Depression and anxiety in epilepsy: the association with demographic and seizure-related variables
Tóm tắt
Depression and anxiety are common psychiatric symptoms in patients with epilepsy, exerting a profound negative effect on health-related quality of life. Several issues, however, pertaining to their association with psychosocial, seizure-related and medication factors, remain controversial. Accordingly, the present study was designed to investigate the association of interictal mood disorders with various demographic and seizure-related variables in patients with newly-diagnosed and chronic epilepsy. We investigated 201 patients with epilepsy (51.2% males, mean age 33.2 ± 10.0 years, range 16–60) with a mean disease duration of 13.9 ± 9.5 years. Depression and anxiety were assessed in the interictal state with the Beck Depression Inventory, 21-item version (BDI-21) and the state and trait subscales of the State-Trait Anxiety Inventory (STAI-S and STAI-T), respectively. The association of mood disorders with various variables was investigated with simple and multiple linear regression analyses. High seizure frequency and symptomatic focal epilepsy (SFE) were independent determinants of depression, together accounting for 12.4% of the variation of the BDI-21. The STAI-S index was significantly associated with the type of epilepsy syndrome (SFE). Finally, high seizure frequency, SFE and female gender were independent determinants of trait anxiety accounting for 14.7% of the variation of the STAI-T. Our results confirm the prevailing view that depression and anxiety are common psychological disorders in epileptics. It is additionally concluded that female gender, high seizure frequency and a symptomatic epilepsy syndrome are independent risk factors for the development of anxiety and/or depression.
Tài liệu tham khảo
Lambert MV, Robertson MM: Depression in epilepsy: etiology, phenomenology, and treatment. Epilepsia. 1999, 40 (Suppl 10): 21-47. 10.1111/j.1528-1157.1999.tb00884.x.
Jacoby A, Baker GA, Steen N, Potts P, Chadwick DW: The clinical course of epilepsy and its psychosocial correlates: finding from a U.K. community study. Epilepsia. 1996, 37: 148-161. 10.1111/j.1528-1157.1996.tb00006.x.
Ettinger AB, Weisbrot DM, Nolan EE, Gadow KD, Vitale SA, Andriola MR, Lenn NJ, Novak GP, Hermann BP: Symptoms of depression and anxiety in pediatric epilepsy patients. Epilepsia. 1998, 39: 595-599. 10.1111/j.1528-1157.1998.tb01427.x.
Jones JE, Hermann BP, Barry JJ, Gilliam F, Kanner AM, Meador KJ: Clinical assessment of Axis I psychiatric morbidity in chronic epilepsy: a multicenter investigation. J Neuropsychiatry Clin Neurosci. 2005, 17: 172-179.
Choi-Kwon S, Chung C, Kim H, Lee S, Yoon S, Kho H, Oh J, Lee S: Factors affecting the quality of life in patients with epilepsy in Seoul, South Korea. Acta Neurol Scand. 2003, 108: 428-434. 10.1046/j.1600-0404.2003.00151.x.
Altshuler LL, Devinsky 0, Post RM, Theodore W: Depression, anxiety, and temporal lobe epilepsy. Laterality of focus and symptoms. Arch Neurol. 1990, 47: 284-288.
Strauss E, Wada J, Moll A: Depression in male and female subjects with complex partial seizures. Arch Neurol. 1992, 49: 391-392.
Standage KF, Fenton GW: Psychiatric symptom profiles of patients with epilepsy: a controlled investigation. Psychol Med. 1973, 5: 152-160.
Taylor DC: Mental state and temporal lobe epilepsy, a correlative account of 100 patients treated surgically. Epilepsia. 1972, 13: 727-765.
Koch-Weser M, Garron DC, Gilley DW, Bergen D, Bleck TP, Morrell F, Ristanovic R, Whisler WW: Prevalence of psychologic disorders after surgical treatment of seizures. Arch Neurol. 1988, 45: 1308-1311.
Hermann BP, Wyler AR: Depression, locus of control, and the effects of epilepsy surgery. Epilepsia. 1989, 30: 332-338.
Mendez MF, Cummings JL, Benson DF: Depression in epilepsy. Significance and phenomenology. Arch Neurol. 1986, 43: 766-770.
Commission on Classification and Terminology of the International League against Epilepsy: Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia. 1989, 30: 389-399.
Kanner AM, Stagno S, Kotagal P, Morris HH: Postictal psychiatric events during prolonged video-electroencephalographic monitoring studies. Arch Neurol. 1996, 53: 258-263.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression. Arch Gen Psychiatry. 1961, 4: 561-571.
Spielberger CD: Manual for the State-Trait Anxiety Inventory. Edited by: Palo Alto, CA. 1983, Consultant Psychologist Press
Folstein MF, Folstein SE, McHugh PR: Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975, 12: 189-198. 10.1016/0022-3956(75)90026-6.
