Psychotic symptoms in narcolepsy: phenomenology and a comparison with schizophrenia.
Hal A Droogleever Fortuyn, G A Lappenschaar, Fokko J Nienhuis, Joop W Furer, Paul P Hodiamont, Cees A Rijnders, Gert Jan Lammers, Willy O Renier, Jan K. Buitelaar, Sebastiaan Overeem
General Hospital Psychiatry January 1, 2009 DOI: 10.1016/j.genhosppsych.2008.12.002 (opens in new tab) via PubMed
Summary
AI-generated from the abstractHypnagogic hallucinations in narcolepsy are multisensory and holistic, unlike the predominantly verbal-auditory hallucinations in schizophrenia. Among 60 narcolepsy patients, 102 schizophrenia patients, and 120 matched controls, psychotic symptoms such as delusions were no more frequent in narcolepsy than in controls, and the prevalence of formal psychotic disorders was not increased. Almost half of narcoleptics reported moderate interference with functioning due to hypnagogic hallucinations, mostly from related anxiety. These phenomenological differences aid in differential diagnosis.
Study at a glance
| Characteristics | Cross-sectional comparative study Qualitative Peer reviewed |
|---|---|
| Sample size | 282 |
| Population | Patients with narcolepsy, patients with schizophrenia, and matched population controls |
| Key finding | Hypnagogic hallucinations in narcolepsy are multisensory and holistic, distinct from the verbal-auditory hallucinations in schizophrenia, and psychotic symptoms are not more frequent in narcolepsy than in controls. |
Abstract
Patients with narcolepsy often experience pervasive hypnagogic hallucinations, sometimes even leading to confusion with schizophrenia. We aimed to provide a detailed qualitative description of hypnagogic hallucinations and other "psychotic" symptoms in patients with narcolepsy and contrast these with schizophrenia patients and healthy controls. We also compared the prevalence of formal psychotic disorders between narcolepsy patients and controls. We used SCAN 2.1 interviews to compare psychotic symptoms between 60 patients with narcolepsy, 102 with schizophrenia and 120 matched population controls. In addition, qualitative data was collected to enable a detailed description of hypnagogic hallucinations in narcolepsy. There were clear differences in the pattern of hallucinatory experiences in narcolepsy vs. schizophrenia patients. Narcoleptics reported multisensory "holistic" hallucinations rather than the predominantly verbal-auditory sensory mode of schizophrenia patients. Psychotic symptoms such as delusions were not more frequent in narcolepsy compared to population controls. In addition, the prevalence of formal psychotic disorders was not increased in patients with narcolepsy. Almost half of narcoleptics reported moderate interference with functioning due to hypnagogic hallucinations, mostly due to related anxiety. Hypnagogic hallucinations in narcolepsy can be differentiated on a phenomenological basis from hallucinations in schizophrenia which is useful in differential diagnostic dilemmas.