{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:19:09Z","timestamp":1791357549499,"version":"4.3.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,4,14]],"date-time":"2018-04-14T00:00:00Z","timestamp":1523664000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004690","name":"Minist\u00e8re de la Sant\u00e9","doi-asserted-by":"publisher","award":["PNMR\u20103"],"award-info":[{"award-number":["PNMR\u20103"]}],"id":[{"id":"10.13039\/501100004690","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    In Kleine\u2010Levin syndrome (\n                    <jats:styled-content style=\"fixed-case\">KLS<\/jats:styled-content>\n                    ), 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\n                    <jats:styled-content style=\"fixed-case\">KLS<\/jats:styled-content>\n                    underwent psychiatric interviews at diagnosis and every year for 1\u201310\u00a0years, leading to diagnosis of former and present comorbid psychiatric disorders. Among the 115 patients (65.2% male and aged 16.1\u00a0\u00b1\u00a04.8\u00a0years at\n                    <jats:styled-content style=\"fixed-case\">KLS<\/jats:styled-content>\n                    onset), 19 (16.5%) had a history of psychiatric disorder prior to\n                    <jats:styled-content style=\"fixed-case\">KLS<\/jats:styled-content>\n                    onset, which persisted afterwards in 10. Twenty\u2010five (21%) patients developed a new, comorbid psychiatric disorder 1\u20136\u00a0years after\n                    <jats:styled-content style=\"fixed-case\">KLS<\/jats:styled-content>\n                    onset, during \u2018asymptomatic\u2019 periods, including mood disorders (\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    14; including major depressive episodes,\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    8; recurrent depressive episodes,\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    2; bipolar I disorder,\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    1; dysthymic disorder,\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    1; adjustment disorder with depressive mood,\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    1; and mood disorder not otherwise specified,\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    1), anxiety disorders (\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    7), eating disorders (\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    2), psychotic disorders not otherwise specified (\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    2), schizoaffective disorder (\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    1) and cannabis dependence (\n                    <jats:italic>n\u00a0<\/jats:italic>\n                    =\n                    <jats:italic>\u00a0<\/jats:italic>\n                    1). Six patients attempted suicide: two before and two after\n                    <jats:styled-content style=\"fixed-case\">KLS<\/jats:styled-content>\n                    onset, and two during episodes. Female sex, longer disease course, longer time incapacitated (356\u00a0\u00b1\u00a0223 versus 155\u00a0\u00b1\u00a0186\u00a0days) 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\n                    <jats:styled-content style=\"fixed-case\">KLS<\/jats:styled-content>\n                    and normality between episodes, one\n                    <jats:styled-content style=\"fixed-case\">KLS<\/jats:styled-content>\n                    patient in five suffers from emerging psychiatric disorders. These disorders may depend on personal vulnerability and, most probably, on psychiatric symptoms during episodes.\n                  <\/jats:p>","DOI":"10.1111\/jsr.12690","type":"journal-article","created":{"date-parts":[[2018,4,14]],"date-time":"2018-04-14T18:43:56Z","timestamp":1523731436000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Emerging psychiatric disorders in Kleine\u2010Levin syndrome"],"prefix":"10.1111","volume":"27","author":[{"given":"Elisabeth","family":"Groos","sequence":"first","affiliation":[{"name":"National Reference Centre for Narcolepsy Hypersomnia and Kleine\u2010Levin Syndrome Pitie\u2010Salpetriere University Hospital AP\u2010HP Paris France"},{"name":"Sleep Disorder Unit Pitie\u2010Salpetriere University Hospital AP\u2010HP Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Chaumereuil","sequence":"additional","affiliation":[{"name":"National Reference Centre for Narcolepsy Hypersomnia and Kleine\u2010Levin Syndrome Pitie\u2010Salpetriere University Hospital AP\u2010HP Paris France"},{"name":"Sleep Disorder Unit Pitie\u2010Salpetriere University Hospital AP\u2010HP Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilde","family":"Flamand","sequence":"additional","affiliation":[{"name":"Sleep Disorder Unit Salengro University Hospital Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Brion","sequence":"additional","affiliation":[{"name":"National Reference Centre for Narcolepsy Hypersomnia and Kleine\u2010Levin Syndrome Pitie\u2010Salpetriere University Hospital AP\u2010HP Paris 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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 Centre for Narcolepsy Hypersomnia and Kleine\u2010Levin Syndrome Pitie\u2010Salpetriere University Hospital AP\u2010HP Paris France"},{"name":"Sleep Disorder Unit Pitie\u2010Salpetriere University Hospital AP\u2010HP Paris France"},{"name":"Sorbonne University Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,14]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"The International Classification of Sleep Disorders \u2010 Revised","author":"American Academy of Sleep Medicine","year":"2005"},{"key":"e_1_2_8_3_1","volume-title":"American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric 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