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Cano-López I, Lozano-García A, Catalán-Aguilar J, Hampel KG, Villanueva V, González-Bono E. The relationship between memory and quality of life is mediated by trait anxiety in patients with temporal lobe epilepsy. Qual Life Res 2023; 32:739-747. [PMID: 36418526 DOI: 10.1007/s11136-022-03306-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Memory deficits are very frequent in patients with drug-resistant epilepsy, but they predict a small proportion of variance of their quality of life (QOL) in previous studies, possibly due to the lack of consideration of mediating factors of this relationship. This study aimed to examine whether trait anxiety mediates the relationship between memory and QOL in this population, controlling the influence of demographic and seizure-related factors. METHODS In this cross-sectional study, 119 adults with drug-resistant temporal lobe epilepsy (TLE) underwent a neuropsychological evaluation, in which memory, anxiety, and QOL were assessed. RESULTS In the total sample, better delayed memory had an effect on better QOL indirectly through lower trait anxiety (B = 0.13, SE = 0.06, p = 0.04, abcs = 0.13; κ2 = 0.18; PMind = 0.76). Additionally, delayed memory has not a direct association with QOL (B = 0.04, SE = 0.09, p = 0.64, Cohen's f 2 = 0.005; PMdir = 0.24), and the total effect of delayed memory on QOL tended to reach statistical significance (B = 0.17, SE = 0.10, p = 0.08). The proposed mediation model yielded excellent fit (CFI = 1.00, RMSEA = 0.0001, SRMR = 0.009, and χ2 (1) = 0.50, p = 0.48) and explained 38% of the variance of QOL. CONCLUSION These findings suggest that trait anxiety is an important factor in understanding the relationship between memory and QOL in patients with TLE, considering the influence of demographic and seizure-related variables, and may have relevant implications for decision-making in this population.
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Affiliation(s)
- Irene Cano-López
- Faculty of Health Sciences, Valencian International University, C/Pintor Sorolla, 21, 46002, Valencia, Spain.
| | - Alejandro Lozano-García
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010, Valencia, Spain
| | - Judit Catalán-Aguilar
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010, Valencia, Spain
| | - Kevin G Hampel
- Refractory Epilepsy Unit. Neurology Service. Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Bulevar Sur, S/N Carretera de Malilla, 46026, Valencia, Spain
| | - Vicente Villanueva
- Refractory Epilepsy Unit. Neurology Service. Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Bulevar Sur, S/N Carretera de Malilla, 46026, Valencia, Spain
| | - Esperanza González-Bono
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010, Valencia, Spain
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Sleep quality and circadian rhythm profile of persons with juvenile myoclonic epilepsy in a tertiary epilepsy center: A case-control study. Seizure 2023; 104:1-5. [PMID: 36435032 DOI: 10.1016/j.seizure.2022.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/19/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This study evaluated sleep quality, chronotype, and excessive diurnal somnolence in persons with Juvenile Myoclonic Epilepsy (JME) and their possible association with clinical variables. METHODS This cross-sectional controlled study evaluated 49 consecutive patients (65% females, mean age 27.53 years) with an electroclinical diagnosis of JME and 49 healthy controls (55% females, mean age 28.55 years). The Pittsburgh Sleep Quality Inventory (PSQI) was used to assess sleep quality and the Epworth Sleepiness Scale (ESS) to evaluate excessive daytime sleepiness. The patients' chronotype was evaluated by the Morningness-Eveningness Questionnaire (MEQ). Epilepsy-related factors gathered from the medical chart and personal interview were epilepsy duration, age at onset, frequency of myoclonic (Mcl), generalized tonic-clonic (GTC) and absence (ABS) seizures, pharmacoresponse, and current antiseizure medication (ASM). RESULTS Persons with JME did not differ from the control group regarding daytime sleepiness (p=0.840); however, the JME group had worse sleep quality (p=0.01) than the controls. Persons with JME presented a more evening chronotype than controls (p = 0.003). The age at onset, epilepsy duration, frequency of Mcl seizure, frequency of GTC seizure, frequency of ABS seizure, and drug response did not predict ESS and MEQ scales. Pharmacoresponsive patients had lower PSQI scores compared with pharmacoresistant patients (p=0.036). CONCLUSION Persons with JME have worse sleep quality and a more evening chronotype. Notably, pharmacoresistant patients present a worse sleep quality that deserves attention and special care due to the relationship between sleep deprivation and seizure worsening.
