PROMIS®-Assessed Sleep Problems and Physical Health Symptoms in Adult Psychiatric Inpatients

Objective: The goal of this study was to assess the relationship between sleep problems and somatic symptoms in a sample of adult psychiatric inpatients and evaluate the utility of the Patient-Reported Outcomes Measurement Information System (R) (PROMIS (R)) Sleep Disturbance Measure as a predictor of physical health symptom severity within this population. Method: Ninety-five adults were assessed following admission to an inpatient psychiatric hospital. Demographic and medical information were extracted via chart review. Participants completed the PROMIS (R) Sleep Disturbance Measure-Short Form, the PROMIS (R) Depression Measure-Short Form, the DSM-5 Cross-Cutting Symptom Measure (CCSM), and the Patient Health Questionnaire-Physical Symptoms (PHQ-15). A hierarchical linear regression was conducted predicting severity of physical symptoms from PROMIS (R) Sleep scores, while controlling for gender, depression scores, number of medications, number of psychiatric diagnoses, and whether the participant was undergoing detoxification. Results: Data showed that 50% of participants reported medium/high levels of physical health symptoms, and 41% reported moderate/severe levels of sleep disturbance. A positive screen on the CCSM Somatic Symptoms domain was a significant predictor of more self-reported physical health symptoms (beta = 0.278, p =.005, 95% CI [1.24, 6.61]). When PROMIS (R) Sleep scores were included, the model accounted for significantly more variability in physical health symptom scores (Delta R-2 = 0.085, F = 9.150, p <.001), and the CCSM Somatic Screener remained a significant predictor (beta = 0.230, p =.013, 95% CI [0.70, 5.79]). PROMIS (R) Sleep scores significantly predicted physical health symptom scores (beta = 0.364, p =.001, 95% CI [0.11, 0.42]). Conclusions: A significant proportion of psychiatric inpatients report elevated levels of physical health symptoms, and greater sleep disturbance is a significant predictor of somatic symptoms severity. The PROMIS (R) Sleep Disturbance Measure may be a better predictor of physical health symptoms among psychiatric inpatients than the CCSM alone. The PROMIS (R) Sleep Disturbance Measure may also serve as a useful screening and outcome assessment tool in future clinical and research work among this understudied population. Identifying and intervening with psychiatric inpatients at risk for poor sleep and more severe physical health symptoms has the potential to positively impact patients' hospitalization and postdischarge outcomes.