Emerging psychiatric disorders in Kleine‐Levin syndrome
- 14 April 2018
- journal article
- research article
- Published by Wiley in Journal of Sleep Research
- Vol. 27 (5), e12690
- https://doi.org/10.1111/jsr.12690
Abstract
In Kleine‐Levin syndrome (KLS), episodes of hypersomnia and cognitive, psychiatric and behavioural disturbances alternate with asymptomatic periods in adolescents. We evaluated whether psychiatric disorders would emerge during asymptomatic periods in a naturalistic, uncontrolled clinical cohort. Patients with primary KLS underwent psychiatric interviews at diagnosis and every year for 1–10 years, leading to diagnosis of former and present comorbid psychiatric disorders. Among the 115 patients (65.2% male and aged 16.1 ± 4.8 years at KLS onset), 19 (16.5%) had a history of psychiatric disorder prior to KLS onset, which persisted afterwards in 10. Twenty‐five (21%) patients developed a new, comorbid psychiatric disorder 1–6 years after KLS onset, during ‘asymptomatic’ periods, including mood disorders (n = 14; including major depressive episodes, n = 8; recurrent depressive episodes, n = 2; bipolar I disorder, n = 1; dysthymic disorder, n = 1; adjustment disorder with depressive mood, n = 1; and mood disorder not otherwise specified, n = 1), anxiety disorders (n = 7), eating disorders (n = 2), psychotic disorders not otherwise specified (n = 2), schizoaffective disorder (n = 1) and cannabis dependence (n = 1). Six patients attempted suicide: two before and two after KLS onset, and two during episodes. Female sex, longer disease course, longer time incapacitated (356 ± 223 versus 155 ± 186 days) and more frequent psychiatric symptoms during episodes (but no family or personal history of psychiatric disorders) were associated with emerging psychiatric disorders. Contrary to the alleged benignity of KLS and normality between episodes, one KLS patient in five suffers from emerging psychiatric disorders. These disorders may depend on personal vulnerability and, most probably, on psychiatric symptoms during episodes.Keywords
Funding Information
- Ministère de la Santé (PNMR-3)
This publication has 26 references indexed in Scilit:
- Thalamic Activation in the Kleine-Levin SyndromeSleep, 2014
- Kleine-Levin syndrome and bipolar disorder: a differential diagnosis of recurrent and resistant depressionBipolar Disorders, 2013
- Diagnosis, disease course, and management of patients with Kleine-Levin syndromeThe Lancet Neurology, 2012
- Kleine–Levin syndrome: A systematic study of 108 patientsAnnals of Neurology, 2008
- Posttraumatic Kleine–Levin syndromeGeneral Hospital Psychiatry, 2006
- Kleine–Levin syndrome: a systematic review of 186 cases in the literatureBrain, 2005
- SPECT Findings in the Kleine-Levin SyndromeSleep, 2005
- Instrument to assess depersonalization-derealization in panic disorderDepression and Anxiety, 2002
- Clinical Features of Kleine-Levin Syndrome with Localized EncephalitisNeuropediatrics, 1993
- A Pathologic Basis for Kleine-Levin SyndromeArchives of Neurology, 1982