The Diagnostic and Statistical Manual of Mental Disorders (DSM) descriptive criterial approach to diagnosis has been criticized for contributing to comorbidity, heterogeneity within conditions, and nonspecificity across conditions. Much research has examined comorbidity and heterogeneity, but less is known about nonspecificity. Here, we examined two nonspecific symptoms: irritability and sleep disturbance. Both are common, clinically significant, and appear in several DSM disorder criteria sets, but their transdiagnostic prevalence is unknown. Leveraging a nationally representative epidemiological study of adolescents (n = 10,148; ages = 13-18), we first identified all instances where irritability or sleep disturbance appears in DSM-5-TR criteria for bipolar, depressive, anxiety, traumatic stress, or disruptive/impulse-control disorders; then found their DSM-IV equivalents in study variables; and finally estimated their prevalence individually and cumulatively across categories. Weighted lifetime prevalence estimates were 79.5% (95% CI [77.8, 81.2]) for irritability and 60.8% [58.7, 62.9] for sleep disturbance. Associations with age and gender were significant but small. Most youth reported multiple symptoms of irritability (weighted M = 3.04, Mdn = 2) and at least one symptom of sleep disturbance (weighted M = 1.61, Mdn = 1). Both problems were extremely common among individuals with specific disorders but were underestimated by the criteria for those conditions. Results suggest that the high prevalence of DSM-defined irritability and sleep problems may be obfuscated by these symptoms being scattered across diagnostic entities. There is a need for more research on assessing, treating, and understanding problems related to irritability and sleep in their own right, cutting across, rather than confined to, particular diagnoses. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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提高非特异性的特异性：估计青少年中诊断性烦躁和睡眠症状的患病率。

《精神疾病诊断与统计手册》(DSM) 描述性标准诊断方法因导致合并症、病情异质性以及不同病情的非特异性而受到批评。许多研究都检查了共病和异质性，但对非特异性知之甚少。在这里，我们检查了两种非特异性症状：烦躁和睡眠障碍。两者都很常见，具有临床意义，并且出现在多个 DSM 疾病标准集中，但它们的跨诊断患病率尚不清楚。利用全国代表性的青少年流行病学研究（n = 10,148；年龄 = 13-18），我们首先确定了 DSM-5-TR 双相情感障碍、抑郁、焦虑、创伤性应激或破坏性标准中出现的烦躁或睡眠障碍的所有情况。 /冲动控制障碍；然后在研究变量中找到它们的 DSM-IV 等效项；最后估计了它们在各个类别中的单独患病率和累积患病率。烦躁的加权终生患病率估计为 79.5% (95% CI [77.8, 81.2])，睡眠障碍的加权终生患病率估计为 60.8% [58.7, 62.9]。与年龄和性别的相关性显着但很小。大多数青少年报告有多种烦躁症状（加权 M = 3.04，Mdn = 2）和至少一种睡眠障碍症状（加权 M = 1.61，Mdn = 1）。这两个问题在患有特定疾病的个体中极为常见，但根据这些疾病的标准却被低估了。结果表明，DSM 定义的烦躁和睡眠问题的高患病率可能因这些症状分散在诊断实体中而变得模糊。需要进行更多的研究来评估、治疗和理解与烦躁和睡眠相关的问题，跨越而不是局限于特定的诊断。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。