Exploring the presence of narcolepsy in patients with schizophrenia
Background:
There are several case reports of patients with narcolepsy and schizophrenia, but a systematic examination of the association of both disorders has not been done. The aim of this work is to assess the frequency of narcolepsy with cataplexy in a large consecutive series of adult patients with schizophrenia and schizoaffective disorder.
Methods:
We screened 366 consecutive patients with schizophrenia or schizoaffective disorder with a sleep questionnaire and the Epworth Sleepines scale (ESS) exploring narcoleptiform symptoms. Those who screened positive were assessed by a sleep specialist, and offered an HLA determination. CSF hypocretin-1 determination was proposed to those who were HLA DQB1*06:02 positive.
Results:
On the screening questionnaire, 17 patients had an ESS score ≥11 without cataplexy, 15 had cataplexy-like symptoms with an ESS score < 11, and four had an ESS score ≥11 plus cataplexy-like symptoms. Of those, 24 patients were evaluated by a sleep specialist. Five of these 24 were HLA DQB1*06:02 positive, and three of these five subjects underwent lumbar puncture showing normal hypocretin-1 levels.
Conclusions:
Our results suggest that narcolepsy with cataplexy is not an unrecognized disease in adult patients with schizophrenia or schizoaffective disorder.
Keywords:
Hallucinations, Narcolepsy, Hypocretin, Psychotic disorders, Schizophrenia
Autoři:
Gemma Sansa 1*; Alba Gavaldà 2; Carles Gaig 3; José Monreal 4; Guadalupe Ercilla 5; Roser Casamitjana 6; Gisela Ribera 1; Alex Iranzo 3; Joan Santamaria 3
Působiště autorů:
Neurology Service and Multidisciplinary Sleep Disorders Unit, Hospital Parc Taulí, Sabadell, Spain.
1; Neuropsychology Department, Neurology Service. Hospital Parc Taulí, Sabadell, Spain.
2; Neurology Service and Multidisciplinary Sleep Disorders Unit, Hospital Clínic of Barcelona, Barcelona, Spain.
3; Psychiatry Service, Hospital Parc Taulí, Sabadell, Spain.
4; Immunology Laboratory, Hospital Clínic of Barcelona, Barcelona, Spain.
5; Biochemistry and Molecular Genetics Laboratory, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic of Barcelona, Barcelona, Spain.
6
Vyšlo v časopise:
BMC Psychiatry 2016, 16:177
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1186/s12888-016-0859-9
© Sansa et al. 2016
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
The electronic version of this article is the complete one and can be found online at: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0859-9
Souhrn
Background:
There are several case reports of patients with narcolepsy and schizophrenia, but a systematic examination of the association of both disorders has not been done. The aim of this work is to assess the frequency of narcolepsy with cataplexy in a large consecutive series of adult patients with schizophrenia and schizoaffective disorder.
Methods:
We screened 366 consecutive patients with schizophrenia or schizoaffective disorder with a sleep questionnaire and the Epworth Sleepines scale (ESS) exploring narcoleptiform symptoms. Those who screened positive were assessed by a sleep specialist, and offered an HLA determination. CSF hypocretin-1 determination was proposed to those who were HLA DQB1*06:02 positive.
Results:
On the screening questionnaire, 17 patients had an ESS score ≥11 without cataplexy, 15 had cataplexy-like symptoms with an ESS score < 11, and four had an ESS score ≥11 plus cataplexy-like symptoms. Of those, 24 patients were evaluated by a sleep specialist. Five of these 24 were HLA DQB1*06:02 positive, and three of these five subjects underwent lumbar puncture showing normal hypocretin-1 levels.
Conclusions:
Our results suggest that narcolepsy with cataplexy is not an unrecognized disease in adult patients with schizophrenia or schizoaffective disorder.
Keywords:
Hallucinations, Narcolepsy, Hypocretin, Psychotic disorders, Schizophrenia
Zdroje
1. Silber MH, Krahn LE, Olson EJ, Pankratz VS. The epidemiology of narcolepsy in Olmsted County, Minnesota: a population-based study. Sleep. 2002;25: 197–202.
