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Handryastuti S, Wiguna T, Chozie NA, Medise BE, Indawati W, Hafifah CN, Winarta W. Evaluating depression in Indonesian adolescents with epilepsy: Comprehensive validation and reliability assessment of the neurological disorders depression inventory-epilepsy for youth Indonesian version (NDDI-E-Y[ID]). Epilepsia Open 2024. [PMID: 39320266 DOI: 10.1002/epi4.13052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 08/20/2024] [Accepted: 09/12/2024] [Indexed: 09/26/2024] Open
Abstract
OBJECTIVES Epilepsy is a common chronic neurological disorder in pediatrics. Depression is an often underdetected comorbidity in childhood epilepsy. This study aimed to adapt the Neurological Disorders Depression Inventory-Epilepsy for Youth (NDDI-E-Y) to the Indonesian language and population, as well as to validate the Indonesian version of NDDI-E-Y (NDDI-E-Y[ID]). METHODS This three-stage study comprised instrument translation, cultural verification, and content validity testing (first stage), pilot testing (second stage), followed by concurrent validity and reliability testing (third stage) of the NDDI-E-Y(ID). Validation was done against the Centre for Epidemiologic Studies Depression Scale - Revised (CESD-R). Content validity, assessed by six experts, was quantified using the content validity index for items (I-CVI) and scale (S-CVI). Participants were adolescents aged 12-17 years diagnosed with any type of epilepsy who completed both instruments. Concurrent validity was evaluated using Spearman's correlation and reliability was measured using Cronbach's alpha. RESULTS The first stage produced a culturally appropriate NDDI-E-Y(ID). Thirty healthy adolescents and 10 adolescents with epilepsy participated in the second stage. In the third stage, another group of 30 adolescents with epilepsy took part. We obtained I-CVI and S-CVI values averaging 1. The NDDI-E-Y(ID) showed a positive and significant correlation with CESD-R (Spearman's rho = 0.671, p < 0.001). A Cronbach's alpha of 0.928 reflected a high internal consistency. SIGNIFICANCE Based on the results, the NDDI-E-Y(ID) was found to be a valid and reliable screening instrument for detecting depression in youth with epilepsy. PLAIN LANGUAGE SUMMARY Depression is an under-recognized problem in youth with epilepsy. Currently available depression screening tools are in English, making it less suitable for detection purposes in Indonesia. This study developed and validated the Indonesian version of the NDDI-E-Y, a depression screening tool for youth with epilepsy.
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Affiliation(s)
- Setyo Handryastuti
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Tjhin Wiguna
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Novie Amelia Chozie
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Bernie Endyarni Medise
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Wahyuni Indawati
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Cut Nurul Hafifah
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Widdy Winarta
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
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Liu GY, Fu FJ, Chou YX, Ye MS, Ouyang YL, Yan MD, Pan L, Li WP, Xie W. Frontiers and hotspots in comorbid epilepsy and depression: a bibliometric analysis from 2003 to 2023. Front Neurol 2024; 15:1413582. [PMID: 38974685 PMCID: PMC11224553 DOI: 10.3389/fneur.2024.1413582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Background Epilepsy ranks among the most common neurological disorders worldwide, frequently accompanied by depression as a prominent comorbidity. This study employs bibliometric analysis to reveal the research of comorbid epilepsy and depression over the past two decades, aiming to explore trends and contribute insights to ongoing investigations. Methods We conducted a comprehensive search on the Web of Science Core Collection database and downloaded relevant publications on comorbid epilepsy and depression published from 2003 to 2023. VOSviewer and CiteSpace were mainly used to analyze the authors, institutions, countries, publishing journals, reference co-citation patterns, keyword co-occurrence, keyword clustering, and other aspects to construct a knowledge atlas. Results A total of 5,586 publications related to comorbid epilepsy and depression were retrieved, with a general upward trend despite slight fluctuations in annual publications. Publications originated from 121 countries and 636 institutions, with a predominant focus on clinical research. The United States led in productivity (1,529 articles), while Melbourne University emerged as the most productive institution (135 articles). EPILEPSY & BEHAVIOR was the journal with the highest publication output (1,189 articles) and citation count. Keyword analysis highlighted emerging trends, including "recognitive impairment" and "mental health," indicating potential future research hotspots and trends. Conclusion This study is one of the first to perform a bibliometric analysis of the 20-year scientific output of comorbid epilepsy and depression. While research has trended upwards, ambiguity in pathogenesis and the absence of standardized diagnostic guidelines remain concerning. Our analysis offers valuable guidance for researchers, informing that this might be a strong area for future collaborations.
