Psychological wellbeing and cognition in narcolepsy

Background: Research has highlighted that people with narcolepsy experience diminished quality of life and psychosocial difficulties. Despite this, research has generally focused on type 1 narcolepsy, with minimal research investigating type 2 narcolepsy being available.

Method: A narrative literature review was carried out to investigate the current research literature investigating the social, psychological, occupational/academic functioning and quality of life in adults with type 2 narcolepsy and compared these difficulties to type 1 narcolepsy. A total of 16 studies were included in the review and were subjected to quality appraisal.

Results: Findings identified that people with type 2 narcolepsy experience significantly higher levels of depression compared to controls. It highlighted the influence of age of onset of symptoms and gender on the presence and severity of psychological difficulties. Significantly impaired social functioning and reduced opportunities for developing relationships was also found, with no differences found between narcolepsy types. Narcolepsy was not found to affect academic outcomes, however people with type 2 narcolepsy reported significantly more difficulties during school and attentional impairment compared to controls. Greater quality of life was found to be associated with better professional prognosis.

Conclusions: The review demonstrates that people with type 2 narcolepsy experience significant psychological and social difficulties which are comparable to those with type 1 narcolepsy. It highlighted that cataplexy did not influence the impact on these domains. Clinical implications from such findings include implementation of psychological intervention which focuses on improving self-efficacy, improving social support, and reducing stigma of the condition. Additionally, it further highlights the need for further research of the psychosocial impact of NT2.