1
|
Niu C, Li P, Du X, Zhao M, Wang H, Yang D, Wu M, Jing W. Risk factors for anxiety in patients with epilepsy: A meta-analysis. Epilepsy Behav 2024; 153:109665. [PMID: 38368787 DOI: 10.1016/j.yebeh.2024.109665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Epilepsy is a very common neurological disease, and it is important to focus on both controlling seizures and alleviating the psychological problems associated with this disease.Anxiety is an important risk factor for epilepsy and seriously affects the quality of life of patients with epilepsy (PWE). However, several risk factors for anxiety in PWE are relatively controversial and understudied. This meta-analysis was performed to identify potential risk factors for anxiety in PWE with the aim of reducing the incidence of anxiety and improving the quality of life among the individuals. METHOD The PubMed, Embase and Cochrane Library databases were systematically searched up to July 2023 to find eligible original English studies. All the search results were reviewed based on our inclusion and exclusion criteria. We calculated the combined odds ratios (ORs), standard mean differences (SMDs) and their corresponding 95% confidence intervals (CIs) to evaluate the effect of the included risk factors on anxiety in PWE. RESULTS Twenty-four studies involving 5,403 PWE were ultimately included. The pooled results of our meta-analysis showed that female sex (OR = 1.67; 95 % CI: 1.30,2.15; p < 0.001), unmarried/divorced/widowed (OR = 0.83; 95 % CI: 0.72,0.96; p = 0.011), low socioeconomic status (OR = 0.47; 95 % CI: 0.33,0.67; p < 0.001), education levels below high school (OR = 1.74; 95 % CI: 1.36,2.23; p < 0.001), a history of trauma (OR = 2.53; 95 % CI: 1.69,3.78; p < 0.001), monotherapy (OR = 0.49; 95 % CI: 0.39,0.62; p < 0.001), AED-induced psychiatric side effects (OR = 2.45; 95 % CI: 1.20,4.98); p = 0.014), depression (OR = 5.45 95 % CI: 2.49,11.94; p < 0.001), a history of suicide (OR = 3.56; 95 % CI: 1.72,7.38; p = 0.001), and illness-related shame (OR = 2.76; 95 % CI: 2.17,3.52; p < 0.001) were risk factors for anxiety. CONCLUSION This meta-analysis showed that female, unmarried, low socioeconomic status, education level below senior high school, a history of trauma, monotherapy, AED-induced psychiatric side effects, depression, a history of suicide, and shame were risk factors for anxiety in PWE. However, further research is needed to determine the effect of other potential risk factors on anxiety in PWE. In addition, most of the studies included in this meta-analysis were not uniform in scale, and the risk factors were not comprehensive; therefore, larger prospective studies in different countries are needed to further investigate these risk factors.
Collapse
Affiliation(s)
- Cailang Niu
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Penghong Li
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Xueqing Du
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Mina Zhao
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Haobo Wang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Debo Yang
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Maolin Wu
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| | - Wei Jing
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, China.
| |
Collapse
|
2
|
Shadid AM, Alsaber N, Aldawish RA, Humaid HM, AlMubarak F, Alazwari LS, Alosaimi NS, Alkhaldi D, Alhumud MH, Shadid AM, Al Zahrani N. Depression and anxiety among patients with epilepsy: A cross-sectional study from Riyadh, Saudi Arabia. J Family Med Prim Care 2024; 13:549-555. [PMID: 38605782 PMCID: PMC11006070 DOI: 10.4103/jfmpc.jfmpc_834_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 04/13/2024] Open
Abstract
Background It is well established that epileptic disorders are associated with a wide range of psychosocial issues that overburden the affected individuals and limit their lifestyle. This study aimed to determine the commonalities between depression and anxiety symptoms among patients with epilepsy (PWE). In addition, we assessed whether depression and anxiety rates varied depending on factors related to the disease. Materials and Methods A cross-sectional study was conducted between October 2021 and March 2022 among all PWE at Prince Mohammed bin Abdulaziz Hospital, and 147 patients who responded to the questionnaires were included for analysis (65.6% response rate). Depression was measured using the Patient Health Questionnaire depression scale (PHQ-9), while anxiety levels were measured using the Generalized Anxiety Disorder scale (GAD-7). Demographic variables such as sex, age, marital status, and factors related to epilepsy were also recorded. Results The results showed that 39.5% and 27.9% of participants had major depressive disorder (MDD) and generalized anxiety disorder (GAD), respectively. The presence of factors that increased susceptibility to seizures was associated with a greater expression of depression (P = 0.035) and anxiety (P = 0.002) symptoms. The presence of symptoms/signs that precede seizures was associated with a higher risk of moderate and severe depression (P = 0.001) and moderate and severe anxiety (P < 0.001). Irregular use of medications was associated with a higher risk of moderate and severe depression (P = 0.037); however, lamotrigine was associated with lower rates of depression among the participants (P = 0.023). Conclusion This study found that PWE had a higher prevalence of MDD and GAD than the general population. However, this accepted paradigm has yet to reflect a meaningful change in constructing condition-specific recommendations for PWE. Our study revealed that the presence of subjectively recognized signs of an impending ictal episode was significantly associated with a higher risk of moderate and severe depression and anxiety. Furthermore, factors that increase the susceptibility to seizures were associated with a higher risk of depression and anxiety. Irregular medication use was associated with a higher risk of moderate and severe depression. However, lamotrigine was associated with lower rates of depression among participants.