2. Longstreth Jr WT, Koepsell TD, Ton TG, Hendrickson AF, van Belle G. The epidemiology of narcolepsy. Sleep. 2007;30:13–26.
3. Dauvilliers Y, Arnulf I, Mignot E. Narcolepsy with cataplexy. Lancet. 2007;369: 499–511.
4. Mignot E, Lammers GJ, Ripley B, Okun M, Nevsimalova S, Overeem S, Vankova J, Black J, Harsh J, Bassetti C, Schrader H, Nishino. The role of cerebrospinal fluid hypocretin measurement in the diagnosis of narcolepsy and other hypersomnias. Arch Neurol. 2002;59:1553–62.
5. de Lecea L, Kilduff TS, Peyron C, Gao X, Foye PE, Danielson PE, Fukuhara C, Battenberg EL, Gautvik VT, Bartlett FS, Frankel WN, van den Pol AN, Bloom FE, Gautvik KM, Sutcliffe JG. The hypocretins: hypothalamus-specific peptides with neuroexcitatory activity. Proc Natl Acad Sci U S A. 1998;95:322–7.
6. Sakurai T, Amemiya A, Ishii M, Matsuzaki I, Chemelli RM, Tanaka H, Williams SC, Richardson JA, Kozlowski GP, Wilson S, Arch JR, Buckingham RE, Haynes AC, Carr SA, Annan RS, McNulty DE, Liu WS, Terrett JA, Elshourbagy NA, Bergsma DJ, Yanagisawa M. Orexins and orexin receptors: a family of hypothalamic neuropeptides and G protein-coupled receptors that regulate feeding behavior. Cell. 1998;92:573–85.
7. Bourgin P, Zeitzer JM, Mignot E. CSF hypocretin-1 assessment in sleep and neurological disorders. Lancet Neurol. 2008;7:649–62.
8. Mignot E, Lin X, Hesla PE, Dement WC, Guilleminault C, Grumet FC. A novel HLA DR17, DQ1 (DQA1-0102/DQB1-0602 positive) haplotype predisposing to narcolepsy in Caucasians. Sleep. 1993;16:764–5.
9. American Academy of Sleep Medicine (ed). International classification of sleep disorders. 3rd ed. American Academy of Sleep Medicine, Darien, IL, 2014.
10. Tsutsui K, Kanbayashi T, Tanaka K, Boku S, Ito W, Tokunaga J, Mori A, Hishikawa Y, Shimizu T, Nishino S. Anti-NMDA-receptor antibody detected in encephalitis, schizophrenia, and narcolepsy with psychotic features. BMC Psychiatry. 2012;12:37.
11. Bassetti C, Aldrich MS. Narcolepsy. Neurol Clin. 1996;14:545–71.
12. Anic-Labat S, Guilleminault C, Kraemer HC, Meehan J, Arrigoni J, Mignot E. Validation of a cataplexy questionnaire in 983 sleep-disorders patients. Sleep. 1999;22:77–87.
13. Goldbart A, Peppard P, Finn L, Ruoff CM, Barnet J, Young T, Mignot E.
Narcolepsy and predictors of positive MSLTs in the Wisconsin Sleep Cohort.
Sleep. 2014;37:1043–51.
14. McGrath J, Saha S, Chant D, Welham J. Schizophrenia: a concise overview of
incidence, prevalence, and mortality. Epidemiol Rev. 2008;30:67–76.
15. van Os J, Kapur S. Schizophrenia. Lancet. 2009;374:635–45.
16. Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A. Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl. 1992;20:1–97.
17. Laruelle M. Imaging dopamine transmission in schizophrenia. A review and meta-analysis. Q J Nucl Med. 1998;42:211–21.
18. Guillin O, Abi-Dargham A, Laruelle M. Neurobiology of dopamine in schizophrenia. Int Rev Neurobiol. 2007;78:1–39.
19. Undurraga J, Garrido J, Santamaria J, Parellada E. Treatment of narcolepsy complicated by psychotic symptoms. Psychosomatics. 2009;50:427–8.
