Résumé
Objectives: to determine the frequency and determinants of depressive symptoms and suicidal thoughts using the Beck Depression Inventory-II (BDI-II) questionnaire in patients with idiopathic hypersomnia (IH) compared to controls, and evaluate changes after IH treatment, and to assess the frequency of major depressive episode (MDE) and suicidal risk (SR) using the face-to-face Mini-International Neuropsychiatric Interview (MINI) in IH patients. Methods: untreated adult IH patients were compared to controls. All participants underwent a comprehensive clinical evaluation and completed the BDI-II self questionnaire which includes one item on suicidal thoughts (item 9). All patients had a standardized evaluation in a National Reference Center for Rare Hypersomnias, during hospitalization. A subgroup of patients completed the BDI-II a second time after several months of stable treatment. Another subgroup of untreated patients underwent the face-to-face MINI to formally diagnose past and current MDE and SR. Results: a total of 729 participants were included: 265 consecutive drug-free patients (194 women, mean 30.61±9.67 yo) and 464 controls (334 women, mean 30.50 ±10.09 yo), with no differences in age, sex or body mass index. IH patients had more moderate to severe depressive symptoms (19.6%) and suicidal thoughts (14.3%) compared to controls (3.7% and 9.1% respectively). Patients with moderate to severe BDI-II scores reported more severe IH symptoms on IH Severity Scale (IHSS), higher levels of anxiety and fatigue and a lower quality of life (QoL). Patients with suicidal thoughts had more anxiety and more severe IH symptoms. After IH management, BDI-II total score and fatigue score decreased, QoL improved but suicidal thoughts and anxiety remained unchanged. Current MDE was diagnosed in 8.0% of patients, past MDE in 44% and SR identified in 18.6% patients. Conclusions: depressive symptoms, depression, suicidal thoughts and SR were frequent in untreated IH. Depressive symptoms and suicidal thoughts were associated with IH severity. BDI-II item 9 did not screen all patients with clinical SR. While IH management improved depressive symptoms, it had no effect on suicidal thoughts.