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Affiliation(s)
- Gui-Yu Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Fan-Jia Fu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Ying-Xin Chou
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Ming-Sha Ye
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yi-Lin Ouyang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Ming-De Yan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Lei Pan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Wei-Peng Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
- Department of Neurology, Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou, China
| | - Wei Xie
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
- Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Associations between 24-hour movement guideline adherence and mental health disorders among young people with active and inactive epilepsy. Epilepsy Behav 2021; 125:108386. [PMID: 34781060 DOI: 10.1016/j.yebeh.2021.108386] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/20/2021] [Accepted: 10/16/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE (1) Examine 24-hour movement guideline adherence among young people with active and inactive epilepsy compared to population norms. (2) Investigate associations between 24-hour movement guideline adherence and mental health disorders among these subpopulations. METHODS Cross-sectional data from the 2016 to 2019 cycles of the National Survey of Children's Health were used. Parental/caregiver reports of movement behaviors (physical activity, screen time, sleep, and sport participation) were used to determine adherence to the 24-hour movement guidelines and associations with mental health disorders for young people with active (n = 663) and inactive epilepsy (n = 526) as well as population norms (n = 49,067) between 6 and 17 years old. Multivariate logistic regression analyses were conducted. RESULTS Young people with active epilepsy were less likely to meet the 24-hour movement guidelines than population norms, largely driven by below average levels of physical activity guideline adherence. Sport participation was lower among both young people with active and inactive epilepsy; seizure severity and health-related limitations played an influential role. Beneficial associations were generally observed between 24-hour movement guideline adherence and mental health disorders, although for young people with active and inactive epilepsy, there was considerable variability among these relationships. CONCLUSIONS Further dissemination of the International League Against Epilepsy's Task Force on Sports and Epilepsy report can help improve promotion of physical activity and sport participation among young people with active and inactive epilepsy. The relationship between 24-hour movement guideline adherence and mental health disorders is complex among young people with epilepsy and longitudinal research is needed to determine causal links.
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Fazel M, Townsend A, Stewart H, Pao M, Paz I, Walker J, Sawyer SM, Sharpe M. Integrated care to address child and adolescent health in the 21st century: A clinical review. JCPP ADVANCES 2021; 1:e12045. [PMID: 37431408 PMCID: PMC10242873 DOI: 10.1002/jcv2.12045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 08/31/2021] [Indexed: 01/07/2023] Open
Abstract
Background Increasing specialisation and technical sophistication of medical tools across the 21st century have contributed to dramatic improvements in the life-expectancy of children and adolescents with complex physical health problems. Concurrently, there is growing appreciation within the community of the extent that children and adolescents experience mental disorders, which are more prevalent in those with complex chronic, serious or life-limiting health conditions. In this context, there are compelling reasons for paediatric services to move to a model of care that promotes greater integration of child psychiatry within the medical, somatic teams that care for children and adolescents in children's hospitals. Aims In this article, we discuss the range of medical disorders managed by contemporary paediatrics. Materials and Methods We conducted a broad review of the literature and existing services, and use individual accounts to illustrate adolescents' healthcare preferences in the context of the challenges they experience around their mental health. Results Relevant disorders include life-limiting disorders, such as cancer; disorders involving the brain, such as epilepsy; common chronic disorders, such as asthma and diabetes; psychiatric emergencies, such as deliberate self-harm; and conditions that most commonly present to paediatric services, but where psychiatric input is required, such as severe eating disorders, somatic symptom disorders and gender dysphoria. The persisting legacy of the historical separation of physical and mental health services is described. Yet there are many models of service integration that can promote more collaborative care between psychiatrists and medical specialists, including some which have been taken to scale. Discussion In essence, clinical teams in children's hospitals require more collaborative approaches that facilitate early recognition and treatment of the psychological aspects of illness as an integral part of patient-centred, family-focussed paediatric care, rather than as something that is bolted on when things go wrong. Conclusion Whilst trust and goodwill between services and providers will be required for novel models of care to be implemented, evaluation of these new models and incorporation of young people's healthcare preferences is needed.