20. Walterfang M, Upjohn E, Velakoulis D. Is schizophrenia associated with narcolepsy? Cogn Behav Neurol. 2005;18:113–8.
21. Bhat SK, Galang R. Narcolepsy presenting as schizophrenia. Am J Psychiatry. 2002;159:1245.
22. Douglass AB, Shipley JE, Haines RF, Scholten RC, Dudley E, Tapp A. Schizophrenia, narcolepsy, and HLA-DR15, DQ6. Biol Psychiatry. 1993;34:773–80.
23. Kishi Y, Konishi S, Koizumi S, Kudo Y, Kurosawa H, Kathol RG. Schizophrenia and narcolepsy: a review with a case report. Psychiatry Clin Neurosci. 2004; 58:117–24.
24. Canellas F, Lin L, Julià MR, Clemente A, Vives-Bauza C, Ollila HM, Hong SC, Arboleya SM, Einen MA, Faraco J, Fernandez-Vina M, Mignot E. Dual cases of type 1 narcolepsy with schizophrenia and other psychotic disorders. J Clin Sleep Med. 2014;10:1011–8.
25. Huang YS, Guilleminault C, Chen CH, Lai PC, Hwang FM. Narcolepsycataplexy and schizophrenia in adolescents. Sleep Med. 2014;15:15–22.
26. Pawluk LK, Hurwitz TD, Schluter JL, Ullevig C, Mahowald MW. Psychiatric morbidity in narcoleptics on chronic high dose methylphenidate therapy. J Nerv Ment Dis. 1995;183:45–8.
27. Ullman KC. Narcolepsy and schizophrenia. Am J Psychiatry. 1977;134:822.
28. Okura M, Riehl J, Mignot E, Nishino S. Sulpiride, a D2/D3 blocker, reduces cataplexy but not REM sleep in canine narcolepsy. Neuropsychopharmacology. 2000;23:528–38.
29. American Psychiatric Association (ed). Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Rev. ed. American Psychiatric Association, Washington, DC, 2000.
30. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14:540–5.
31. Nishino S, Ripley B, Overeem S, Nevsimalova S, Lammers GJ, Vankova J, Okun M, Rogers W, Brooks S, Mignot E. Low cerebrospinal fluid hypocretin (Orexin) and altered energy homeostasis in human narcolepsy. Ann Neurol. 2001;50:381–8.
32. Ripley B, Overeem S, Fujiki N, Nevsimalova S, Uchino M, Yesavage J, Di Monte D, Dohi K, Melberg A, Lammers GJ, Nishida Y, Roelandse FW, Hungs M, Mignot E, Nishino S. CSF hypocretin/orexin levels in narcolepsy and other neurological conditions. Neurology. 2001;57:2253–8.
33. Nishino S, Kanbayashi T. Symptomatic narcolepsy, cataplexy and hypersomnia, and their implications in the hypothalamic hypocretin/orexin system. Sleep Med Rev. 2005;9:269–310.
34. Han F, Lin L, Schormair B, Pizza F, Plazzi G, Ollila HM, Nevsimalova S, Jennum P, Knudsen S, Winkelmann J, Coquillard C, Babrzadeh F, Strom TM, Wang C, Mindrinos M, Fernandez Vina M, Mignot E. HLA DQB1*06:02 negative narcolepsy with hypocretin/orexin deficiency. Sleep. 2014;37:1601–8.
35. Benson KL. Sleep in schizophrenia: impairments, correlates, and treatment. Psychiatr Clin North Am. 2006;29:1033–45.
36. Kluge M, Himmerich H, Wehmeier PM, Rummel-Kluge C, Dalal M, Hinze-Selch D, Kraus T, Dittmann RW, Pollmächer T, Schuld A. Sleep propensity at daytime as assessed by Multiple Sleep Latency Tests (MSLT) in patients with schizophrenia increases with clozapine and olanzapine. Schizophr Res. 2012; 135:123–7.
37. Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD, Severe J, Hsiao JK; Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005;353:1209–23.
Štítky
PsychiatriaČlánok vyšiel v časopise
BMC Psychiatry
![Číslo 177](https://www.prelekara.sk/media/cache/resolve/journal_issue/media/image_pdf/e0f40d9583a938a004aee4a0fa584e01.jpeg)
2016 Číslo 177
Najčítanejšie v tomto čísle