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Soraya H, Amin MM, Husada MS, Effendy E. Factors Associated with Anxiety Scores in People with Epilepsy in Neurological Installations of Haji Adam Medan Center General Hospital. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND: Anxiety disorder is the most prevalent comorbidity that may persist chronically in individuals with epilepsy. Unfortunately, anxiety is commonly ignored and rarely reported by epileptic patient. Therefore, early intervention and proper treatment should be addressed in these people. Acknowledging risk factors related to anxiety among epileptic patients may be useful in tailoring more appropriate psychiatric support.
AIM: The aim of our study is to investigate risk factors related to anxiety among epileptic patients.
METHODS: This cross-sectional predictive analytical multivariate study was conducted through March to May 2021 in Haji Adam Malik General Hospital Medan involving 84 epileptic patients visiting Neurology outpatient clinic who fulfilled inclusion and exclusion criteria COVID-19 health protocols. Anxiety score was assessed using HADS-A self-reported questionnaire.
RESULTS: We found that most of our patients are female who have experienced epilepsy for around 3 years. Exacerbations occurs approximately 4 times a year with duration of 10–20 min. Finally, we found that age, seizure duration, epileptic frequency, and gender are independent risk factors for anxiety severity among epileptic patients.
CONCLUSION: Age, seizure duration, epileptic frequency, and gender are independent risk factors for anxiety severity among epileptic patients.
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Erken HY, Karaeminogullari O, Yilmaz O, Mirel K, Ozer RO. Local Anesthesia and Conscious Sedation Does Not Affect Patient's Mood and Anxiety Levels during Percutaneous Endoscopic Lumbar Diskectomy: A Prospective Study. J Neurol Surg A Cent Eur Neurosurg 2021; 83:435-441. [PMID: 34918309 DOI: 10.1055/s-0041-1739203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND STUDY AIMS Undergoing a surgical procedure can be very stressful for patients and can lead to high anxiety levels during both the preoperative and the postoperative period. Levels of anxiety and fear may depend on multiple factors including the type of anesthesia to be used. The objective of this study is to evaluate whether patient's awareness of the surgical environment in the operating room under local anesthesia and conscious sedation (LACS) affects their mood and anxiety levels. METHODS We performed a prospective study for a series of consecutive patients who underwent transforaminal percutaneous endoscopic lumbar diskectomy (PELD) for the treatment of lumbar disk herniation. The patients completed Profile of Mood States (POMS) and State-Trait Anxiety Inventory (STAI) forms in the preoperative period and in the early postoperative period. We divided the patients into two groups according to the type of anesthesia applied during surgery: LACS and general anesthesia (GA) groups. We compared the preoperative and postoperative POMS and STAI scores between groups and the change of these scores between the preoperative and postoperative periods in each group. RESULTS In this study, we included 30 patients who underwent PELD between May and December 2019 and met the inclusion criteria. The GA group consisted of 16 patients and the LACS group consisted of 14 patients. In each group, POMS and STAI scores decreased in the early postoperative period compared with the preoperative period. We found no significant difference in percentage of POMS and STAI TX-1 score changes between the LACS and GA groups. CONCLUSION The results of our study show that patients' awareness of the surgical environment in the operating room under LACS does not significantly affect their mood and anxiety levels and patients do not seem to endure increased emotional stress during the PELD operation, as compared with PELD operation under GA.