Collapse
Affiliation(s)
- Abdullah M. Shadid
- Department of Medicine, King Saud University Hospital, Riyadh, Saudi Arabia
| | - Naif Alsaber
- Department of Medicine, King Saud University Hospital, Riyadh, Saudi Arabia
| | - Reema A. Aldawish
- Department of Medicine, College of Medicine, Princess Nourah University, Riyadh, Saudi Arabia
| | - Hameed M. Humaid
- Department of Medicine, King Saud University Hospital, Riyadh, Saudi Arabia
| | - Faris AlMubarak
- Department of Medicine, King Saud University Hospital, Riyadh, Saudi Arabia
| | - Leenah S. Alazwari
- Department of Medicine, College of Medicine, Princess Nourah University, Riyadh, Saudi Arabia
| | - Nourah S. Alosaimi
- Department of Medicine, College of Medicine, AlMaarefa University, Riyadh, Saudi Arabia
| | - Danah Alkhaldi
- Department of Medicine, College of Medicine, AlMaarefa University, Riyadh, Saudi Arabia
| | | | | | - Nourah Al Zahrani
- Department of Neurology, Prince Mohammad Bin Abdulaziz Hospital, Riyadh, Saudi Arabia
| |
Collapse
|
3
|
Guo W, Li YX, Zhang Y, Lv XR, Wang SX, Zhang SY, Wang ES, Chen XJ, Li Y. Risk analysis of depression among adult patients with epilepsy of different sex: a retrospective single-center study from China. Front Psychiatry 2023; 14:1283983. [PMID: 38111615 PMCID: PMC10725914 DOI: 10.3389/fpsyt.2023.1283983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/20/2023] [Indexed: 12/20/2023] Open
Abstract
Objective To determine sex differences in the prevalence of depression and assess the risk factors for depression among adult patients with epilepsy from the Dali area of China. Methods We retrospectively analyzed the clinical data of adult patients with epilepsy who visited the First Affiliated Hospital of Dali University from January 2017 to January 2022. Patient Health Questionnaire-9 was used to assess depressive symptoms in patients with epilepsy. The risk factors of depression were analyzed by binary logistic regression among different sex in patients with epilepsy. Results There were significant sex differences in depression in patients with epilepsy (p < 0.001), and females were 4.27 times more likely to suffer from depression than males (95% confidence interval: 3.70-4.92). The risk factors for depression among female patients with epilepsy included occupation (p < 0.001), years with epilepsy (p < 0.001), seizure frequency (p < 0.001), seizure type (p < 0.001), etiology (p < 0.001), number of antiseizure medications used (p < 0.001), antiseizure medications (p < 0.001), and electroencephalogram findings (p < 0.001). The risk factors for depression among male patients with epilepsy included age (p < 0.001), ethnicity (p < 0.001), occupation (p < 0.001), years with epilepsy (p < 0.001), seizure frequency (p < 0.001), seizure type (p < 0.001), etiology (p < 0.001), number of antiseizure medications used (p < 0.001), antiseizure medications (p < 0.001), and electroencephalogram findings (p < 0.001). Conclusion Adult female patients with epilepsy had a higher risk of depression than adult male patients with epilepsy. There were sex differences in the risk factors associated with depression among patients with epilepsy.