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Affiliation(s)
- Mina Fazel
- Department of PsychiatryUniversity of OxfordOxfordUK
- The Oxford Psychological Medicine CentreOxford University Hospitals NHSFTOxfordUK
| | - Alice Townsend
- Sunderland and South Tyneside NHS Foundation TrustTyne and WearUK
| | - Harriet Stewart
- The Oxford Psychological Medicine CentreOxford University Hospitals NHSFTOxfordUK
| | - Maryland Pao
- Department of Health and Human ServicesNational Institute of Mental HealthNational Institutes of HealthBethesdaMarylandUSA
| | - Isabel Paz
- The Oxford Psychological Medicine CentreOxford University Hospitals NHSFTOxfordUK
| | - Jane Walker
- Department of PsychiatryUniversity of OxfordOxfordUK
- The Oxford Psychological Medicine CentreOxford University Hospitals NHSFTOxfordUK
| | - Susan M. Sawyer
- Centre for Adolescent HealthRoyal Children’s HospitalParkvilleVictoriaAustralia
- Murdoch Children’s Research InstituteParkvilleVictoriaAustralia
- Department of PaediatricsThe University of MelbourneParkvilleVictoriaAustralia
| | - Michael Sharpe
- Department of PsychiatryUniversity of OxfordOxfordUK
- The Oxford Psychological Medicine CentreOxford University Hospitals NHSFTOxfordUK
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Jules-Dole N, Uribe-Cardenas R, McReynolds LJ, Borden L, Chambers S, Bell WR, Ahn ES, Raabe E, Salpekar JA. Psychosis Remitted After Ependymoma Resection in a School-Aged Child. J Neuropsychiatry Clin Neurosci 2021; 32:305-308. [PMID: 31795806 DOI: 10.1176/appi.neuropsych.19070147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Nadimire Jules-Dole
- The Departments of Psychiatry (Jules-Dole, Borden, Chambers, Salpekar), Neurosurgery (Uribe-Cardenas), Pathology (Bell, Raabe), and Neurology (Salpekar) and the Division of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center (McReynolds, Raabe), Johns Hopkins University School of Medicine, Baltimore; the Department of Neurological Surgery, Cornell University, New York (Uribe-Cardenas); the Department of Neurologic Surgery, Mayo Clinic, Rochester Minn. (Ahn); and the Kennedy Krieger Institute, Baltimore (Salpekar)
| | - Rafael Uribe-Cardenas
- The Departments of Psychiatry (Jules-Dole, Borden, Chambers, Salpekar), Neurosurgery (Uribe-Cardenas), Pathology (Bell, Raabe), and Neurology (Salpekar) and the Division of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center (McReynolds, Raabe), Johns Hopkins University School of Medicine, Baltimore; the Department of Neurological Surgery, Cornell University, New York (Uribe-Cardenas); the Department of Neurologic Surgery, Mayo Clinic, Rochester Minn. (Ahn); and the Kennedy Krieger Institute, Baltimore (Salpekar)
| | - Lisa J McReynolds
- The Departments of Psychiatry (Jules-Dole, Borden, Chambers, Salpekar), Neurosurgery (Uribe-Cardenas), Pathology (Bell, Raabe), and Neurology (Salpekar) and the Division of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center (McReynolds, Raabe), Johns Hopkins University School of Medicine, Baltimore; the Department of Neurological Surgery, Cornell University, New York (Uribe-Cardenas); the Department of Neurologic Surgery, Mayo Clinic, Rochester Minn. (Ahn); and the Kennedy Krieger Institute, Baltimore (Salpekar)
| | - Lindsay Borden
- The Departments of Psychiatry (Jules-Dole, Borden, Chambers, Salpekar), Neurosurgery (Uribe-Cardenas), Pathology (Bell, Raabe), and Neurology (Salpekar) and the Division of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center (McReynolds, Raabe), Johns Hopkins University School of Medicine, Baltimore; the Department of Neurological Surgery, Cornell University, New York (Uribe-Cardenas); the Department of Neurologic Surgery, Mayo Clinic, Rochester Minn. (Ahn); and the Kennedy Krieger Institute, Baltimore (Salpekar)
| | - Shawn Chambers
- The Departments of Psychiatry (Jules-Dole, Borden, Chambers, Salpekar), Neurosurgery (Uribe-Cardenas), Pathology (Bell, Raabe), and Neurology (Salpekar) and the Division of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center (McReynolds, Raabe), Johns Hopkins University School of Medicine, Baltimore; the Department of Neurological Surgery, Cornell University, New York (Uribe-Cardenas); the Department of Neurologic Surgery, Mayo Clinic, Rochester Minn. (Ahn); and the Kennedy Krieger Institute, Baltimore (Salpekar)
| | - W Robert Bell
- The Departments of Psychiatry (Jules-Dole, Borden, Chambers, Salpekar), Neurosurgery (Uribe-Cardenas), Pathology (Bell, Raabe), and Neurology (Salpekar) and the Division of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center (McReynolds, Raabe), Johns Hopkins University School of Medicine, Baltimore; the Department of Neurological Surgery, Cornell University, New York (Uribe-Cardenas); the Department of Neurologic Surgery, Mayo Clinic, Rochester Minn. (Ahn); and the Kennedy Krieger Institute, Baltimore (Salpekar)