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Affiliation(s)
- H Yener Erken
- Department of Orthopaedics and Traumatology, Çanakkale Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| | | | - Onur Yilmaz
- Department of Orthopaedics and Traumatology, Çanakkale Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| | - Kerem Mirel
- Department of Orthopaedics and Traumatology, Çanakkale Onsekiz Mart University Faculty of Medicine, Canakkale, Turkey
| | - R Ozgur Ozer
- Department of Orthopaedics and Traumatology, Bayindir Saglik Grubu, Ankara, Turkey
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Li P, Lin J, Wu C, Huang S, Zhu S. The impact of social factors, especially psychological worries on anxiety and depression in patients with epilepsy. Epilepsy Behav 2021; 125:108376. [PMID: 34775247 DOI: 10.1016/j.yebeh.2021.108376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Social factors are believed to affect mental health in patients with epilepsy (PWE). However, there is still a lack of sufficient manifest proof, given the difficulty of exposing PWE to relatively consistent natural social environments with a low or high level of social interaction to study their significant role. METHODS This single-center, longitudinal study was conducted via online questionnaires during the coronavirus disease 2019. PWE were recruited from downtown Wuhan and surrounding areas. The Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 were used to assess psychological status. RESULTS We analyzed 588 questionnaires completed by 294 PWE who participated in the dual survey. Under lockdown and reopening, the prevalence of anxiety was 13.6%/22.5%, and the prevalence of depression was 19.4%/34.0%. Raising children and seizure-related characteristics, including uncontrolled seizures, seizure exacerbation, seizure frequency ≥ 2/m, and changes in drug regimen, were risk factors in the first and second surveys. A high education level (OR = 1.946, 95% CI = 1.191-3.182), low life satisfaction (OR = 1.940, 95% CI = 1.007-3.737), worry about unanticipated seizures (OR = 2.147, 95% CI = 1.049-4.309), and worry about purchasing medication outside (OR = 2.063, 95% CI = 1.060-4.016) were risk factors for higher scores after reopening. Worry about unanticipated seizures (OR = 3.012, 95% CI = 1.302-6.965) and in-person medical consultation (OR = 2.319, 95% CI = 1.262-4.261) were related to newly diagnosed patients with psychological disorder after reopening. CONCLUSIONS We identified an association between social variables and epileptic psychiatric comorbidities.
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Affiliation(s)
- Ping Li
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, China
| | - Jiahe Lin
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, China
| | - Chunmei Wu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, China
| | - Shanshan Huang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, China.
| | - Suiqiang Zhu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, China.
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Sex differences in factors associated with quality of life in patients with epilepsy in Northeast China. Epilepsy Behav 2021; 121:108076. [PMID: 34082318 DOI: 10.1016/j.yebeh.2021.108076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/10/2021] [Accepted: 05/11/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We aimed to investigate sex differences in factors associated with poor quality of life (QOL) in a cohort of patients with epilepsy (PWE) in Northeast China. METHODS A consecutive cohort of 221 PWE from the First Hospital of Jilin University was recruited. The Chinese versions of the Patient Health Questionnaire-9 (PHQ-9), the Beck Anxiety Inventory (BAI), and the Quality of Life in Epilepsy Inventory (QOLIE-31) were used to measure depressive symptoms, anxiety symptoms, and the QOL. RESULTS A total of 221 adult PWE participated in this study. In the multivariate regression model, three independent factors were found to be significantly associated with the total QOLIE-31 score in men: epilepsy duration (p = 0.007), the PHQ-9 score (p < 0.001), and the BAI score (p < 0.001). As for the subscale domain of QOL, marital status showed a relationship with cognitive function (p = 0.047), and residence was related with medication effects (p = 0.034). Two independent factors were found to be significantly associated with the total QOLIE-31 score in women: the PHQ-9 score (p < 0.001) and the BAI score (p < 0.001). The education level of women was positively associated with three subdomain scores of QOL, including overall QOL (p < 0.001), emotional well-being (p = 0.028), and energy/fatigue (p = 0.025). CONCLUSION We found that high levels of depressive and anxiety symptoms are strong predictors of a poor QOL in both men and women. Sex differences also occur in several demographic and clinical factors influencing the overall QOL or subscale domain scores such as epilepsy duration, marital status, and educational level. Timely diagnosis and treatment of psychiatric comorbidities might be crucial for improving the QOL in both men and women.