Collapse
Affiliation(s)
- Wang Guo
- Clinical Medical School, Dali University, Dali, China
| | - Yu-xuan Li
- Clinical Medical School, Dali University, Dali, China
| | - Yi Zhang
- Clinical Medical School, Dali University, Dali, China
| | - Xue-rui Lv
- Clinical Medical School, Dali University, Dali, China
| | | | - Shuang-yuan Zhang
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China
| | - En-si Wang
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China
| | - Xin-jie Chen
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China
| | - Yun Li
- Department of Neurology, The First Affiliated Hospital of Dali University, Dali, China
| |
Collapse
|
4
|
Davletshin AI, Matveeva AA, Poletaeva II, Evgen'ev MB, Garbuz DG. The role of molecular chaperones in the mechanisms of epileptogenesis. Cell Stress Chaperones 2023; 28:599-619. [PMID: 37755620 PMCID: PMC10746656 DOI: 10.1007/s12192-023-01378-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/28/2023] Open
Abstract
Epilepsy is a group of neurological diseases which requires significant economic costs for the treatment and care of patients. The central point of epileptogenesis stems from the failure of synaptic signal transmission mechanisms, leading to excessive synchronous excitation of neurons and characteristic epileptic electroencephalogram activity, in typical cases being manifested as seizures and loss of consciousness. The causes of epilepsy are extremely diverse, which is one of the reasons for the complexity of selecting a treatment regimen for each individual case and the high frequency of pharmacoresistant cases. Therefore, the search for new drugs and methods of epilepsy treatment requires an advanced study of the molecular mechanisms of epileptogenesis. In this regard, the investigation of molecular chaperones as potential mediators of epileptogenesis seems promising because the chaperones are involved in the processing and regulation of the activity of many key proteins directly responsible for the generation of abnormal neuronal excitation in epilepsy. In this review, we try to systematize current data on the role of molecular chaperones in epileptogenesis and discuss the prospects for the use of chemical modulators of various chaperone groups' activity as promising antiepileptic drugs.
Collapse
Affiliation(s)
| | - Anna A Matveeva
- Engelhardt Institute of Molecular Biology RAS, 119991, Moscow, Russia
- Moscow Institute of Physics and Technology, 141700, Dolgoprudny, Moscow Region, Russia
| | - Inga I Poletaeva
- Biology Department, Lomonosov Moscow State University, 119991, Moscow, Russia
| | | | - David G Garbuz
- Engelhardt Institute of Molecular Biology RAS, 119991, Moscow, Russia
| |
Collapse
|
5
|
Qin SK, Yang ZX, Guan ZW, Zhang JH, Ping X, Lu Y, Pei L. Exploring the association between epilepsy and depression: A systematic review and meta-analysis. PLoS One 2022; 17:e0278907. [PMID: 36520790 PMCID: PMC9754200 DOI: 10.1371/journal.pone.0278907] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE This study offers meta-analytic data on the potential association between epilepsy and depression especially for the prevalence of depression in epilepsy or vice versa. METHODS The relevant studies were searched and identified from nine electronic databases. Studies that mentioned the prevalence and/or incidence of epilepsy and depression were included. Hand searches were also included. The search language was English and the search time was through May 2022. Where feasible, random-effects models were used to generate pooled estimates. RESULTS After screening electronic databases and other resources, 48 studies from 6,234 citations were included in this meta-analysis. The period prevalence of epilepsy ranged from 1% to 6% in patients with depression. In population-based settings, the pooled period prevalence of depression in patients with epilepsy was 27% (95% CI, 23-31) and 34% in clinical settings (95% CI, 30-39). Twenty studies reported that seizure frequency, low income, unemployment of the patients, perception of stigma, anxiety, being female, unmarried status, disease course, worse quality of life, higher disability scores, and focal-impaired awareness seizures were risk factors for depression. CONCLUSION Our study found that epilepsy was associated with an increased risk of depression. Depression was associated with the severity of epilepsy.