| | - Edward S Ahn
- The Departments of Psychiatry (Jules-Dole, Borden, Chambers, Salpekar), Neurosurgery (Uribe-Cardenas), Pathology (Bell, Raabe), and Neurology (Salpekar) and the Division of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center (McReynolds, Raabe), Johns Hopkins University School of Medicine, Baltimore; the Department of Neurological Surgery, Cornell University, New York (Uribe-Cardenas); the Department of Neurologic Surgery, Mayo Clinic, Rochester Minn. (Ahn); and the Kennedy Krieger Institute, Baltimore (Salpekar)
| | - Eric Raabe
- The Departments of Psychiatry (Jules-Dole, Borden, Chambers, Salpekar), Neurosurgery (Uribe-Cardenas), Pathology (Bell, Raabe), and Neurology (Salpekar) and the Division of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center (McReynolds, Raabe), Johns Hopkins University School of Medicine, Baltimore; the Department of Neurological Surgery, Cornell University, New York (Uribe-Cardenas); the Department of Neurologic Surgery, Mayo Clinic, Rochester Minn. (Ahn); and the Kennedy Krieger Institute, Baltimore (Salpekar)
| | - Jay A Salpekar
- The Departments of Psychiatry (Jules-Dole, Borden, Chambers, Salpekar), Neurosurgery (Uribe-Cardenas), Pathology (Bell, Raabe), and Neurology (Salpekar) and the Division of Oncology, Division of Pediatric Oncology, Sidney Kimmel Comprehensive Cancer Center (McReynolds, Raabe), Johns Hopkins University School of Medicine, Baltimore; the Department of Neurological Surgery, Cornell University, New York (Uribe-Cardenas); the Department of Neurologic Surgery, Mayo Clinic, Rochester Minn. (Ahn); and the Kennedy Krieger Institute, Baltimore (Salpekar)
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Kim JS, Kim DY, Jo HJ, Hwang YH, Song JY, Yang KI, Hong SB. Effect of Long-Term Treatment with Vagus Nerve Stimulation on Mood and Quality of Life in Korean Patients with Drug-Resistant Epilepsy. J Clin Neurol 2021; 17:385-392. [PMID: 34184446 PMCID: PMC8242313 DOI: 10.3988/jcn.2021.17.3.385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/26/2021] [Accepted: 01/26/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND PURPOSE This study aimed to determine the long-term effects of vagus nerve stimulation (VNS) treatment on suicidality, mood-related symptoms, and quality of life (QOL) in patients with drug-resistant epilepsy (DRE). We also investigated the relationships among these main effects, clinical characteristics, and VNS parameters. METHODS Among 35 epilepsy patients who underwent VNS implantation consecutively in our epilepsy center, 25 patients were recruited to this study for assessing the effects of VNS on suicidality, mood-related symptoms, and QOL. The differences in these variables between before and after VNS treatment were analyzed statistically using paired t-tests. Multiple linear regression analyses were also performed to determine how the patients' demographic and clinical characteristics influenced the variables that showed statistically significant changes after long-term VNS treatment. RESULTS After VNS, our patients showed significant improvements not only in the mean seizure frequency but also in suicidality, depression, and QOL. The reduction in depression was associated with the improvement in QOL and more-severe depression at baseline. The reduction in suicidality was associated with higher suicidality at baseline, smaller changes in depression, and less-severe depression at baseline. Improved QOL was associated with lower suicidality at baseline. CONCLUSIONS This study found that VNS decreased the mean seizure frequency in patients with DRE, and also improved their depression, suicidality, and QOL. These results provide further evidence for therapeutic effect of VNS on psychological comorbidities of patients with DRE.
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Affiliation(s)
- Jeong Sik Kim
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Yeop Kim
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Jin Jo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Ha Hwang
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joo Yeon Song
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang Ik Yang
- Sleep Disorders Center, Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea
| | - Seung Bong Hong
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University School of Medicine, Seoul, Korea.
