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Research Article| Volume 34, ISSUE 11, P773-780, December 01, 1993

Schizophrenia, narcolepsy, and HLA-DR15, DQ6

DOI:https://doi.org/10.1016/0006-3223(93)90066-M
Schizophrenia, narcolepsy, and HLA-DR15, DQ6
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      Abstract

      A strong association between HLA-DR2, DQ1 and narcolepsy-cataplexy has been known since 1986. In 1990 a subdivision (HLA-DR15, DQ6) was shown to be equally associated. Narcolepsy symptoms include rapid eye movement (REM)-sleep intrusion hallucinations during the day. Some narcoleptics may be so hallucinated that they become delusional and receive a diagnosis of schizophrenia. Fifty-six inpatient schizophrenics and 56 normal controls were compared to see if there was an excess of the narcolepsy-associated antigens (NAA) among schizophrenics. Patients had frequency of the NAA 3.89 times higher than controls. After a subset was studied by night (n = 9) and day (n = 7) polysomnography, two patients were found to be true narcoleptics. Their psychosis improved with treatment for narcolepsy. When NAA(+) and NAA(−) schizophrenics were compared, the NAA(+) subgroup had significantly higher Brief Psychiatric Rating Scale (BPRS) scores and more hospitalizations. There were no effects attributable only to gender or race. We conclude that narcolepsy can simulate schizophrenia in some cases, and that even in nonnarcoleptic patients, the HLA-DR15, DQ6 antigens mark a group of severe schizophrenics that merits further study.

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      Article info

      Publication history

      Received in revised form: August 13, 1993
      Received: January 6, 1993

      Footnotes

      ☆Supported by NIH grant No. MO1-RR00042 (Kughn Clinical Research Center, University of Michigan Medical Center), and by infrastructure provided by Dr. Spencer Falcon via the Battle Creek Initiative Program of the Dept. of Veterans Affairs (Central Region). We thank Angela Messina for her invaluable technical assistance with the data analysis.

      ☆An earlier version of this paper was read at the Annual Meeting of the Society of Biological Psychiatry, New Orleans, LA., May 1991.

      Identification

      DOI: https://doi.org/10.1016/0006-3223(93)90066-M

      Copyright

      © 1993 Published by Elsevier Inc.

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