The Misinterpretation of a Non-REM Sleep Parasomnia as Suicidal Behavior in an Adolescent

ABSTRACT

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.

KEYWORD

Non-REM parasomnia - sleepwalking - self-injurious behavior - adolescent

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