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KARAPINAR E, YUNUSOĞLU C, TEKIN B, DEDE HÖ, BEBEK N, BAYKAN B, GÜRSES C. Depression is a major determinant of sleep abnormalities in patients with epilepsy. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:772-777. [DOI: 10.1590/0004-282x20200064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/27/2020] [Indexed: 02/05/2023]
Abstract
ABSTRACT Introduction: We aimed to identify sleep disorders in patients with epilepsy and compare this group with a healthy population. We also analyzed the features of sleep disorders in patients with epilepsy to demonstrate the effect of seizures and seizure types on sleep. Methods: Our study assessed 43 patients with epilepsy and 53 age- and gender-matched healthy controls. The demographic and clinical data of all participants were recorded. The Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index (PSQI), International Restless Legs Syndrome Study Group Rating Scale, Berlin Questionnaire, and Beck Depression Inventory (BDI) were administered to all study subjects. The interview used to evaluate insomnia is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition - DSM-5 diagnostic criteria. Results: Twenty-four patients (55.8%) and 26 controls (49.1%) are women. The mean age of patients and controls was 34.2±11.37 (16-71) and 34.6±11.28 (16-77), respectively. Patients with epilepsy had depression more often than controls, a result that was statistically significant (p<0.0001). We found no statistically significant difference between sleep parameters of patients and controls with normal BDI scores (p>0.05). Patients with depression had worse results on the Berlin Questionnaire and PSQI total score, with statistical significance (p=0.002). Nocturnal seizures, seizure type, and drug treatment had no effect on sleep (p>0.05). Conclusion: We concluded that depression rather than epilepsy negatively affects sleep, suggesting that all patients should be asked about their mood and sleep complaints.
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Affiliation(s)
| | | | - Betül TEKIN
- University of Health Sciences Prof. Dr. Mazhar Osman Bakırköy Research and Training Hospital for Psychiatry, Neurology, Neurosurgery, Turkey
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Gökçen O, Turgut M. An Overview of Anxiety Disorders and Depression in Children with Epilepsy: A Literature Review. JOURNAL OF PEDIATRIC EPILEPSY 2020. [DOI: 10.1055/s-0040-1715566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractComorbid psychiatric disorders in children with epilepsy have long been a subject of medical literature. Many studies conducted by pediatric neurologists, neurosurgeons, psychiatrists, and psychologists have revealed that psychiatric disorders, including anxiety disorders and depression, are frequently seen in children and adolescents with epilepsy. Due to various etiologies behind epilepsy, causes, manifestation, and treatment of anxiety and depression all have unique aspects. We think there are multiple reasons behind anxiety disorders and depression in children with epilepsy, varying from the physiological nature of the epilepsy itself to the environmental factors such as family, parenting, and social status. In this article, we aim to review the causes, risk factors, and management of anxiety disorders and depression in children with epilepsy.
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Affiliation(s)
- Onur Gökçen
- Psychiatry Clinic, Kütahya Health Sciences University School of Medicine, Kütahya, Turkey
| | - Mehmet Turgut
- Department of Neurosurgery, Aydın Adnan Menderes University School of Medicine, Aydın, Turkey
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Salpekar JA. The long view of epilepsy and depression in pediatrics. Dev Med Child Neurol 2020; 62:543-544. [PMID: 31769020 DOI: 10.1111/dmcn.14416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jay A Salpekar
- Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Abstract
Stress is ubiquitous in chronic medical conditions; however, the connections to psychiatric and neurologic conditions are not always clearly established. Epilepsy is a unique illness that is intimately intertwined with stress and anxiety not only as a result of the disease process but also as a cause of disease exacerbation. Anxiety and depression also involve stress management and often overlap with epilepsy. Anxiety symptoms themselves may be present as intrinsic aspects of seizure phenomena, either during the events or closely related to them. The pathways of stress and anxiety involve the hypothalamic pituitary adrenal (HPA) axis and explain at least in part how stress may lead to worsening seizure control. Ultimately, the study of stress, anxiety, and epilepsy offers insight into mind and body connections, and furthers understanding of neuropsychiatric illness.
