Connections between narcolepsy type one and adult patients with diagnosed schizophrenia or schizoaffective disorder was a previously unexplored topic. This article focuses on the frequency that narcolepsy type one, which can also be called narcolepsy with cataplexy, appears in adult patients with diagnosed schizophrenia or schizoaffective disorder. There are reports of patients that have been diagnosed with both narcolepsy and schizophrenia, but the relationship between these two disorders had not been examined until this work. I found this concept very interesting because secondary narcolepsy, a disorder that is different from type one narcolepsy, can be caused by neurological disorders. Research was previously conducted concerning the presence of schizophrenia in a group of children and adolescents with narcolepsy, and a small group developed schizophrenia or schizoaffective disorder after being diagnosed with narcolepsy. The aim of this research was to increase the understanding of both disorders.
Narcolepsy type one is not a very common disorder and has many different symptoms that begin in adolescence. There are four main symptoms excessive daytime sleepiness, cataplexy, hypnagogic or hypnopompic hallucinations and sleep paralysis. Cataplexy is characterized by sudden muscle weakness while a person is still aware. Symptoms are caused by a deficiency of hypocretin, neuropeptides that play a role in alertness. Low levels of hypocretin is very common in patients with narcolepsy type one.
Schizophrenia is a disorder that is much more common than narcolepsy with cataplexy. Symptoms of this disorder also become apparent during adolescence. Common symptoms include hallucinations and delusions. It is suggested that schizophrenia can be caused by both environmental and genetic factors.
There are several reasons that could explain the associations between these disorders. It may be a consequence of stimulant therapy. However, this is not a common side effect. Another reason for this association may be that narcoleptic symptoms, such as hypnagogic hallucinations, may be misdiagnosed. It is also possible that both narcolepsy type one and schizophrenia share physiopathological factors. The fourth factor that may be that these disorders occur in the same patient merely by chance.
Patients with schizophrenia or schizoaffective disorder above the age of eighteen and able to answer questions being asked were invited to participate in this research. All participants were from the adult Psychiatry Department of the Hospital Parc Taulí. A stepwise approach with three phases was used in this experiment. The first phase included patients being screened with a questionnaire. Each patient was questioned by the same psychologist. This psychologist asked questions that focused on the four main symptoms of narcolepsy. Excessive daytime sleepiness was measured by the Epworth sleepiness scale.
The second phase of this experiment included patients that scored greater than or equal to eleven on the Epworth sleepiness scale or had cataplectic features. These patients were evaluated by a neurologist who administered a systemized clinical interview. Medications that patients were taking were also evaluated. Patients who suffered from excessive daytime sleepiness or cataplexy experiences were then tested for HLA typing. Specifically, the researchers were looking for HLA DQB1*06:02 because narcolepsy type one occurs primarily in patients who were positive for this type of HLA. Those patients who were positive for HLA DQB1*06:02 went on to the third phase of the experiment. In this phase, hypocretin-1 levels in cerebrospinal fluid were tested. This was tested because narcolepsy with cataplexy can be diagnosed by low values of hypocretin-1 in cerebrospinal fluid.
The experiment included 366 patients that had previously been diagnosed with either schizophrenia or schizoaffective disorder and the age of participants ranged from18 to 81 years old. Thirty-six of the 366 patients had an Epworth sleepiness scale score of greater than or equal to eleven or had previously experienced cataplexy. Twenty-four of the thirty-six patients that were asked to participate in the second phase of the experiment were evaluated by the same neurologist. The age range of the second phase was 21 to 57 years old. Five of these patients were positive for HLA DQB1*06:02. Two of these patients refused to participate in the third phase of the experiment. There was no patient that had clear narcolepsy type one in this group of participants.
The connection between narcolepsy type one and adult patients with diagnosed schizophrenia or schizoaffective disorder was very difficult to study because many of the medications the patients were taking can significantly affect rapid eye movement sleep. These patients could not be taken off medications because of ethical reasons. There were no other ethical issues in this experiment.
One goal of this article was to understand more about both narcolepsy type one and schizophrenia or schizoaffective disorder. This also seeks to explore the theory of whether narcolepsy with cataplexy and schizophrenia share physiopathological factors. This research found no correlation between the frequency of these disorders. I found it very interesting that there could be a connection between schizophrenia or schizoaffective disorder and narcolepsy type two, but not narcolepsy with cataplexy. There is still large amount of information that is unknown about this subject. However, this article is one study that can be used to clarify more about these disorders.
This article also explored many concepts of psychology that I did not understand before. I learned much more about the different types of narcolepsy. I was also unaware that there could be connections between different types of disorders. One concept I learned more about through reading this article was the concept of using a stepwise approach performing an experiment.