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Farnia V, Afshari D, Abdoli N, Radmehr F, Moradinazar M, Alikhani M, Behrouz B, Khodamoradi M, Farhadian N. The effect of substance abuse on depression, anxiety, and stress (DASS-21) in epileptic patients. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2020.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Serrano burneo DC, Bowden SC, Simpson LC. Incremental Validity of the Minnesota Multiphasic Personality Inventory, Second Edition (MMPI‐2) Relative to the Beck Depression Inventory‐Second Edition (BDI‐II) in the Detection of Depressive Symptoms. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Daniela C. Serrano burneo
- Centre for Clinical Neurosciences & Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, Australia,
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia,
| | - Stephen C. Bowden
- Centre for Clinical Neurosciences & Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, Australia,
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia,
| | - Leonie C. Simpson
- Centre for Clinical Neurosciences & Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, Australia,
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia,
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Paiva ML, Lima EM, Siqueira IB, Rzezak P, Koike C, Moschetta SP, Vincentiis S, Alessi R, Khafif TC, Mendoza M, Valente KD. Seizure control and anxiety: Which factor plays a major role in social adjustment in patients with Juvenile Myoclonic Epilepsy? Seizure 2020; 80:234-239. [PMID: 32663782 DOI: 10.1016/j.seizure.2020.06.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aimed to determine the presence of anxiety disorder and severity of anxiety symptoms in an extensive series of consecutive patients with JME and its association with epilepsy-related factors. In addition, we evaluated the impact of anxiety and clinical variables on social adjustment. METHODS We prospectively evaluated 112 (56.2 % females, mean age 27.2 years) patients with an electroclinical diagnosis of JME and 61 (52.4 % females, mean age 29.3 years) healthy controls. Anxiety symptoms were assessed by the State and Trait Anxiety Inventory (STAI). Social functioning was addressed with Self-Report Social Adjustment Scale (SAS). The patient group was also evaluated with a psychiatric interview. RESULTS Patients with JME presented more severe anxiety symptoms and worse social adjustment compared with controls. The presence of anxiety disorder and the severity of anxiety symptoms was associated with frequent seizures - generalized tonic-clonic seizures (p = 0.008) and drug-resistant epilepsy (p = 0.021). Regarding social adjustment, the severity of anxiety symptoms was associated with lower economic adjustment (p = 0.039), while the presence of anxiety disorder impacted family relationships (p 0.025). The presence of hard-to-control myoclonic seizure was associated with lower scores on work (p = 0.019), leisure activities (p = 0.008), family relationship (p = 0.022) and overall social adjustment (p = 0.038). CONCLUSION Patients with JME have severe anxiety symptoms and worse social adjustment. Anxiety disorder and symptoms were associated with frequent seizures and drug-resistant epilepsy. Epilepsy-related factors and anxiety impaired distinct aspects of social functioning.
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Affiliation(s)
- Maria Luisa Paiva
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Ellen Marise Lima
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Isabelle Bimbatti Siqueira
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Patricia Rzezak
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Camila Koike
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Sylvie P Moschetta
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Silvia Vincentiis
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Rudá Alessi
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Tatiana Cohab Khafif
- Bipolar Disorder Program, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Melanie Mendoza
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil
| | - Kette D Valente
- Laboratory of Clinical Neurophysiology, Department of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Brazil.
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Morningstar M, Hung A, Mattson WI, Gedela S, Ostendorf AP, Nelson EE. Internalizing symptoms in intractable pediatric epilepsy: Structural and functional brain correlates. Epilepsy Behav 2020; 103:106845. [PMID: 31882324 DOI: 10.1016/j.yebeh.2019.106845] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 01/09/2023]
Abstract
Internalizing disorders (i.e., depression and anxiety) are common comorbidities in people with epilepsy. In adults with epilepsy, comorbid depression or anxiety is associated with worse seizure control and reduced quality of life, and may be linked to specific neural biomarkers. Less is known about brain correlates of internalizing symptoms in pediatric populations. In the current study, we performed a retrospective analysis of 45 youth between the ages of 6 and 18 years old with intractable epilepsy. Individuals were evaluated for internalizing symptoms on the Child Behavior Checklist (CBCL) and underwent magnetic resonance (MR) and fluorodeoxyglucose (FDG)-positron emission tomography (PET) imaging as part of the clinical evaluation for surgical treatment of epilepsy. Forty-two percent of patients experienced clinically significant internalizing symptoms based on parent report. Compared with individuals who scored in the normal range, youth with clinical levels of internalizing problems showed overall reductions in cortex volume, as well as widespread reductions in cortical thickness and functional activation in the bilateral occipital/parietal lobe, left temporal regions, and left inferior frontal cortex on MR and PET scans. There were no group differences in amygdala or hippocampus volumes, nor other patient- or illness-related variables such as age, sex, or the type, lateralization, or duration of epilepsy. Results suggest that high rates of internalizing disorders are present in youth with refractory epilepsy. Multifocal reductions in cortical thickness and function may be nonspecific risk factors for clinically meaningful internalizing symptoms in youth with chronic epilepsy. As such, the presence of broad cortical thinning and reduced glucose uptake upon radiological examination may warrant more focused clinical evaluation of psychological symptoms.