Collapse
Affiliation(s)
- Shao-kun Qin
- Hebei University of Chinese Medicine, Shijiazhuang, Hebei, China
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
| | - Zi-xian Yang
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- School of Chinese Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Zhen-wei Guan
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, Hebei, China
| | - Jin-hu Zhang
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, Hebei, China
| | - Xin Ping
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, Hebei, China
| | - Ye Lu
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, Hebei, China
- * E-mail: (YL); (LP)
| | - Lin Pei
- Hebei Key Laboratory of Turbidity, Shijiazhuang, Hebei, China
- Hebei Academy of Chinese Medicine Sciences, Shijiazhuang, Hebei, China
- * E-mail: (YL); (LP)
| |
Collapse
|
6
|
Alkaabi AJ, Alkous A, Mahmoud K, AlMansoori A, Elbarazi I, Suliman A, Alam Z, AlAwadi F, Al-Maskari F. The prevalence and correlates of depression among patients with chronic diseases in the United Arab Emirates. PLoS One 2022; 17:e0278818. [PMID: 36516141 PMCID: PMC9749973 DOI: 10.1371/journal.pone.0278818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Chronic diseases constitute a major public health problem in the United Arab Emirates (UAE) and are the leading cause of mortality and morbidity. Chronic diseases have been found to be associated with an increased prevalence of depression and depressive symptoms. Depression can have detrimental effect on the prognosis of the disease and quality of life in patients. AIMS AND OBJECTIVES This study aimed to estimate the prevalence and correlates of depression in a sample of patients suffering from chronic disease in Al-Ain city, UAE. MATERIALS AND METHODS A cross-sectional survey based study was conducted with 417 participants recruited from seven primary health care centers of Al-Ain city. Men and women aged 18 years and above suffering from chronic disease filled the Patient Health Questionnaire (PHQ-9). Univariate and multivariable logistic regressions were performed on the collected data to investigate correlates of different factors with depression. Data was analyzed using SPSS (version 26). The study was approved by Ambulatory Healthcare Services (AHS) Human Ethics Research Committee. RESULTS The majority 62.41% (n = 254) of the sample were females, 57.97% (n = 240) aged above 55 years and with a median (Q25, Q75) duration of chronic disease of 8 (4, 15) years. The prevalence of depression was 21.1% (95% CI: 17.5%-25.3%). With severe depression was in 1.7% and mild-moderate in 34.7% of the participants. Depression severity was statistically significantly associated with increasing age (p = 0.006), low level of education (p<0.001), presence of asthma (p = 0.007) and heart disease (p = 0.013). Unadjusted logistic regression reported that presence of depression was significantly associated with female gender (cOR = 1.8, [95% CI; 1.1-3.1], p = 0.025), and presence of chronic kidney disease (cOR = 4.9, [95% CI; 1.3-20.2], p = 0.020) and heart disease (cOR = 2.9, [95% CI; 1.6-5.4], p = 0.001) longer duration of disease in years (cOR = 1.04, [95% CI; 1.01-1.07], p = 0.003). However, in the adjusted logistic regression analysis, participants with heart disease (aOR = 2.8, [95% CI; 1.4-5.5], p = 0.004), and with longer duration of disease (aOR = 1.04, [1.01-1.07], p = 0.014) remained significantly associated statistically with higher chance of having depression. CONCLUSION The prevalence of depression was quite high and the study highlights for health care professionals and policy makers, the importance of mental health support as part of a comprehensive management plan for patients with chronic diseases. A multidisciplinary comprehensive program will improve the long-term outcomes of these patients. Patients with chronic diseases may need more support and counseling at primary health care levels.
Collapse
Affiliation(s)
- A. J. Alkaabi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, Abu Dhabi, UAE
| | - A. Alkous
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, Abu Dhabi, UAE
| | - K. Mahmoud
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, Abu Dhabi, UAE
| | - A. AlMansoori
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, Abu Dhabi, UAE
| | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, Abu Dhabi, UAE
| | - Abubaker Suliman
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, Abu Dhabi, UAE
| | - Zufishan Alam
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, Abu Dhabi, UAE
| | | | - Fatima Al-Maskari
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, Abu Dhabi, UAE
- Zayed Centre for Health Sciences, United Arab Emirates University, AlAin, Abu Dhabi, UAE
- * E-mail:
| |
Collapse
|
7
|
Rodent Models of Audiogenic Epilepsy: Genetic Aspects, Advantages, Current Problems and Perspectives. Biomedicines 2022; 10:biomedicines10112934. [PMID: 36428502 PMCID: PMC9687921 DOI: 10.3390/biomedicines10112934] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022] Open
Abstract
Animal models of epilepsy are of great importance in epileptology. They are used to study the mechanisms of epileptogenesis, and search for new genes and regulatory pathways involved in the development of epilepsy as well as screening new antiepileptic drugs. Today, many methods of modeling epilepsy in animals are used, including electroconvulsive, pharmacological in intact animals, and genetic, with the predisposition for spontaneous or refractory epileptic seizures. Due to the simplicity of manipulation and universality, genetic models of audiogenic epilepsy in rodents stand out among this diversity. We tried to combine data on the genetics of audiogenic epilepsy in rodents, the relevance of various models of audiogenic epilepsy to certain epileptic syndromes in humans, and the advantages of using of rodent strains predisposed to audiogenic epilepsy in current epileptology.
