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

Author:

Simoncini Malucelli Giorgia1,Mercante Anna2ORCID,Pizza Fabio23,Brunetti Valerio14ORCID,Biscarini Francesco3,Vandi Stefano23,Mazzoni Alice2,Franceschini Christian5ORCID,Della Marca Giacomo14ORCID,Vollono Catello16,Chieffo Daniela Pia Rosaria78,Plazzi Giuseppe39ORCID

Affiliation:

1. Department of Neurosciences Università Cattolica del Sacro Cuore Rome Italy

2. IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy

3. Department of Biomedical and Neuromotor Sciences University of Bologna Bologna Italy

4. UOC di Neurologia – Dipartimento di Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa‐Collo Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy

5. Department of Medicine and Surgery University of Parma Parma Italy

6. UOC di Neurofisiopatologia – Dipartimento di Neuroscienze Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy

7. Clinical Psychology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy

8. Department Women Children and Public Health Catholic University of Sacred Heart Rome Italy

9. Department of Biomedical Metabolic and Neural Sciences, University of Modena and Reggio Emilia Modena Italy

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.

Publisher

Wiley

Subject

Behavioral Neuroscience,Cognitive Neuroscience,General Medicine

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