Why do sleep disorders belong to mental disorder classifications? A network analysis of the « Sleep-Wake Disorders » section of the DSM-5
Journal of Psychiatric Research. 2021-10-01; 142: 153-159
DOI: 10.1016/J.JPSYCHIRES.2021.07.050
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1. J Psychiatr Res. 2021 Oct;142:153-159. doi: 10.1016/j.jpsychires.2021.07.050.
Epub 2021 Aug 1.
Why do sleep disorders belong to mental disorder classifications? A network
analysis of the « Sleep-Wake Disorders » section of the DSM-5.
Gauld C(1), Lopez R(2), Morin CM(3), Maquet J(4), Mcgonigal A(5), Geoffroy
PA(6), Fakra E(7), Philip P(8), Dumas G(9), Micoulaud-Franchi JA(10).
Author information:
(1)Department of Psychiatry, University of Grenoble, Avenue du Maquis du
Grésivaudan, 38 000, Grenoble, France; UMR CNRS 8590 IHPST, Sorbonne University,
Paris 1, France.
(2)Department of Psychiatry and Addictive Medicine, Assistance Publique-Hôpitaux
de Paris (AP-HP), University Hospital Bichat, 46 rue Henri Huchard, 75018,
Paris, France; Inserm, U1061, Université Montpellier 1, Montpellier, France.
(3)École de psychologie, Université Laval, Québec City, Québec, Canada; Centre
d’étude des troubles du sommeil, Institut universitaire en santé mentale de
Québec, Quebec City, Canada.
(4)Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse,
Toulouse, France; Centre d’investigation clinique 1436, Centre Hospitalier
Universitaire de Toulouse, Toulouse, France.
(5)Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital,
Epileptology Department, Marseille, France.
(6)Département de psychiatrie et d’addictologie, AP-HP, GHU Paris Nord, DMU
Neurosciences, Hopital Bichat – Claude Bernard, F-75018, Paris, France; GHU
Paris – Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France;
Université de Paris, NeuroDiderot, Inserm, F-75019, Paris, France; CNRS UPR
3212, Institute for Cellular and Integrative Neurosciences, F-67000, Strasbourg,
France.
(7)Department of Psychiatry, University Hospital of Saint-Etienne,
Saint-Etienne, France; INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research
Center, Psychiatric disorders: neuroscience Research and clinical Research,
PSYR2 Team, Lyon, France.
(8)University Sleep Clinic, Services of Functional Exploration of the Nervous
System, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076,
Bordeaux, France; USR CNRS 3413 SANPSY, University Hospital of Bordeaux, 33 076,
Bordeaux, France.
(9)Center for Complex Systems and Brain Sciences, Florida Atlantic University,
Boca Raton, FL, 33431, USA; Centre de recherche du Centre Hospitalier
Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada.
(10)University Sleep Clinic, Services of Functional Exploration of the Nervous
System, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076,
Bordeaux, France; USR CNRS 3413 SANPSY, University Hospital of Bordeaux, 33 076,
Bordeaux, France. Electronic address:
.
This article proposes to investigate how Sleep disorders have been
conceptualized within the DSM-5 through symptom network analysis of the
diagnostic criteria of the « Sleep-Wake Disorders » section in the DSM-5. We
hypothesize that the analysis of the most central symptoms will allow us to
better analyze the position of Sleep disorders in Mental disorders. We thus i)
extracted the symptoms of the DSM-5 diagnostic criteria of Sleep-Wake disorders,
ii) built the Sleep-Wake disorder DSM-5 network representation, and iii)
quantified its structure at local and global levels using classical symptom
network analysis. Thirty-four different symptoms were identified among the 53
DSM-5 diagnostic criteria of the 9 main disorders of the « Sleep-Wake Disorders »
section. The symptom network structure of this section showed that the most
central sleep symptoms are « Daytime Sleepiness », the Insomnia symptoms group
(« Insomnia initiating », « Insomnia maintaining » and « Non-restorative sleep »), and
Behavioral sleep symptoms (such as « Altered oniric activity », « Ambulation »,
« Abnormal responsiveness »). This network analysis shown that the belonging of
Sleep-Wake disorders in the DSM-5 have been associated with central sleep
symptoms considered as « Mental », given their phenomenality (qualitative nature
of the experience) and subjectivity (in personal mental lives). Such a symptom
network analysis can serve as an organizing framework to better understand the
complexity of Sleep-Wake disorders by promoting research to connect the
architecture of the symptom network to relevant biological, psychological and
sociocultural factors.
Copyright © 2021 Elsevier Ltd. All rights reserved.
DOI: 10.1016/j.jpsychires.2021.07.050
PMID: 34359009 [Indexed for MEDLINE]