Collapse
|
8
|
Association between epilepsy and risk of depression: A meta-analysis. Psychiatry Res 2022; 312:114531. [PMID: 35413534 DOI: 10.1016/j.psychres.2022.114531] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/21/2022] [Accepted: 03/26/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Recent studies provided inconsistent evidence for the association between epilepsy and risk of depression. METHODS We searched for articles published in the databases (Web of Science, Google Scholar and PubMed) and before December 2021. We used STATA 12.0 software to compute odds ratios (ORs)/relative risks (RRs) and their 95% confidence intervals (CIs). RESULTS The meta-analysis indicated that epilepsy was associated with an increased risk of depression with a random effects model (OR/RR = 2.05; 95% CI: 1.77-2.37, I2 = 37.7%, p = 0.036). Subgroup studies indicated that epilepsy was associated with an increased risk of depression in both case-control and cohort studies (case-control studies: OR = 2.32; 95% CI: 1.91-2.82; cohort studies: RR = 1.71; 95% CI: 1.53-1.92). Subgroup studies indicated that epilepsy was associated with an increased risk of depression in Asian, African and Caucasian populations (Asian: OR/RR = 2.42; 95% CI: 1.48-3.95; African: OR/RR = 2.48; 95% CI: 1.88-3.28; Caucasian: OR/RR = 1.86; 95% CI: 1.60-2.15). Subgroup studies showed that epilepsy was associated with an increased risk of depression among adolescents and adults (adolescents: OR/RR = 2.54; 95% CI: 1.86-3.46; adults: OR/RR = 2.22; 95% CI: 1.79-2.75). CONCLUSIONS Epilepsy is at increased risk of depression comorbidity.
Collapse
|
9
|
Wang S, Yang J, Wei N, Lv W, Jiang Z, Huang H, Zhang J, Xu P, Yu CY, Xu Z. Anxiety and depression among epilepsy patients in low-risk areas for COVID-19 in the northern part of Guizhou Province, China, during the COVID-19 pandemic. ACTA EPILEPTOLOGICA 2022. [PMCID: PMC9084936 DOI: 10.1186/s42494-022-00092-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This study was aimed to investigate whether patients with epilepsy (PWE) have higher depression and anxiety levels than the normal population in low-risk areas for coronavirus disease 2019 (COVID-19) in the northern part of Guizhou Province, China, during the COVID-19 epidemic, to evaluate their knowledge on COVID-19, and to analyze related factors for the psychological distress of PWE at this special time.
Methods
The survey was conducted online from February 28, 2020 to March 7, 2020 via a questionnaire. PWE from the outpatient clinic of epilepsy of the Affiliated Hospital of Zunyi Medical University, and healthy people matched for age and sex, participated in this study. Mental health was assessed via a generalized anxiety self-rating scale (GAD-7) and the self-rating depression scale (PHQ-9). The knowledge of COVID-19 in both groups was investigated.
Results
There were no significant differences in the general demographics between the PWE and healthy control groups. The scores of PHQ-9 (P < 0.01) and GAD-7 (P < 0.001) were higher in the PWE group than in the healthy group. There was a significant difference in the proportions of respondents with different severities of depression and anxiety, between the two groups, which revealed significantly higher degree of depression and anxiety in PWE than in healthy people (P = 0, P = 0). Overwhelming awareness and stressful concerns for the pandemic and female patients with epilepsy were key factors that affect the level of anxiety and depression in PWE. Further, the PWE had less accurate knowledge of COVID-19 than healthy people (P < 0.001). There was no statistically significant difference between the two groups in the knowledge of virus transmission route, incubation period, susceptible population, transmission speed, clinical characteristics, and isolation measures on COVID-19 (P > 0.05). PWE knew less about some of the prevention and control measures of COVID-19 than healthy people.
Conclusions
During the COVID-19 epidemic, excessive attention to the epidemic and the female sex are factors associated with anxiety and depression in PWE, even in low-risk areas.