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Affiliation(s)
- Michele Morningstar
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States of America; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, United States of America.
| | - Andy Hung
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States of America
| | - Whitney I Mattson
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States of America
| | - Satyanarayana Gedela
- Department of Pediatrics and Neurology, Emory University College of Medicine, Atlanta, GA, United States of America
| | - Adam P Ostendorf
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, United States of America; Department of Neurology, Nationwide Children's Hospital, Columbus, OH, United States of America
| | - Eric E Nelson
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States of America; Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, United States of America
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Margolis SA, Gonzalez JS, Faria C, Kenney L, Grant AC, Nakhutina L. Anxiety disorders in predominantly African American and Caribbean American adults with intractable epilepsy: The role of perceived epilepsy stigma. Epilepsy Behav 2019; 99:106450. [PMID: 31419635 DOI: 10.1016/j.yebeh.2019.106450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Anxiety disproportionately affects people with epilepsy (PWE) and leads to poor outcomes. Yet, risk factors are not well understood especially among underserved groups. This cross-sectional study aimed to identify epilepsy-specific predictors of anxiety disorders in predominantly African American and Caribbean American PWE. MATERIALS AND METHODS The prevalence of anxiety disorders was established via diagnostic interview (Mini-International Neuropsychiatric Interview (MINI)). We identified the extent to which aspects of seizure burden (seizure frequency, seizure severity, convulsive vs. nonconvulsive seizures), seizure worry, and perceived epilepsy stigma were associated with anxiety disorder diagnosis. Finally, logistic regression assessed the overall and independent contributions of significant risk factors. RESULTS There were 60 participants (62% women, 52% African American, 27% Caribbean American, 20% Hispanic/Latino) with an average of 2 seizures per month. Nearly half of the sample (43%) had ≥1 anxiety disorder, with 62% of affected individuals qualifying for agoraphobia. Those with anxiety disorders tended to have convulsive seizures (p = 0.037) and endorsed greater seizure worry (p = 0.012), more general symptoms of anxiety (p = 0.005), and worse perceived epilepsy stigma (p = 0.003). Logistic regression accounted for 28% to 37.6% of the variance in anxiety disorder diagnostic status and correctly classified 73% of cases; however, only perceived epilepsy stigma made a unique contribution. CONCLUSIONS Anxiety disorders were prevalent in these predominantly African American and Caribbean American PWE. Epilepsy-specific risk factors included convulsive seizures, seizure worry, and perceived epilepsy stigma. Interventions aimed at treating anxiety disorders in diverse PWE may especially benefit from targeting stigma beliefs.
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Affiliation(s)
- Seth A Margolis
- Rhode Island Hospital, 593 Eddy St., Providence, RI 02903, USA; Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, 222 Richmond St., Providence, RI 02903, USA.
