Restless Legs Syndrome in a Community Sample of Korean Adults: Prevalence, Impact on Quality of Life, and Association with DSM-IV Psychiatric Disorders

Department of Psychiatry, Gachon University of Medicine and Science, Incheon, South Korea.
Sleep (Impact Factor: 4.59). 08/2009; 32(8):1069-76.
Source: PubMed


Conflicting reports on prevalence of RLS exist in Asian countries due to differences in sampling strategies and assessment instruments. We assessed the prevalence, correlates, quality of life, and psychiatric comorbidity of RLS in South Korea.
Cross-sectional nationwide survey.
Nationally representative sample of 6,509 Korean adults aged 18-64.
Face-to-face interviews based on the Korean translation of the four features of RLS defined by the International RLS Study Group (IRLSSG), the Korean version of Composite International Diagnostic Interview (K-CIDI), and EuroQol (EQ-5D) were conducted for all participants. The weighted prevalence of RLS in South Korea was 0.9% (men, 0.6%; women, 1.3%). Subjects with RLS had a lower quality of life according to EQ-5D than those without RLS. Adjusted odds ratio for lifetime diagnosis of DSM-IV major depressive disorder (2.57, 95% confidence interval [1.33, 4.96]), panic disorder (18.9 [4.72, 75.9]) and posttraumatic stress disorder (3.76 [1.32, 10.7]) suggest strong association between RLS and DSM-IV depression and anxiety disorders.
Prevalence of RLS estimated based on the IRLSSG diagnostic criteria is substantially lower in South Korea than in Western countries. Differences in culture and risk factors that affect the expression of RLS may vary across the countries.

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    • "Most of these patients present with the complaints of insomnia rather than RLS itself. Prevalence of RLS appears to be lower in the Asian countries as compared to their western counterparts; and, RLS has been found to substantially increase the risk of Major Depressive Disorder and Anxiety Disorders.[2] Restless leg syndrome is usually diagnosed according to the criteria proposed by International RLS Research Group.[1] "
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    ABSTRACT: The objective of this study is to translate and validate the International Restless Leg Syndrome Study Group rating scale (IRLS) in Hindi language. Thirty one consecutive patients diagnosed of Restless Leg Syndrome (RLS) were included in the study. Control group comprised of 31 subjects not having any symptom of RLS. The scale was procured from MAPI research trust; and, permission for the translation was sought. The translation was done according to the guidelines provided by the publisher. After translation, final version of the scale was applied in both the groups to find out the reliability and clinical validity. RLS group had a predominance of females, and they were younger than the male counterparts (Age=36.80 ± 10.46 years vs 45.18 ± 8.34 years; t=2.28; P=0.03). There was no difference in the mean age between groups (RLS=39.77 ± 10.44 years vs Non RLS=38.29 ± 11.29 years; t=-0.53; P=0.59). IRLS scores were significantly different between both groups on all items (P<0.001). Translated version showed high reliability (Cronbach's alpha=0.86). IRLS scores were significantly different between both groups on all items (P<0.001). Hindi version of IRLS is reliable and a clinically valid tool that can be applied in Hindi speaking population.
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    • "The disease specific, health-related, and psychosocial quality of life of this population is reduced compared to the general population and is comparable to that of patients with type 2 diabetes mellitus and osteoarthritis [2,3]. The lifetime prevalence of comorbid depression and anxiety disorders is elevated by odds ratios of 2.1 to 5.3 in RLS compared to the community at large [4-6]. Sleep problems, leg dysaesthesias, and the psychological sequelae of the disorder are all particularly implicated in contributing to impaired daily functioning [7,8]. "
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    ABSTRACT: Restless legs syndrome (RLS) is a chronic disorder with substantial impact on quality of life similar to that seen in diabetes mellitus or osteoarthritis. Little is known about the psychological characteristics of RLS patients although psychological factors may contribute to unfavourable treatment outcome. In an observational cross-sectional design, we evaluated the psychological features of 166 consecutive RLS patients from three outpatient clinics, by means of the Symptom Checklist 90-R (SCL-90-R) questionnaire. Additionally, the Beck Depression Inventory-II (BDI-II) and the International RLS Severity Scale (IRLS) were measured. Both treated and untreated patients were included, all patients sought treatment. Untreated patients (n = 69) had elevated but normal scores on the SCL-90-R Global Severity Index (GSI; p = 0.002) and on the sub-scales somatisation (p < 0.001), compulsivity (p = 0.003), depression (p = 0.02), and anxiety (p = 0.004) compared with a German representative sample. In the treated group, particularly in those patients who were dissatisfied with their actual treatment (n = 62), psychological distress was higher than in the untreated group with elevated scores for the GSI (p = 0.03) and the sub-scales compulsivity (p = 0.006), depression (p = 0.012), anxiety (p = 0.031), hostility (p = 0.013), phobic anxiety (p = 0.024), and paranoid ideation (p = 0.012). Augmentation, the most serious side effect of dopaminergic, i.e. first-line treatment of RLS, and loss of efficacy were accompanied with the highest psychological distress, as seen particularly in the normative values of the sub-scales compulsivity and anxiety. Generally, higher RLS severity was correlated with higher psychological impairment (p < 0.001). Severely affected RLS patients show psychological impairment in multiple psychological domains which has to be taken into account in the treatment regimen.
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    • "Clinically significant RLS is common and results in serious disturbances of sleep and quality of life of the affected person [2] [3] [4]. It has been reported to result in lack of energy and lack of concentration in the following day and to be associated with reduced general health status [5]. "
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    ABSTRACT: This study assessed the prevalence and severity of restless leg syndrome (RLS) among patients attending primary health care (PHC) facilities. We interviewed 1303 consecutive patients attending PHC face-to-face using the International Restless Legs Syndrome Study Group (IRLSSG) criteria. We assessed the severity of RLS using the IRLSSG severity scale for RLS. The prevalence of RLS in our sample was 5.2% and was highest among participants between 45 and 60 years of age. The overall prevalence was roughly equal between males and females; however, RLS was more prevalent in females older than 45 years compared to males in the same age group. Eight participants (11.8%) reported mild symptoms, 29 (42.6%) moderate, 29 (42.6%) severe, and 2 (2.9%) very severe. None of the participants had been diagnosed or treated for RLS. Restless leg syndrome is common among Saudis (Arabs). Our study supports the findings of reports in other countries demonstrating that primary care physicians do not often recognize RLS.
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