Cited by 319Sleep and related disordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesObstructive Sleep Apnea Research

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Validation of the Insomnia Severity Index in Primary Care

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Gagnon, C., Belanger, L., Ivers, H., Morin, C. M.·2013·The Journal of the American Board of Family Medicine

DOI 10.3122/jabfm.2013.06.130064

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Abstract

BACKGROUND: Although insomnia is a prevalent complaint with significant consequences on quality of life, health, and health care utilization, it often remains undiagnosed and untreated in primary care settings. Brief, reliable, and valid instruments are needed to facilitate screening for insomnia in general practice. This study examined psychometric indices of the Insomnia Severity Index (ISI) to identify individuals with clinically significant insomnia in primary care settings. METHODS: A sample of 410 patients recruited from 6 general medical clinics completed the ISI before their appointment with a primary care physician. A subsample of 101 individuals also completed a semistructured clinical interview by telephone to determine the presence or absence of an insomnia disorder. Reliability and validity indices were computed, as was the discriminative capacity of each individual item. Convergence between ISI total score and the diagnosis derived from the interview was investigated. Receiver operator characteristic analyses were used to determine the optimal ISI cutoff score that correctly identified individuals with an insomnia disorder. RESULTS: ISI internal consistency was excellent (Cronbach α = 0.92), and each individual item showed adequate discriminative capacity (r = 0.65-0.84). The area under the receiver operator characteristic curve was 0.87 and suggested that a cutoff score of 14 was optimal (82.4% sensitivity, 82.1% specificity, and 82.2% agreement) for detecting clinical insomnia. Agreement between the ISI cut score and the diagnostic interview was moderate (κ = 0.62). CONCLUSIONS: These findings suggest that the ISI is a valid screening instrument for detecting insomnia among patients consulting in primary care settings.

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Authors: Gagnon, C., Belanger, L., Ivers, H., & Morin, C. M.
Affiliations: Université Laval (CA)
ORCID: Ivers, H.
Morin, C. M.
Venue: The Journal of the American Board of Family Medicine
Publisher: American Board of Family Medicine (ABFM)
Published: 2013-11-01
Volume: 26
Issue: 6
Pages: 701-710
ISSN: 1557-2625 (ISSN-L)
1558-7118
DOI: 10.3122/jabfm.2013.06.130064
OpenAlex: W2131444989
Cited by: 319
References: 50
Citations by year: 2026: 20 · 2025: 29 · 2024: 34 · 2023: 34 · 2022: 37 · 2021: 51 · 2020: 36 · 2019: 23 · 2018: 14 · 2017: 15 · 2016: 16 · 2015: 5 · 2014: 3 · 2013: 2
FWCI: 11.72
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: The Journal of the American Board of Family Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Keywords: Insomnia Severity Index, insomnia screening, primary care, psychometric validation, internal consistency, cut-off values, diagnostic accuracy, insomnia diagnosis, general practice
MeSH terms: Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Primary Health Care, Psychometrics, Quality of Life, Quebec, Surveys and Questionnaires, Retrospective Studies, ROC Curve, Severity of Illness Index, Prevalence

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Validation of the Insomnia Severity Index in Primary Care

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