ABSTRACT

Introduction

The core symptoms of narcolepsy such as excessive daytime sleepiness and cataplexy are well known. However, there is mounting evidence for a much broader symptom spectrum, including psychiatric symptoms. Disordered sleep has previously been linked with dissociative symptoms, which may imply that patients with narcolepsy are more prone to develop such symptoms.

Objectives

To investigate the frequency of dissociative symptoms in adult patients with narcolepsy type 1 compared to population controls.

Methods

In a retrospective case control study, sixty adult patients fulfilling the criteria for narcolepsy type 1 and 120 matched population control subjects received a structured interview using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) to assess dissociative symptoms and disorders.

Results

A majority of narcolepsy patients reported dissociative symptoms, and even fulfilled the DSM-IV-TR criteria of a dissociative disorder (62% vs 1% in controls, p < .001). Most frequently reported symptoms were “dissociative amnesia” (37% vs 1%, p < .001) and “dissociative disorder of voluntary movement” (32% vs 1%, p < .001).

Conclusion

Dissociative symptoms are strikingly prevalent in adult patients with narcolepsy type 1. Although a formal diagnosis of dissociation disorder should not be made as the symptoms can be explained by narcolepsy as an underlying condition, the findings do illustrate the extent and severity of the dissociative symptoms. As for the pathophysiological mechanism, there may be symptom overlap between narcolepsy and dissociation disorder. However, there may also be a more direct link between disrupted sleep and dissociative symptoms. In either case, the high frequency of occurrence of dissociative symptoms should result in an active inquiry by doctors, to improve therapeutic management and guidance.

中文翻译：

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分离症状在患有 1 型嗜睡症的成年人中非常普遍

摘要

介绍

嗜睡症的核心症状如白天过度嗜睡和猝倒是众所周知的。然而，越来越多的证据表明，症状范围更广，包括精神症状。睡眠障碍以前与分离症状有关，这可能意味着发作性睡病患者更容易出现这种症状。

目标

研究与人群对照组相比，成人 1 型发作性睡病患者分离症状的频率。

方法

在一项回顾性病例对照研究中，符合 1 型发作性睡病标准的 60 名成年患者和 120 名匹配的人群对照受试者接受了使用神经精神病学临床评估表 (SCAN) 评估分离症状和障碍的结构化访谈。

结果

大多数发作性睡病患者报告了分离症状，甚至达到了分离障碍的 DSM-IV-TR 标准（对照组为 62% vs 1%，p < .001）。最常报告的症状是“分离性遗忘”（37% vs 1%，p < .001）和“分离性自主运动障碍”（32% vs 1%，p < .001）。

结论

分离症状在患有 1 型发作性睡病的成年患者中非常普遍。尽管不应做出分离障碍的正式诊断，因为症状可以用发作性睡病作为潜在疾病来解释，但研究结果确实说明了分离症状的范围和严重程度。就病理生理机制而言，发作性睡病与解离障碍之间可能存在症状重叠。然而，睡眠中断和分离症状之间也可能存在更直接的联系。在任何一种情况下，分离症状的高发生率都应引起医生的积极询问，以改善治疗管理和指导。