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Short- and long-term effects of group psychotherapy for patients with Narcolepsy Type 1

Conference Paper/Poster - Sep 27, 2022

Units
Keywords
Neurologie; Psychotherapie; Gruppenpsychotherapie; Gruppentherapie; kognitive Verhaltenstherapie; KTV; Psychosomatik; PSOMA; Narkolepsie; Typ 1
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Citation
Schmid D, Reiss V, Gehrig C, Germann N, von Manitius S (2022). Short- and long-term effects of group psychotherapy for patients with Narcolepsy Type 1.
Project
Type
Conference Paper/Poster (English)
Conference Name
Poster presented at the ESRS conference 2022 (Athens (Greece))
Publisher Proceedings
Publication Date
Sep 27, 2022
Issn Print
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Brief description/objective

Objectives/Introduction:
Narcolepsy type 1 (NT1) is a severe chronic disorder of the sleep-wake system with excessive daytime sleepiness and cataplexy. It is often accompanied by psychiatric symptoms. Standard therapy focusses on pharmacotherapy while psychotherapeutic aspects as quality of life (QoL), emotion regulation and disease acceptance are neglected. The aim of this pilot study was to explore the efficiency of an additional method-integrating group-psychotherapy (cognitive-behavioural and body-oriented) on comorbid affective symptoms.

Methods:
This prospective single-arm interdisciplinary study included 10 patients (6 women, 4 men) with NT1 (ICSD). Medication did not change during the study period (24 weeks). We collected psychometric data at T-1 (6 weeks waiting control phase), T0 (pre-intervention), T1 (post-intervention; 6 weeks after T0) and T2 follow-up (12 weeks after T1). Psychometric data included specific sleep-related symptoms (PSQI, FSS, ESS), affective symptoms (HADS), emotion regulation (FEEL-E), health-related QoL (SF-12), disease acceptance, processing and coping (FKV-LIS-SE), as well as data concerning severity and burden of specific narcoleptic symptoms.

Preliminary Results:
We found trends towards improvement in mean scores of psychological QoL (T0 → T1), emotional and social burden of specific narcoleptic symptoms (T0 → T1) and affective distress and regulation (T0 → T1 → T2). However, results did not reach statistical significance.

1. Emotional and social burden of typical narcoleptic symptoms: cataplexies: 1.8 → 1.3; hypnagogic hallucinations: 1.2 → 1
2. Psychological subscale of QoL (SF-12): 60.4 → 64.8
3. Depression and anxiety (HADS): anxiety: 7.7 → 6.3 → 7; depression: 6.9 → 6.7 → 5.7
4. Emotion regulation (FEEL-E): 20 → 18.6 → 17.3

A subsample of 3 patients with clinically relevant anxiety or depressive symptoms showed even greater improvement in the aspects listed above. There were no relevant changes in PSQI, FSS, ESS and FKS-LIS-SE.

Discussion/Conclusion:
The results indicate a reduction in the psychological burden of narcolepsy symptoms in the whole group, lacking statistical relevance according to a small sample size. Patients with clinically relevant anxiety or depressive symptoms benefited more strikingly from group therapy. We suggest to further explore cognitive behavioural therapy in a group setting as a complementary treatment strategy for narcolepsy, especially in a subgroup of NT1 patients with relevant comorbid affective symptoms and in order to prevent depression or anxiety disorders.