Collapse
|
10
|
AlSaeed S, Alkhawajah NM, Ayyash M, Aljarallah S, Alarieh R, Abu-Shaheen A. Assessment of factors associated with depression and anxiety among pwMS in Saudi Arabia. BMC Neurol 2022; 22:120. [PMID: 35337277 PMCID: PMC8948449 DOI: 10.1186/s12883-022-02632-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 03/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background Multiple sclerosis (MS) is an inflammatory chronic disease that is characterized by an increased prevalence of adverse mental health outcomes in patients with MS (pwMS). The main aim of this study is to investigate the factors of depression and anxiety in pwMS in the Kingdom of Saudi Arabia (KSA). Materials and methods This is a cross-sectional study conducted in KSA during the period from March to June 2020. Participants were recruited from the Neuroimmunology clinics in King Fahad Medical City (KFMC) and King Saud University medical city (KSUMC)in Riyadh City, KSA. The Hospital Anxiety and Depression Scale (HADS) was used to measure depression and anxiety. Fatigue Severity Scale (FSS) was used to measure fatigue in pwMS. A simple random sampling technique was utilized to select participants and the data were analyzed using SPSS v.24.0. Results A total of 529 participants participated in this study with a response rate of 53.1%. The prevalences of anxiety and depression were 35.3% and 19.7%, respectively. The findings also revealed that depression was more likely to be significantly affected by being male, low education, unemployment, physical inactivity, and fatigue but the anxiety was significantly affected by region, unemployment, short duration since last MS relapse, physical inactivity, and fatigue. Conclusion Anxiety and depression are not uncommon in pwMS. Given their impact on the lives of affected patients, early detection and management of these symptoms and their associated factors are crucial.
Collapse
Affiliation(s)
| | | | - Mohsen Ayyash
- School of Mathematical Sciences, Universiti Sains Malaysia, USM, 11800, Penang, Malaysia
| | | | - Rola Alarieh
- Department of Nuerology, King Fahad Medical City, Riyadh, Saudi Arabia
| | | |
Collapse
|
11
|
Seid J, Mebrahtu K, Andualem F. Prevalence and associated factors of anxiety disorder symptoms among people with epilepsy in Mekelle, Ethiopia, 2019: Institutional-based cross-sectional study. Nurs Open 2022; 9:1731-1743. [PMID: 35170244 PMCID: PMC8994931 DOI: 10.1002/nop2.1198] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 12/12/2021] [Accepted: 01/30/2022] [Indexed: 11/09/2022] Open
Abstract
Aim Anxiety can have a profound influence on the health‐related quality of life of people with epilepsy and caregivers. The study aimed to assess the prevalence and associated factors of anxiety disorder among people with epilepsy. Design An institutional‐based cross‐sectional study was conducted. Method From 18 April 2019–30 May 2019, systematically selected 300 peoples with epilepsy were recruited. Anxiety was assessed by using the generalized anxiety disorder‐7 (GAD‐7). The data were entered by using Epi Info and analysed by SPSS version 25. Result The prevalence of anxiety was 38.3%. Secondary educational status, medication‐related side effect, substance use history, seizure‐related physical trauma, stress symptoms and a mental illness belief were significantly associated factors. The prevalence of anxiety disorder symptom was high, and it reinforced the need for recognition and treatment of mental disorders in people with epilepsy.
Collapse
Affiliation(s)
- Jemal Seid
- Department of Psychiatric Nursing, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Kalayu Mebrahtu
- Department of Psychiatric Nursing, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatric Nursing, College of Health Sciences, Adigrat University, Tigray, Ethiopia
| |
Collapse
|
12
|
Weiss A, Canetti L, David SB, Reuveni I, Ekstein D. Seizure phobia: A distinct psychiatric disorder among people with epilepsy. Seizure 2021; 95:26-32. [PMID: 34974230 DOI: 10.1016/j.seizure.2021.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE Epilepsy is characterized by unpredictable attacks. Hence, people with epilepsy (PWE) may develop anxious anticipation of upcoming seizures. Seizure phobia is an anxiety disorder wherein seizure anticipatory situations trigger fear, accompanied by avoidance behaviors. Research on seizure phobia among PWE is scarce. Therefore, we aimed to describe the diagnosis of seizure phobia and its association with demographic, psychiatric and neurological variables. METHODS This is a cross-sectional study of adult PWE in a tertiary epilepsy outpatient clinic. Data were collected from semi-structured interviews, demographic questionnaires and medical records. Patients with and without seizure phobia were compared in terms of sociodemographic, psychiatric, and neurological variables. A logistic regression analysis was performed to identify variables that predicted seizure phobia. RESULTS Among 69 PWE included in the study, 19 (27.5%) were diagnosed with seizure phobia. In comparison with PWE without seizure phobia, PWE with seizure phobia were predominantly female (84.2% vs 44.2%, p = 0.005), and had more comorbid anxiety disorders (84.2% vs 34.9%, p = 0.01), past major depressive episode (MDE) (63.2% vs 20.9%, p = 0.003), and post-traumatic stress disorder (26.3% vs 7%, p = 0.05). There was a significant association between seizure phobia and comorbid psychogenic non-epileptic seizures (36.8% vs 11.6%, p = 0.034). However, no significant association was found with epilepsy-related variables. A multivariate logistic regression model indicated anxiety and a past MDE as predictive factors for seizure phobia (R2 = 0.43). CONCLUSION Seizure phobia is a distinct psychiatric entity among PWE. Further research is required to understand its etiology, risk factors, and potential interventions for these patients.
