Background ans Aims:Chronic insomnia (ChI) is a common condition in Primary Care (PC). Regardless that it's often related to psychiatric morbidity it appears to be a strong predictor of future depression and a disabling disorder by itself. The aim of this study was to measure and compare clinical and psychiatric characteristics of both patients with primary ChI and secondary ChI.Methods:A random sample of 225 subjects older than 18 years old, from 3 PC Centres of the area of Madrid (Spain) was interviewed using the Oviedo Sleep Questionnaire, a semi-structured interview for sleep disorders. The subjects completed the Patient Health Questionnaire. Data about medical conditions, drug treatments, days of work lost (last year) and use of health care services (last 3 months), were also collected. Psychiatric and clinical characteristics between groups (primary vs secondary ChI) were compared.Results:78 patients fulfilled criteria for ChI and 53 (67.9 %) of them were suffering from any psychiatric disorder (including subtreshold conditions). Patients with primary ChI compared to secondary insomnia patients had no significant differences in age, gender, use of health care resources and days of work lost. However, patients with secondary ChI compared to primary ChI had more somatic and depressive symptoms (U-Mann-Witney test; p=0.002 and p<0.001, respectively).Conclussions:There is an important group of patients among PC attendees suffering primary ChI. Patients suffering primary ChI are comparable to patients with psychiatric disorders and insomnia in terms of days of work lost and use of health care resources.

Background and Aims:Previous data suggest that there is an important group of patients between primary care (PC) attendees suffering a psychiatric disorder that remain undetected. Our aim was to know data about this group of patients compared with patients without psychiatric pathology (PWP) and patients with already known psychiatric pathology (PKP).Methods:A random sample of 225 subjects older than 18 years old, from 3 PC Centres of the area of Madrid (Spain) completed the Patient Health Questionnaire (PHQ). Data about medical and psychiatric conditions, drug treatments, days of work lost (last year) and use of health care services (last 3 months), were also collected. Psychiatric and clinical characteristics between groups were compared.Results:50 (22,2%) patients were suffering a psychiatric condition according to PHQ but without recognition by their general practioner. This group of patients were younger than PWP and PKP (ANOVA; p=0,021 and p=0,013). They were suffering more depressive symptoms and somatic complaints than PWP (p<0,001 and p<0,001 respectively). In terms of days of work lost and use of health care services did not differ from PWP.Conclusions:The results suggest that other reasons rather than the symptomathology (depresive symptoms, somatic complaints) may be important in the proccess of detection of mental health problems in PC. Both days of work lost and the number of visits to general practioner appear to be two determinant factors.

linked to psychiatric disorders in three previous studies. We therefore aimed to investigate whether there is an association between Sudden Infant Death Syndrome (SIDS) and psychiatric disorders. Methods: We used a case-control study design. Cases were women registered with a general practice on a UK primary care database with a live birth between 1987 to 2000 and a subsequent SIDS. Controls were women matched for general practice with a live birth born in the same index year as the matched SIDS, with infant survival for the first year of life. Conditional logistic regression analysis examined the effect of maternal psychiatric disorders and potential confounders. Results:169 linked mother-infant cases of SIDS were matched with 662 mother-infant controls. SIDS was independently associated with a history of depression in the year before birth and male gender. There was weak evidence of an association of SIDS with depression in the 6 months after birth. Conclusions: Perinatal depression is associated with SIDS; women with perinatal depression need optimal treatment and advice on preventative behaviours to reduce the risk of SIDS.