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave., Bronx, NY 10461, USA; Albert Einstein College of Medicine, Yeshiva University, 1300 Morris Park Ave., Bronx, NY 10461, USA
| | - Caylin Faria
- Bridgewater State University, 131 Summer St., Bridgewater, MA 02324, USA
| | - Lauren Kenney
- Rhode Island Hospital, 593 Eddy St., Providence, RI 02903, USA
| | - Arthur C Grant
- State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY 11203, USA
| | - Luba Nakhutina
- State University of New York (SUNY) Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY 11203, USA
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Siciliano M, Trojano L, Trojsi F, Monsurrò MR, Tedeschi G, Santangelo G. Assessing anxiety and its correlates in amyotrophic lateral sclerosis: The state-trait anxiety inventory. Muscle Nerve 2019; 60:47-55. [PMID: 30897219 DOI: 10.1002/mus.26475] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 03/17/2019] [Accepted: 03/19/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION We evaluated: (1) psychometric properties of State-Trait Anxiety Inventory Form Y (STAI Form Y); (2) clinical correlates of state and trait anxiety; (3) associations of anxiety with quality of life (QoL) dimensions. METHODS We assessed 159 patients with amyotrophic lateral sclerosis (ALS) on STAI Form Y and on tests and questionnaires for depression, apathy, QoL, and cognitive abilities. RESULTS Clinically diagnosed anxiety (by Mini International Neuropsychiatric Inventory) occurred in 30 (19%) patients. STAI Form Y fitted a 2-factor structure and showed good psychometric properties. State and trait anxiety were weakly associated with female sex, bulbar functional decay, and cognitive decline in language and memory; trait anxiety was associated with lower educational attainment and poorer scores on visuospatial tasks. State and trait anxiety were associated with poorer physical and psychosocial QoL dimensions. CONCLUSIONS Anxiety is tightly associated with QoL in ALS, and can be reliably assessed by STAI Form Y. Muscle Nerve, 2019.
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Affiliation(s)
- Mattia Siciliano
- Department of Advanced Medical and Surgical Sciences - MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100, Caserta, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100, Caserta, Italy
| | - Francesca Trojsi
- Department of Advanced Medical and Surgical Sciences - MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Rosaria Monsurrò
- Department of Advanced Medical and Surgical Sciences - MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences - MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100, Caserta, Italy
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Wiglusz MS, Landowski J, Cubała WJ. Psychometric properties and diagnostic utility of the State-Trait Anxiety Inventory in epilepsy with and without comorbid anxiety disorder. Epilepsy Behav 2019; 92:221-225. [PMID: 30690323 DOI: 10.1016/j.yebeh.2019.01.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 12/28/2018] [Accepted: 01/04/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Anxiety disorders are frequent comorbid disorder in patients with epilepsy (PWEs). The availability of validated screening instruments to detect anxiety disorders in PWEs is limited. The aim of the present study was to validate State-Trait Anxiety Inventory (STAI) in adult PWEs for the detection of anxiety disorders. METHODS A total of 96 outpatients with epilepsy completed the self-report symptom scale and were diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Text Revision (DSM-IV-TR) Axis I disorders (SCID-I). The sensitivity, specificity, positive and negative predictive values, and receiver operating characteristic (ROC) curves were assessed to determine the optimal threshold scores for the State-Trait Anxiety Inventory State (STAI-S) and State-Trait Anxiety Inventory Trait (STAI-T) anxiety subscales. RESULTS Receiver operating characteristic analyses for STAI-T showed area under the curve at 84.7%. For diagnoses of anxiety disorders, the STAI-T demonstrated the best psychometric properties for a cutoff score ≥ 52 with sensitivity of 81.3%, specificity of 77.5%, positive predictive value (PPV) of 41.9%, and negative predictive value (NPV) of 95.4%. CONCLUSIONS The STAI-T proved to be a valid and reliable psychometric instrument in terms of screening for anxiety disorders in PWEs. In the epilepsy setting, STAI-T maintains adequate sensitivity, acceptable specificity, and high NPV but low PPV for diagnosing anxiety disorders with an optimum cutoff score ≥ 52.
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Affiliation(s)
- Mariusz S Wiglusz
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Poland.
| | - Jerzy Landowski
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Poland
| | - Wiesław J Cubała
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Poland
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Avedisova AS, Lebedeva AV, Pashnin EV, Kustov GV, Akzhigitov RG, Guekht AB. [Anxiety disorders in epilepsy]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 118:37-44. [PMID: 30698542 DOI: 10.17116/jnevro201811810237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This review is devoted to the place of anxiety disorders in the spectrum of psychiatric comorbidity in patients with epilepsy. The authors present general characteristics of anxiety manifestations and current views on the classification and qualification of anxiety disorders in such patients. Recent data show the relationship of anxiety with different forms of epilepsy, demographic and gender characteristics, localization of epileptic focus. The problem of bidirectional relationship of anxiety and epilepsy as well as the temporal relationship between anxiety and epileptic states are considered.
