Exploring the emotional and behavioural profile in paediatric narcolepsy type 1: A case–control study

Abstract

SummaryNarcolepsy type 1 (NT1) is a central disorder of hypersomnolence often arising in childhood and adolescence. NT1 has a significant, but poorly defined, psychological impact. We aimed to investigate the psycho‐social functioning of children and adolescents with NT1. We performed a cross‐sectional, child and parent‐reported questionnaire survey in 37 children and adolescents (6–17 years) with NT1, compared with age‐ and sex‐matched controls. Questionnaires (SSHS, ESS‐CHAD, CDI, MASC, CBCL, CRS‐R, and SNAP‐IV) evaluated various aspects of behavioural and emotional profiles, sleep habits, and daytime sleepiness. Subsequently, NT1 intra‐group analysis was performed to investigate the effect of sex (males vs females) and pharmacological treatment (treated vs non‐treated) on psychological features. The NT1 questionnaires total scores were then correlated with the clinical characteristics (age, body mass index [BMI], ESS‐CHAD score, cerebrospinal hypocretin‐1 [Hcrt‐1] levels, and diagnostic delay). Patients with NT1 showed a higher tendency to depressive symptoms, anxiety, somatisation, inattention, hyperactivity, oppositional/defiant problems, and other maladaptive behaviours compared with controls. Among NT1 patients, females showed a higher propensity to anxiety, and non‐treated patients displayed higher depressive symptoms. Psychological symptoms increased with age, BMI, and daytime sleepiness in patients with NT1, while a younger age was associated with more frequent somatisation symptoms. Lower cerebrospinal Hcrt‐1 levels correlated with poorer social competencies, daily activities, and inattention. Diagnostic delay was associated with a higher impact of depressive symptoms and behavioural problems. NT1 in children and adolescents is associated with poorer functioning in multiple psychological domains calling for a multidisciplinary approach and monitoring to reduce disease burden and to prevent psychiatric consequences.