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Brenner LA, Henry BR, Shepard JA, Martin DN, Goodkin HP. Is the Neurological Disorders Depression Inventory-Epilepsy for Youth (NDDI-E-Y) more sensitive than a neurologist? A quality improvement project. Epilepsy Behav 2020; 104:106913. [PMID: 32036241 DOI: 10.1016/j.yebeh.2020.106913] [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: 09/16/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Depression is one of the most prevalent psychiatric comorbidities in epilepsy. This quality improvement project compared a standardized rating scale, the Neurological Disorders Depression Inventory-Epilepsy for Youth (NDDI-E-Y), with physician opinion to see if it improved sensitivity to depressive symptoms. RESULTS A convenience sample of thirty adolescents with epilepsy ages 12-17 (mean [M] = 15.02, standard deviation [SD] = 1.81; 53% female) participated in the screening. Thirteen percent of the sample scored in the Elevated range on the NDDI-E-Y (exceeded cutoff). Seven percent of the sample were rated by the physician as definitely showing signs of depression. There were two false negatives when the NDDI-E-Y score exceeded the established cutoff, but physician rating was negative for depressive symptoms. CONCLUSION This pilot project shows that the NDDI-E-Y is a convenient clinical tool with the potential to improve sensitivity in the detection of depressive symptoms in adolescents with epilepsy.
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Affiliation(s)
- Laurie A Brenner
- Department of Neurology, University of Virginia, Charlottesville, VA, USA.
| | - Brooke R Henry
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
| | - Jaclyn A Shepard
- Department of Psychiatry & Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, USA
| | - David N Martin
- Claude Moore Health Sciences Library, University of Virginia, Charlottesville, VA, USA
| | - Howard P Goodkin
- Department of Neurology, University of Virginia, Charlottesville, VA, USA; Department of Pediatrics, University of Virginia, Charlottesville, VA, USA
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Salpekar JA, Mula M. Common psychiatric comorbidities in epilepsy: How big of a problem is it? Epilepsy Behav 2019; 98:293-297. [PMID: 30149996 DOI: 10.1016/j.yebeh.2018.07.023] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 11/28/2022]
Abstract
Psychiatric illness and epilepsy commonly co-occur in adults and in children and adolescents. Theories of comorbidity are complex, but recurring associations between the conditions suggest overlap that is more than simple co-occurrence. Common underlying pathophysiology may imply that epilepsy itself may constituently include psychiatric symptoms. Conditions such as depression or cognitive difficulties commonly occur and in some cases, are considered to be associated with specific epilepsy characteristics such as localization or seizure type. Regardless of etiologic attributions to psychiatric comorbidity, it is clear today that treatment for epilepsy needs to target psychiatric illness. In many cases, quality-of-life improvements depend more upon addressing psychiatric symptoms than seizures themselves. This article is part of the Special Issue "Obstacles of Treatment of Psychiatric Comorbidities in Epilepsy".
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Affiliation(s)
- Jay A Salpekar
- Kennedy Krieger Institute, Johns Hopkins University, USA.
| | - Marco Mula
- Institute of Medical and Biomedical Education, St George's University of London, United Kingdom; Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
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Chen F, He X, Luan G, Li T. Role of DNA Methylation and Adenosine in Ketogenic Diet for Pharmacoresistant Epilepsy: Focus on Epileptogenesis and Associated Comorbidities. Front Neurol 2019; 10:119. [PMID: 30863356 PMCID: PMC6399128 DOI: 10.3389/fneur.2019.00119] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/29/2019] [Indexed: 01/02/2023] Open
Abstract
Epilepsy is a neurological disorder characterized by a long term propensity to produce unprovoked seizures and by the associated comorbidities including neurological, cognitive, psychiatric, and impairment the quality of life. Despite the clinic availability of several novel antiepileptic drugs (AEDs) with different mechanisms of action, more than one-third of patients with epilepsy suffer with pharmacoresistant epilepsy. Until now, no AEDs have been proven to confer the efficacy in alteration of disease progression or inhibition of the development of epilepsy. The ketogenic diet, the high-fat, low-carbohydrate composition is an alternative metabolic therapy for epilepsy, especially for children with drug-resistant epilepsy. Recently clinical and experimental results demonstrate its efficacy in ameliorating both seizures and comorbidities associated with epilepsy, such as cognitive/psychiatric concerns for the patients with refractory epilepsy. Of importance, ketogenic diet demonstrates to be a promising disease-modifying or partial antiepileptogenesis therapy for epilepsy. The mechanisms of action of ketogenic diet in epilepsy have been revealed recently, such as epigenetic mechanism for increase the adenosine level in the brain and inhibition of DNA methylation. In the present review, we will focus on the mechanisms of ketogenic diet therapies underlying adenosine system in the prevention of epileptogenesis and disease modification. In addition, we will review the role of ketogenic diet therapy in comorbidities associated epilepsy and the underlying mechanisms of adenosine.