Fountoulakis KN, Iacovides A, Kleanthous S, Samolis S, Gougoulias K, Kaprinis GS, Bech P: The Greek translation of the symptoms rating scale for depression and anxiety: preliminary results of the validation study. BMC Psychiatry. 2003, 3: 21-10.1186/1471-244X-3-21.
Kogeorgos J, Fonagy P, Scott DF: Psychiatric symptom patterns of chronic epileptics attending a neurological clinic: a controlled investigation. Br J Psychiatry. 1982, 140: 236-243.
Septien L, Grass P, Giroud M, Didi-Roy R, Brunotte F, Pelletier JL, Dumas R: Depression and temporal lobe epilepsy: the possible role of laterality of the epileptic foci and gender. Neurophysiol Clin. 1993, 23: 327-336. 10.1016/S0987-7053(05)80124-8.
Hawton K, Fagg J, Marsack P: Association between epilepsy and attempted suicide. J Neurol Neurosurg Psychiatry. 1980, 43: 168-170.
Victoroff JI, Benson DF, Engel J Jr, Grafton S, Mazziotta JC: Interictal depression in patients with medically intractable complex partial seizures: electroencephalography and cerebral metabolic correlates [abstract]. Ann Neurol. 1990, 28: 221-
Robertson MM, Channon S, Baker J: Depressive symptomatology in a general hospital sample of outpatients with temporal lobe epilepsy: a controlled study. Epilepsia. 1994, 35: 771-777. 10.1111/j.1528-1157.1994.tb02510.x.
Beyenburg S, Mitchell AJ, Schmidt D, Elger CE, Reuber M: Anxiety in patients with epilepsy: systematic review and suggestions for clinical management. Epilepsy Behav. 2005, 7: 161-171. 10.1016/j.yebeh.2005.05.014.
Fountoulakis KN, Papadopoulou M, Kleanthous S, Papadopoulou A, Bizeli V, Nimatoudis I, Iacovides A, Kaprinis GS: Reliability and psychometric properties of the Greek translation of the State-Trait Anxiety Inventory form Y: preliminary data. Ann Gen Psychiatry. 2006, 5: 2-10.1186/1744-859X-5-2.
Andrade L, Gorenstein C, Vieira Filho AH, Tung TC, Artes R: Psychometric properties of the Portuguese version of the State-Trait Anxiety Inventory applied to college students: factor analysis and relation to the Beck Depression Inventory. Braz J Med Biol Res. 2001, 34: 367-374. 10.1590/S0100-879X2001000300011.
Depaulis A, Helfer V, Deransart C, Marescaux C: Anxiogenic-like consequences in animal models of complex partial seizures. Neurosci Biobehav Rev. 1997, 21: 767-774. 10.1016/S0149-7634(96)00060-7.
Moore PM, Baker GA: The neuropsychological and emotional consequences of living with intractable temporal lobe epilepsy: implications for clinical management. Seizure. 2002, 11: 224-230. 10.1053/seiz.2001.0668.
Gilliam F, Hecimovic H, Sheline Y: Psychiatric comorbidity, health, and function in epilepsy. Epilepsy Behav. 2003, 4 (Suppl 4): 26-30. 10.1016/j.yebeh.2003.10.003.
Boylan LS, Flint LA, Labovitz DL, Jackson SC, Starner K, Devisnky O: Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy. Neurology. 2004, 62: 258-261.
O'Donoghue MF, Goodridge DM, Redhead K, Sander JW, Duncan JS: Assessing the psychosocial consequences of epilepsy: a community-based study. Br J Gen Pract. 1999, 49: 211-214.
Gilliam FG, Santos J, Vahle V, Carter J, Brown K, Hecimovic H: Depression in epilepsy: ignoring clinical expression of neuronal network dysfunction?. Epilepsia. 2004, 45 (Suppl 2): 28-34. 10.1111/j.0013-9580.2004.452005.x.
Smith DF, Baker GA, Dewey M, Jacoby A, Chadwick DW: Seizure frequency, patient perceived seizure severity and the psychosocial consequences of intractable epilepsy. Epilepsy Res. 1991, 9: 231-241. 10.1016/0920-1211(91)90057-M.
Quiske A, Helmstaedter C, Lux S, Elger CE: Depression in patients with temporal lobe epilepsy is related to mesial temporal sclerosis. Epilepsy Research. 2000, 39: 121-125. 10.1016/S0920-1211(99)00117-5.
Marsh L, Rao V: Psychiatric complications in patients with epilepsy: a review. Epilepsy Res. 2002, 49: 11-33. 10.1016/S0920-1211(02)00008-6.
Goldstein MA, Harden CL: Epilepsy and anxiety. Epilepsy Behav. 2000, 1: 228-234. 10.1006/ebeh.2000.0080.
Vazquez B, Devinsky O: Epilepsy and anxiety. Epilepsy Behav. 2003, 4 (Suppl 4): 20-25. 10.1016/j.yebeh.2003.10.005.