The utility of the REM latency test in psychiatric diagnosis: A study of 81 depressed outpatients

To examine the utility of the REM (rapid eye movement) latency test in identifying outpatient primary depressions, 81 consecutive referrals to a sleep disorders center were evaluated in a phenomenologic, sleep polygraphic, and psychometric study. Modified Feighner (St. Louis) diagnoses were definite primary depression (n=19), probable primary depression (n=30), depression chronologically secondary to preexisting psychiatric disorders (n=19), and nonaffective psychiatric disorder (n=13). There were 18 nonpsychiatric controls. REM latency less than 70 minutes on 2 consecutive nights detected 62% of primary depressions, discriminating them from the other diagnostic groups with 88% specificity. There were no false positives among controls. These data provided a 90% confidence for the diagnosis of primary depression in this outpatient sample. Requiring 2 consecutive nights of shortened REM latency appears to improve significantly the specificity of a test previously considered to have high sensitivity but relatively low specificity for depressive disorders.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/23905/1/0000148.pd

REM density in the differential diagnosis of psychiatric from medical-neurologic disorders: A replication

The discriminatory power of rapid eye movement (REM) density in 61 outpatients with medical, neurologic, and psychiatric disorders and 8 noncase controls was assessed. REM density was significantly lower in a group of patients with medical-neurologic disease as compared with psychiatric and control subjects without evidence for such disease. Furthermore, low scores discriminated depressions occurring in the context of somatic disease when compared with those in the absence of such disease. The differences between groups were not accounted for by age or sex. The cutoff REM density score of 12.56, based on the 99% lower confidence limit of the noncase controls, provided the highest sensitivity (0.82) without loss of specificity (0.80). It was concluded that REM density may have merit as a general measure of diffuse central nervous system pathology, whether primary or secondary to widespread systemic disease. The findings of Kupfer's group are upheld and extended to a broader medical and neuropsychiatric population than in the original Pittsburgh study.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/24174/1/0000433.pd