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Affiliation(s)
- A S Avedisova
- Serbsky National Medical Research Centre for Psychiatry and Narcology, Moscow, Russia; Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia
| | - A V Lebedeva
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
| | - E V Pashnin
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia
| | - G V Kustov
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia
| | - R G Akzhigitov
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia
| | - A B Guekht
- Moscow Research and Clinical Center for Neuropsychiatry of the Healthcare Department, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia
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Zhao T, Gao Y, Zhu X, Wang N, Chen Y, Zhang J, He G, Feng Y, Xu J, Han X, Zhang J. Awareness, attitudes toward epilepsy, and first aid knowledge of seizures of hospital staff in Henan, China. Epilepsy Behav 2017; 74:144-148. [PMID: 28738284 DOI: 10.1016/j.yebeh.2017.06.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 12/15/2022]
Abstract
AIM The aim of this study was to evaluate awareness of, attitudes toward, and first aid knowledge of seizures of hospital staff in Henan, China. METHOD Two hundred nineteen hospital staff, including doctors, nurses, medical technicians, logisticians, and executives working at tertiary hospitals in Henan, China, completed the survey from March to September in 2016. The data comprised the demographic data section, awareness of epilepsy section, attitude toward epilepsy section, and first aid knowledge of seizure attack section. RESULTS The participants obtained a mean score of 7.48±1.705 on the awareness of epilepsy section, and a mean score of 5.32±1.165 on the first aid knowledge of seizure attacks section. There were significant correlations between educational level (r=0.187, P=0.006), occupation (r=-0.244, P=0.000), and attitudes toward patients with epilepsy (r=0.351, P=0.000) with the awareness of epilepsy. There were significant correlations between age (r=0.170, P=0.014), educational status (r=0.139, P=0.040), and professional titles (r=0.197, P=0.004) with the first aid knowledge of seizures. CONCLUSION The study showed that hospital staff had a moderate level of knowledge regarding epilepsy, and they generally displayed a positive attitude. It was also determined that as the awareness of epilepsy increased, they displayed more positive attitudes toward patients with epilepsy. The study also suggests that specialists working on epilepsy should provide more lectures and educational sessions to improve the knowledge of and attitude toward epilepsy and first aid knowledge of seizures among hospital staff.
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Affiliation(s)
- Ting Zhao
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Yajuan Gao
- Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450000, China
| | - Xuerui Zhu
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Na Wang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Yanan Chen
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Jiahui Zhang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Guinv He
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Yan Feng
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Jun Xu
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
| | - Xiong Han
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China.
| | - Jiewen Zhang
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital, Henan University, Zhengzhou 450003, China
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Jaitovich Groisman I, Hurlimann T, Shoham A, Godard B. Practices and views of neurologists regarding the use of whole-genome sequencing in clinical settings: a web-based survey. Eur J Hum Genet 2017; 25:801-808. [PMID: 28488681 DOI: 10.1038/ejhg.2017.64] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 02/28/2017] [Accepted: 03/28/2017] [Indexed: 12/23/2022] Open
Abstract
The use of Whole-Genome Sequencing (WGS) in clinical settings has brought up a number of controversial scientific and ethical issues. The application of WGS is of particular relevance in neurology, as many conditions are difficult to diagnose. We conducted a worldwide, web-based survey to explore neurologists' views on the benefits of, and concerns regarding, the clinical use of WGS, as well as the resources necessary to implement it. Almost half of the 204 neurologists in the study treated mostly adult patients (48%), while the rest mainly children (37.3%), or both (14.7%). Epilepsy (73%) and headaches (57.8%) were the predominant conditions treated. Factor analysis brought out two profiles: neurologists who would offer WGS to their patients, and those who would not, or were not sure in which circumstances it should be offered. Neurologists considering the use of WGS as bringing more benefits than drawbacks currently used targeted genetic testing (P<0.05) or treated mainly children (P<0.05). WGS' benefits were directed towards the patients, while its risks were of a financial and legal nature. Furthermore, there was a correlation between respondents' current use of genetic tests and an anticipation of increased use in the future (P<0.001). However, over half of respondents did not feel sufficiently informed to use WGS in their practice (53.5%). Our results highlight gaps in education, organization, and funding to support the use of WGS in neurology, and draw attention to the need for resources that could strongly contribute to more straightforward diagnoses and possibly better treatment of neurological conditions.
