Clara Odilia Inocente1, Marie-Paule Gustin2, Sophie Lavault3, Anne Guignard-Perret4, Aude Raoux4, Noemie Christol4, Daniel Gerard5, Yves Dauvilliers6, Rubens Reimão7, Flora Bat-Pitault8, Jian-Sheng Lin1, Isabelle Arnulf3, Michel Lecendreux9, Patricia Franco10. 1. Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon 1, Lyon, France. 2. Université de Lyon, Université Lyon 1, Department of Public Health, Institute of Pharmacy (ISPB), EA4173, F-69373 Lyon, France; Hospices Civils de Lyon, Service de Biostatistique, 162 Avenue Lacassagne, 69424 Lyon Cedex 03, France. 3. National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR Narcolepsie-Hypersomnie), France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Unité des Pathologies du Sommeil, Paris, France. 4. Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon 1, Lyon, France; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR Narcolepsie-Hypersomnie), France; Pediatric Sleep Unit, Hôpital Femme Mère Enfant, University Lyon 1, Lyon, France. 5. Service de Psychiatrie Infantile, U502, Hôpital Neurologique, University Lyon 1, Lyon, France. 6. National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR Narcolepsie-Hypersomnie), France; Inserm U1061, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France. 7. Sleep Medicine Advanced Research Group, Division of Clinical Neurology, Clinical Hospital, University of São Paulo School of Medicine, São Paulo SP, Brazil. 8. Child and Adolescent Psychopathology Unit, Salvator Hospital, Public Assistance-Marseille Hospitals, University Aix-Marseille II, Marseille, France. 9. National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR Narcolepsie-Hypersomnie), France; Centre Pédiatrique des Pathologies du Sommeil, Hôpital Robert Debré, Paris, France. 10. Integrative Physiology of Brain Arousal System, CRNL, INSERM-U1028, University Lyon 1, Lyon, France; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome (CNR Narcolepsie-Hypersomnie), France; Pediatric Sleep Unit, Hôpital Femme Mère Enfant, University Lyon 1, Lyon, France. Electronic address: Patricia.Franco@chu-lyon.fr.
Abstract
OBJECTIVES: We aimed to evaluate depressive feelings and their correlations in children and adolescents with narcolepsy collected in national reference centers for narcolepsy. METHODS: We compared clinical and sleep characteristics of patients with and without depressive symptoms evaluated on the Children's Depression Inventory (CDI). RESULTS: Our study sample included 88 children (44 boys; 44 de novo patients) with a mean age of 11.9 ± 3.1 years at diagnosis (37.5% were aged ⩽ 10 years). Obesity was found in 59% of the sample and cataplexy was present in 80.7%. The DQB1*0602 allele was positive in 93.5% of our sample. There were 25% of children who had clinically depressive feelings (CDI>16), especially girls older than the age of 10 years. Bivariate associations indicated that depressive feelings were associated with fatigue (48%), hyperactivity (31%), insomnia (16%), and excessive daytime sleepiness (EDS) (14-24%). In the multivariate model adjusted for gender and age, only fatigue explained the variability of the depression score. CONCLUSION: In our large cohort, high levels of depressive symptoms essentially expressed by fatigue affected 25% of children with narcolepsy. The girls older than 10 years of age were especially vulnerable. The similar prevalence of depressive feelings in treated vs never-treated patients suggests a specific need for diagnosing and managing this symptom in young patients with narcolepsy.
OBJECTIVES: We aimed to evaluate depressive feelings and their correlations in children and adolescents with narcolepsy collected in national reference centers for narcolepsy. METHODS: We compared clinical and sleep characteristics of patients with and without depressive symptoms evaluated on the Children's Depression Inventory (CDI). RESULTS: Our study sample included 88 children (44 boys; 44 de novo patients) with a mean age of 11.9 ± 3.1 years at diagnosis (37.5% were aged ⩽ 10 years). Obesity was found in 59% of the sample and cataplexy was present in 80.7%. The DQB1*0602 allele was positive in 93.5% of our sample. There were 25% of children who had clinically depressive feelings (CDI>16), especially girls older than the age of 10 years. Bivariate associations indicated that depressive feelings were associated with fatigue (48%), hyperactivity (31%), insomnia (16%), and excessive daytime sleepiness (EDS) (14-24%). In the multivariate model adjusted for gender and age, only fatigue explained the variability of the depression score. CONCLUSION: In our large cohort, high levels of depressive symptoms essentially expressed by fatigue affected 25% of children with narcolepsy. The girls older than 10 years of age were especially vulnerable. The similar prevalence of depressive feelings in treated vs never-treated patients suggests a specific need for diagnosing and managing this symptom in young patients with narcolepsy.