The misinterpretation of a non-REM sleep parasomnia as suicidal behavior in an adolescent.
We report a case of misinterpretation of a non-REM sleep parasomnia as suicidal behavior in an early adolescent. A 12-year-old female with a history of sleepwalking but no prior psychiatric diagnosis awoke in the middle of the night with a deep laceration to her neck and complete amnesia for the event. During the initial 2-week pediatric hospitalization, it was believed that the wound was intentionally self-inflicted despite patient claims and evidence to the contrary. The patient was placed on a psychiatric hold and transferred to an appropriate facility. We review rule-out diagnoses and evidence supporting this case as an example of a violent non-REM parasomnia resulting in self-injurious behavior. Diagnostic and treatment implications are discussed.
Shatkin
Jess P
JP
UCLA Neuropsychiatric Institute and Hospital, Los Angeles, California, USA. jshatkin@sbcglobal.net
Feinfield
Kristin
K
Strober
Michael
M
D000293:Adolescent; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D020447:Parasomnias / Q000175:diagnosis* / Q000523:psychology*; D016728:Self-Injurious Behavior / Q000175:diagnosis* / Q000523:psychology*; D012894:Sleep Stages / Q000502:physiology*; D013406:Suicide, Attempted / Q000523:psychology*