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Affiliation(s)
- Fan Chen
- Beijing Key Laboratory of Epilepsy Research, Department of Neurology, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Xinghui He
- Beijing Key Laboratory of Epilepsy Research, Department of Neurosurgery, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Guoming Luan
- Beijing Key Laboratory of Epilepsy Research, Department of Neurosurgery, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, China
| | - Tianfu Li
- Beijing Key Laboratory of Epilepsy Research, Department of Neurology, Beijing Institute for Brain Disorders, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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Abstract
PURPOSE OF REVIEW The overlap of neuropsychiatric illness and developmental disability continues to be prominently recognized in clinical practice and in the academic literature. Theoretical and practical considerations may represent a frontier for understanding brain and behavior relationships. The purpose of this review is to explore this common relationship and report on recent literature that helps advance the larger fields of psychiatry and neurology. RECENT FINDINGS Overlap between developmental disability, epilepsy, and neuropsychiatric illness may be more common than originally thought. Excessive excitatory neurotransmitter activity may be present in epilepsy and in autism spectrum disorder. Specific seizure types may be associated with features of developmental disabilities and neuropsychiatric conditions. SUMMARY Neuropsychiatric illness is common in epilepsy and more frequent in developmental disabilities than generally recognized. Seizure foci in the temporal lobe may play a significant role. Brain connectivity and specific neurotransmitter systems are active areas of investigation. Antiepileptic drugs may improve neuropsychiatric symptoms in persons with developmental disability and epilepsy.
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Kellermann TS, Mueller M, Carter EG, Brooks B, Smith G, Kopp OJ, Wagner JL. Prediction of specific depressive symptom clusters in youth with epilepsy: The NDDI-E-Y versus Neuro-QOL SF. Epilepsia 2017; 58:1370-1379. [DOI: 10.1111/epi.13808] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Tanja S. Kellermann
- Department of Neurosurgery; Medical University of South Carolina; Charleston South Carolina U.S.A
| | - Martina Mueller
- College of Nursing; Medical University of South Carolina; Charleston South Carolina U.S.A
| | - Emma G. Carter
- Department of Neurology; Medical University of South Carolina; Charleston South Carolina U.S.A
| | - Byron Brooks
- Department of Psychology; East Tennessee State University; Johnson City Tennessee U.S.A
| | - Gigi Smith
- College of Nursing; Medical University of South Carolina; Charleston South Carolina U.S.A
- Comprehensive Epilepsy Program; Medical University of South Carolina; Charleston South Carolina U.S.A
- Department of Pediatrics; Medical University of South Carolina; Charleston South Carolina U.S.A
| | | | - Janelle L. Wagner
- College of Nursing; Medical University of South Carolina; Charleston South Carolina U.S.A
- Comprehensive Epilepsy Program; Medical University of South Carolina; Charleston South Carolina U.S.A
- Department of Pediatrics; Medical University of South Carolina; Charleston South Carolina U.S.A
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Abstract
Mood disorders associated with epilepsy are very common and overrepresented compared with other chronic medical conditions. Depression is a particularly common and worrisome comorbidity, especially because suicidality seems to be increased significantly in the context of epilepsy. Although psychosocial stressors commonly are associated, intrinsic characteristics of seizure disorders may contribute to the expression of depressive symptoms. Depression and epilepsy may exacerbate each other. Epilepsy with seizure foci in the temporal lobe may represent a higher risk of developing depression, especially if the seizures do not generalize. Treatment of depression is multifaceted and includes psychotherapy and sophisticated regimens of anticonvulsants. Most antidepressants may be used safely and effectively in the context of depression, although high-quality evidence is lacking. Ultimately, treatment of comorbid mood disorder has important implications for outcome and quality of life, perhaps even more than treatment of epilepsy itself.
