{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:17:41Z","timestamp":1791357461675,"version":"4.3.1"},"reference-count":120,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T00:00:00Z","timestamp":1620172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Narcolepsy is a rare sleep disorder in which psychotic\u2010like symptoms can present diagnostic and therapeutic challenges. We aimed to review the association between, and medical management of, narcolepsy and psychosis in children and adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We reviewed the full text of 100 papers from 187 identified by a PubMed search on\n                      <jats:italic>narcolepsy<\/jats:italic>\n                      plus any of these keywords:\n                      <jats:italic>psychosis<\/jats:italic>\n                      ,\n                      <jats:italic>schizophrenia<\/jats:italic>\n                      ,\n                      <jats:italic>delusion<\/jats:italic>\n                      ,\n                      <jats:italic>side effects<\/jats:italic>\n                      ,\n                      <jats:italic>safety<\/jats:italic>\n                      , and\n                      <jats:italic>bipolar disorder<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three relevant groups are described. (i) In typical narcolepsy, psychotic\u2010like symptoms include predominantly visual hallucinations at the sleep\u2010wake transition (experienced as \u201cnot real\u201d) and dissociation because of intrusion of rapid eye movement (REM) sleep phenomena into wakefulness. (ii) Atypical patients (\u201cthe psychotic form of narcolepsy\u201d) experience more severe and vivid, apparently REM\u2010related hallucinations or dream\/reality confusions, which patients may rationalize in a delusion\u2010like way. (iii) Some patients have a comorbid schizophrenia spectrum disorder with psychotic symptoms unrelated to sleep. Psychostimulants used to treat narcolepsy may trigger psychotic symptoms in all three groups. We analyzed 58 published cases from groups 2 and 3 (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a017 and 41). Features that were reported significantly more frequently in atypical patients include visual and multimodal hallucinations, sexual and mystical delusions, and false memories. Dual diagnosis patients had more disorganized symptoms and earlier onset of narcolepsy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Epidemiological studies tentatively suggest a possible association between narcolepsy and schizophrenia only for very early\u2010onset cases, which could be related to the partially overlapping neurodevelopmental changes observed in these disorders. We propose a clinical algorithm for the management of cases with psychotic\u2010like or psychotic features.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13300","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T08:27:27Z","timestamp":1617006447000},"page":"28-41","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Narcolepsy and psychosis: A systematic review"],"prefix":"10.1111","volume":"144","author":[{"given":"Cyril","family":"Hanin","sequence":"first","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Rares \u00e0 Expression Psychiatrique Department of Child and Adolescent Psychiatry Piti\u00e9\u2010Salp\u00eatri\u00e8re University Hospital Assistance Publique\u2010H\u00f4pitaux de Paris Sorbonne University Paris France"},{"name":"Facult\u00e9 de M\u00e9decine Sorbonne Universit\u00e9 Groupe de Recherche Clinique n\u00b015 \u2010 Troubles Psychiatriques et D\u00e9veloppement (PSYDEV Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2240-2516","authenticated-orcid":false,"given":"Isabelle","family":"Arnulf","sequence":"additional","affiliation":[{"name":"National Reference Center for Rare Hypersomnias Piti\u00e9\u2010Salp\u00eatri\u00e8re University Hospital Assistance Publique\u2010H\u00f4pitaux de Paris Sorbonne University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Baptiste","family":"Maranci","sequence":"additional","affiliation":[{"name":"National Reference Center for Rare Hypersomnias Piti\u00e9\u2010Salp\u00eatri\u00e8re University Hospital Assistance Publique\u2010H\u00f4pitaux de Paris Sorbonne University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Lecendreux","sequence":"additional","affiliation":[{"name":"Pediatric Sleep Center and National Reference Center for Narcolepsy and Hypersomnia Robert Debr\u00e9 University Hospital Assistance Publique\u2010H\u00f4pitaux de Paris Paris VII University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas F.","family":"Levinson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Stanford University Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cohen","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Rares \u00e0 Expression Psychiatrique Department of Child and Adolescent Psychiatry Piti\u00e9\u2010Salp\u00eatri\u00e8re University Hospital Assistance Publique\u2010H\u00f4pitaux de Paris Sorbonne University Paris France"},{"name":"Facult\u00e9 de M\u00e9decine Sorbonne Universit\u00e9 Groupe de Recherche Clinique n\u00b015 \u2010 Troubles Psychiatriques et D\u00e9veloppement (PSYDEV Paris France"},{"name":"CNRS UMR 7222 Institute 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