Phenomenology and psychiatric correlates of pseudocataplexy.

IF 5.3 2区 医学 Q1 CLINICAL NEUROLOGY Sleep Pub Date : 2024-11-08 DOI:10.1093/sleep/zsad234
Marco Menchetti, Francesco Biscarini, Giombattista Sallemi, Elena Antelmi, Christian Franceschini, Stefano Vandi, Giulia Neccia, Valentina Baldini, Giuseppe Plazzi, Fabio Pizza
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Abstract

Study objectives: Pseudocataplexy is a rare functional neurological disorder that mimics cataplexy, pathognomonic for narcolepsy type 1 (NT1). We describe the psychiatric comorbidity and personality traits of patients with pseudocataplexy versus NT1 cases.

Methods: The case-control observational study enrolled consecutive patients with pseudocataplexy and a control group of age-matched consecutive NT1 patients. The diagnostic work-up included a structured interview, 48-hour polysomnography, multiple sleep latency test, cataplexy provoking test, and hypocretin-1 measurement in cerebrospinal fluid. All participants were administered Beck Depression Inventory, State-Trait Anxiety Inventory, Patient Health Questionnaire-15 (PHQ-15), Personality Inventory for DSM-5 brief form, and quality-of-life (QoL) measurement by 36-item Short Form health survey (SF-36).

Results: Fifteen patients with pseudocataplexy and 30 with NT1 were included. Despite the suspicion of possible cataplexy, none of the pseudocataplexy participants fulfilled international diagnostic criteria for NT1. Pseudocataplexy patients presented higher rates of moderate state anxiety (40% vs. 10%, p = 0.018), medium level of somatic symptoms, defined by PHQ-15 score > 10 (66.7% vs. 16.7%, p = 0.003), and a trend towards moderate-to-severe depressive symptoms (33.3% vs. 10%, p = 0.054) compared to NT1. No significant differences in personality traits emerged. Pseudocataplexy patients had worse QoL profiles in almost all SF-36 domains including physical (mean ± SD: 37.7 ± 9.88 vs. 51.13 ± 7.81, p < 0.001) and mental (mean ± SD: 33.36 ± 12.69 vs.42.76 ± 11.34, p = 0.02) summary scores.

Conclusions: Patients with pseudocataplexy present more severe psychiatric symptoms and a lower QoL profile in comparison with patients with NT1. The severe somatoform and affection impairment in pseudocataplexy may explain the poorer QoL and should require a tailored therapeutic approach.

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假性共济失调的现象学和精神病学相关性。
研究目的:假性猝倒是一种罕见的功能性神经系统疾病,类似于猝倒,是1型发作性睡病(NT1)的病理特征。我们描述了假性共济失调患者与NT1患者的精神共病和个性特征。方法:病例对照观察研究纳入了连续的假性共济失调患者和年龄匹配的连续NT1患者的对照组。诊断检查包括结构化访谈、48小时多导睡眠图、多次睡眠潜伏期测试、诱发猝倒测试和脑脊液中的低视网膜蛋白-1测量。所有参与者都接受了Beck抑郁量表、状态特质焦虑量表、患者健康问卷-15(PHQ-15)、DSM-5简式人格量表和36项简式健康调查(SF-36)的生活质量测量。结果:包括15例假性共济失调患者和30例NT1患者。尽管怀疑可能有猝倒,但没有一名假性猝倒参与者符合NT1的国际诊断标准。与NT1相比,假性猝倒患者表现出更高的中度焦虑率(40%对10%,p=0.018)、中等水平的躯体症状(PHQ-15评分>10)(66.7%对16.7%,p=0.003),以及中度至重度抑郁症状的趋势(33.3%对10%,p=0.054)。人格特征没有出现显著差异。假性中风患者在几乎所有SF-36领域的生活质量状况都较差,包括身体(平均值±标准差:37.7±9.88 vs.51.13±7.81,P结论:与NT1患者相比,假性中风患者表现出更严重的精神症状和更低的生活质量。假性共济失调的严重体型和情感障碍可能解释了生活质量较差的原因,应该需要量身定制的治疗方法。
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来源期刊
Sleep
Sleep 医学-临床神经学
CiteScore
10.10
自引率
10.70%
发文量
1134
审稿时长
3 months
期刊介绍: SLEEP® publishes findings from studies conducted at any level of analysis, including: Genes Molecules Cells Physiology Neural systems and circuits Behavior and cognition Self-report SLEEP® publishes articles that use a wide variety of scientific approaches and address a broad range of topics. These may include, but are not limited to: Basic and neuroscience studies of sleep and circadian mechanisms In vitro and animal models of sleep, circadian rhythms, and human disorders Pre-clinical human investigations, including the measurement and manipulation of sleep and circadian rhythms Studies in clinical or population samples. These may address factors influencing sleep and circadian rhythms (e.g., development and aging, and social and environmental influences) and relationships between sleep, circadian rhythms, health, and disease Clinical trials, epidemiology studies, implementation, and dissemination research.
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