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Affiliation(s)
- Jay Salpekar
- Dr. Salpekar is director of the Neuropsychiatry and Epilepsy Program, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, Baltimore (e-mail: )
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Wagner JL, Kellermann T, Mueller M, Smith G, Brooks B, Arnett A, Modi AC. Development and validation of the NDDI-E-Y: a screening tool for depressive symptoms in pediatric epilepsy. Epilepsia 2016; 57:1265-70. [PMID: 27354177 DOI: 10.1111/epi.13446] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To validate the revised 12-item revised Neurological Disorders Depression Inventory-Epilepsy for Youth (NDDI-E-Y), a self-report screening tool for depressive symptoms tailored to youth ages 12-17 with epilepsy. METHODS Youth at two sites completed the NDDI-E-Y during a routine epilepsy visit. Youth at one site also completed the Children's Depression Inventory-2 (CDI-2). Seizure and demographic data were abstracted from the electronic medical record. Exploratory factor analyses were conducted. Internal consistency, area under the curve (AUC), and construct validity were assessed. RESULTS NDDI-E-Y questionnaires were analyzed for 143 youth. The coefficient for internal consistency for the NDDI-E-Y was 0.92. Factor analyses suggested a one-factor solution with all 12 items loading on the factor. The NDDI-E-Y was positively correlated with the CDI-2 (N = 99). Sensitivity and specificity of the NDDI-E-Y were high. SIGNIFICANCE Reliability and construct validity were established for the revised 12-item NDDI-E-Y. The NDDI-E-Y is a brief, free measure of depressive symptoms that can be administered during a routine epilepsy visit.
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Affiliation(s)
- Janelle L Wagner
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, U.S.A.,Comprehensive Epilepsy Program, Medical University of South Carolina, Charleston, South Carolina, U.S.A.,Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Tanja Kellermann
- Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Martina Mueller
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Gigi Smith
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, U.S.A.,Comprehensive Epilepsy Program, Medical University of South Carolina, Charleston, South Carolina, U.S.A.,Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Byron Brooks
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, U.S.A
| | - Alex Arnett
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, Ohio, U.S.A
| | - Avani C Modi
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, Ohio, U.S.A
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Zhen XH, Quan YC, Jiang HY, Wen ZS, Qu YL, Guan LP. Fucosterol, a sterol extracted from Sargassum fusiforme, shows antidepressant and anticonvulsant effects. Eur J Pharmacol 2015; 768:131-8. [PMID: 26515446 DOI: 10.1016/j.ejphar.2015.10.041] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 10/16/2015] [Accepted: 10/23/2015] [Indexed: 01/20/2023]
Abstract
We previously showed that extracts of Sargassum fusiforme significantly reduce immobility time in the forced swim test and tail suspension test, suggesting that these extracts possess antidepressant-like effects. Here, fucosterol extracted from S. fusiforme was evaluated for antidepressant and anticonvulsant activities in mice. Fucosterol (10, 20, 30 and 40mg/kg) significantly shortened immobility time in the forced swim test and tail suspension test for30min after treatment but had no effect on locomotor activity in the open field test. Fucosterol significantly increased serotonin, norepinephrine and the metabolite 5-hydroxyindoleacetic acid in mouse brain, suggesting that the effects of fucosterol may be mediated through these neurotransmitters. As assessed using maximal electroshock, fucosterol (20, 40, 100mg/kg) possessed anticonvulsant activity, whereas rotarod toxicity test results indicated that fucosterol did not induce neurotoxicity at the same dose levels in mice. Thus, fucosterol may be a useful antidepressant adjunct candidate for treating depression in patients with epilepsy. A significant increase in hippocampal brain-derived neurotrophic factor (BDNF) levels was found in the fucosterol 20mg/kg group (P<0.05). Our findings suggested that fucosterol may possess an antidepressant-like effect, which may be mediated by increasing central BDNF levels.
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Affiliation(s)
- Xing-Hua Zhen
- Food and Pharmacy College, Zhejiang Ocean University and Zhejiang Provincial Engineering Technology Research Center of Marine Biomedical Products, Zhejiang, Zhoushan 316022, China
| | - Ying-Chun Quan
- Yanbian University School of Medicine, Jilin 133000, Yanji, China
| | - Hai-Ying Jiang
- Yanbian University School of Medicine, Jilin 133000, Yanji, China
| | - Zheng-Shun Wen
- Food and Pharmacy College, Zhejiang Ocean University and Zhejiang Provincial Engineering Technology Research Center of Marine Biomedical Products, Zhejiang, Zhoushan 316022, China
| | - You-Le Qu
- Food and Pharmacy College, Zhejiang Ocean University and Zhejiang Provincial Engineering Technology Research Center of Marine Biomedical Products, Zhejiang, Zhoushan 316022, China.
| | - Li-Ping Guan
- Food and Pharmacy College, Zhejiang Ocean University and Zhejiang Provincial Engineering Technology Research Center of Marine Biomedical Products, Zhejiang, Zhoushan 316022, China.
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