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Affiliation(s)
- Iris Jaitovich Groisman
- Groupe de recherche Omics-Ethics, Institut de recherche en santé publique, Université de Montréal, Montreal, Quebec, Canada
| | - Thierry Hurlimann
- Groupe de recherche Omics-Ethics, Institut de recherche en santé publique, Université de Montréal, Montreal, Quebec, Canada
| | - Amir Shoham
- Département de psychologie, Faculté des arts et des sciences, Université de Montréal, Montreal, Quebec, Canada
| | - Béatrice Godard
- Groupe de recherche Omics-Ethics, Institut de recherche en santé publique, Université de Montréal, Montreal, Quebec, Canada
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Gender differences in depression, but not in anxiety in people with epilepsy. Seizure 2015; 32:37-42. [PMID: 26552559 DOI: 10.1016/j.seizure.2015.07.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 07/14/2015] [Accepted: 07/17/2015] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Anxiety and depression are frequent comorbidities in people with epilepsy (PWE), but possible gender differences are often neglected. The aim of the present study was to analyze if men and women with epilepsy differ with regard to anxiety and depressive symptoms and to identify possible predictors. METHODS Adult consecutive PWE (N=302; 53% women) completed self-report questionnaires, including the depression module of the Patient Health Questionnaire (PHQ-9), the anxiety module of the Hospital Anxiety and Depression Scale (HADS-A) and the subscales "medication effects" and "seizure worry" of the Patient-weighted Quality of Life in Epilepsy Inventory-31-P (QOLIE-31-P). RESULTS There was no gender difference in extent of anxiety (p=.532), which was mainly due to higher anxiety levels in men compared to the general population. The gender difference in depressive symptoms was significant (p=.009), with female patients being more affected. The most important predictors for anxiety and depressive symptoms were detrimental effects of medication (QOL medication effects) and of seizure worry (QOL seizure worry). Moreover, these predictors were more closely associated with anxiety and depressive symptoms in men. CONCLUSION Future intervention studies could show whether providing more information about the illness and medication effects may improve anxiety and depression. Our results suggest that such interventions should be tailored to the different needs of men and women.
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The effect of intraoperative sounds of saw and hammer on psychological condition in patients with total knee arthroplasty: prospective randomized study. ScientificWorldJournal 2015; 2015:690569. [PMID: 25793222 PMCID: PMC4352437 DOI: 10.1155/2015/690569] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 06/19/2014] [Indexed: 11/17/2022] Open
Abstract
Purpose. Surgical procedures are likely to be stressful for patients and their families. Total knee arthroplasty (TKA) is a major surgical procedure used in the treatment of osteoarthritis. During this procedure the sounds of the saw and hammer may irritate the patient and adversely affect mood. The present study examines the effect of these intraoperative sounds during TKA on postoperative mood and anxiety, by comparing two different anesthetic procedures.
Methods. A total of 40 patients who underwent TKA for grade IV gonarthrosis participated in the study. Patients were randomly divided into two groups: 20 patients in the general anesthesia group and 20 patients in the spinal anesthesia group. Mood and anxiety changes were evaluated using the Profile of Mood States (POMS) and State-Trait Anxiety Inventory (STAI) instruments, respectively. Results. The postoperative POMS value in the spinal anesthesia group was definitively higher than the general anesthesia group, though the difference in preoperative and postoperative POMS and STAI scores between the two groups was not significant. Conclusion. It would seem that sounds of hammer and saw have no evident negative effect on patient's mood. Regional anesthesia is advisable for TKA patients and appropriate sedation can be administered during the operation if needed.
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Barahmand U, Haji A. The impact of intolerance of uncertainty, worry and irritability on quality of life in persons with epilepsy: Irritability as mediator. Epilepsy Res 2014; 108:1335-44. [DOI: 10.1016/j.eplepsyres.2014.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 07/06/2014] [Accepted: 07/14/2014] [Indexed: 10/25/2022]
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