestingly, patients with an antisocial personality disorder or traits were particularly dissatisfied with their sleep. The most common causes of sleep problems were suboptimal sleep hygiene, stress or ruminating, negative sleep conditioning, and side effects of psychotropic medication. Of the poor sleepers, 40.7% received a hypnotic drug.
  
  
  CONCLUSIONS
  Despite intensive clinical treatment, sleep problems are experienced by a large number of forensic psychiatric patients. It would be worthwhile to examine the effects of pharmacological and non-pharmacological sleep interventions on both psychiatric symptoms and reactive aggressive behavior in forensic patients.
authors.affiliation: Department of Forensic Psychiatry, Mental Health Services Drenthe, Assen, The Netherlands. Electronic address: Jeanine.Kamphuis@ggzdrenthe.nl.
authors.forename: Jeanine
authors.initials: J
authors.lastname: Kamphuis
authors.forename: Julie
authors.initials: J
authors.lastname: Karsten
authors.forename: Al
authors.initials: A
authors.lastname: de Weerd
authors.forename: Marike
authors.initials: M
authors.lastname: Lancel
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005555:Forensic Psychiatry; D006778:Hospitals, Psychiatric; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010554:Personality Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D012890:Sleep; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives
keywords: Forensic psychiatry; Insomnia; Personality disorder; Sleep disorder; Sleep hygiene