Collapse
Affiliation(s)
- Aviva Weiss
- Psychiatric Hostels affiliated with Kidum Rehabilitation Projects, Jerusalem, Israel; Alma Center for Treatment of Sexually Abused Patients, Jerusalem, Israel
| | - Laura Canetti
- Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel; Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shiri Ben David
- Neuropsychiatry Clinic, Hadassah Medical Center, Jerusalem, Israel; Department of Psychology, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel; Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dana Ekstein
- Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; Department of Neurology, Ginges Center for Neurogenetics, Hadassah Medical Center, Jerusalem, Israel.
| |
Collapse
|
13
|
Zhong R, Chen Q, Li M, Lu Y, Zhao Q, Zhang X, Lin W. Factors contributing to comorbid depressive symptoms in adult people with newly diagnosed epilepsy: A 12-month longitudinal study. Epilepsy Behav 2021; 124:108326. [PMID: 34619545 DOI: 10.1016/j.yebeh.2021.108326] [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: 06/04/2021] [Revised: 09/04/2021] [Accepted: 09/04/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES We aimed to investigate the point prevalence of comorbid depressive symptoms from the time of newly diagnosed epilepsy to 12 months and to identify the factors contributing to comorbid depressive symptoms over a 12-month period in patients with newly diagnosed epilepsy (PWNDE). METHODS A consecutive cohort of PWNDE from the First Hospital of Jilin University was recruited. Depressive symptoms were evaluated using the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy scale (C-NDDI-E). Multivariate stepwise logistic regression models were used to confirm the factors contributing to depressive symptoms in patients. RESULTS The point prevalence of depressive symptoms among PWNDE slightly decreased from 24.8% at baseline to 22.3% at 12 months. A MoCA score < 26 was identified as an independent risk factor contributing to depressive symptoms at baseline (OR = 2.419, 95% CI: 1.093-5.350, P = 0.029) and at 12 months (OR = 3.007, 95% CI: 1.223-7.390, P = 0.016). The adjusted OR for depressive symptoms in female patients was 0.365 (95% CI: 0.171-0.779, P = 0.009) compared with male patients. Depressive symptoms at baseline (OR = 4.539, 95% CI: 1.973-10.445, P < 0.001) were identified as significant predictors of depressive symptoms at 12 months. CONCLUSION There was a slight decrease in the prevalence of comorbid depressive symptoms in PWNDE over the 12-month period after epilepsy diagnosis. Cognitive impairment and baseline depressive symptoms were independent risk factors for comorbid depressive symptoms at 12 months.
Collapse
Affiliation(s)
- Rui Zhong
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Qingling Chen
- Department of Hepatology, Tianjin Medical University, Tianjin Second People's Hospital, Tianjin, China
| | - Mengmeng Li
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Yingxue Lu
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Qian Zhao
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Xinyue Zhang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Weihong Lin
- Department of Neurology, The First Hospital of Jilin University, Changchun, China.
| |
Collapse
|
14
|
Kassie SA, Alia J, Hyland L. Biopsychosocial implications of living with multiple sclerosis: a qualitative study using interpretative phenomenological analysis. BMJ Open 2021; 11:e049041. [PMID: 34404710 PMCID: PMC8372815 DOI: 10.1136/bmjopen-2021-049041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is estimated to affect 2.8 million people worldwide, with increasing prevalence in all world regions (Walton et al). While there is no cure for MS, medication and lifestyle modifications can slow disease progression and enhance patients' quality of life. The biopsychosocial model of health recognises important interactions among biological, psychological and social factors in illness, including those relating to illness management, which contribute to the experience of those diagnosed with MS. OBJECTIVE This qualitative, idiographic study aimed to explore the lived experiences of patients in the United Arab Emirates (UAE) diagnosed with S. METHODS Semistructured interviews were conducted with a purposive sample of eight patients with MS ranging in age from 25 to 56 years. All participants were residing in the UAE at the time of data collection. Interpretative phenomenological analysis was used to analyse the data. RESULTS Three superordinate themes were identified from patients' candid accounts of their lives with MS, highlighting issues of illness management, acceptance and gratitude, and adaptive coping. These themes broadly illustrate biological, psychological and social aspects of patients' MS experiences. CONCLUSION The study emphasised the importance of adopting the biopsychosocial model to treat and manage MS. Additionally, it highlights the need for routine assessment and early, multidimensional approach with multidisciplinary team efforts to improve patients' quality of life.
Collapse
Affiliation(s)
- Seada A Kassie
- Shared Clinical Services, American Center for Psychiatry and Neurology, Abu Dhabi, UAE
- Psychology, Middlesex University Dubai, Dubai, UAE
| | - Jannat Alia
- Department of Neurology, American Center for Psychiatry and Neurology, Abu Dhabi, UAE
| | - Lynda Hyland
- Psychology, Middlesex University Dubai, Dubai, UAE
| |
Collapse
|
15
|
Nigussie K, Lemma A, Sertsu A, Asfaw H, Kerebih H, Abdeta T. Depression, anxiety and associated factors among people with epilepsy and attending outpatient treatment at primary public hospitals in northwest Ethiopia: A multicenter cross-sectional study. PLoS One 2021; 16:e0256236. [PMID: 34388228 PMCID: PMC8363019 DOI: 10.1371/journal.pone.0256236] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To assess the magnitude and factors associated with depression and anxiety among people with epilepsy and attending out-patient treatment at central Gondar zone primary public hospitals, northwest, Ethiopia. Method An institutional based cross-sectional study was conducted from May—June, 2020 at central Gondar zone primary public hospitals. A total of 589 participants were chosen by systematic sampling technique. Data was collected by utilizing Amharic version interviewer-administered structured and semi-structured questioners. Depression and anxiety were assessed by using hospital anxiety and depression scale. Bivariate and multivariate logistic regression analysis was done to recognize variables related to both depression and anxiety. Association was described by using “adjusted odds ratio” (AOR) along with 95% full Confidence interval (CI). Finally, P-values < 0.05 in adjusted analysis were taken as a cut off for significant association. Result Out of 556 participants included in the study, 30.9%, 33.1% had depression and anxiety respectively. Being divorced/widowed (AOR = 2.43, 95% CI, 1.18–4.99), using two and above number of antiepileptic medications (AOR = 1.77,95% CI,1.02–3.09), very frequent seizure frequency (AOR = 2.68, 95% CI,1.30–5.51), current substance use (AOR = 1.82, 95% CI, 1.03–3.22), perceived stigma (AOR = 5.67,95% CI,3.14–8.18), and hazardous alcohol use (AOR = 2.84, 95% CI,1.32–6.09) were statistically associated with depression. While, being a single (AOR = 1.65, 95% CI, 1.04–2.63), using two and above number of antiepileptic medications (AOR = 2.27, 95% CI, 1.42–3.62), duration of illness ≥16 years (AOR = 2.82, 95% CI, 1.26–6.31), and perceived stigma (AOR = 2.49, 95% CI, 1.63–3.82) were statistically associated with anxiety at a p-value < 0.05. Conclusion This study showed that the magnitude of depression and anxiety were relatively high among people with epilepsy. Using two and above number of antiepileptic medications and perceived stigma were statistically associated with both depression and anxiety. Screening, early identification and providing appropriate intervention of depression and anxiety among people with epilepsy should be great concern for the health care providers.
Collapse
Affiliation(s)
- Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- * E-mail:
| | - Alemu Lemma
- Department of Psychiatry, School of Medicine, College of Medial and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Addisu Sertsu
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Henock Asfaw
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Habtamu Kerebih
- Department of Psychiatry, School of Medicine, College of Medial and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tilahun Abdeta
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
16
|
Muhigwa A, Preux PM, Gérard D, Marin B, Boumediène F, Ntamwira C, Tsai CH. Comorbidities of epilepsy in low and middle-income countries: systematic review and meta-analysis. Sci Rep 2020; 10:9015. [PMID: 32488109 PMCID: PMC7265529 DOI: 10.1038/s41598-020-65768-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/06/2020] [Indexed: 01/30/2023] Open
Abstract
Epilepsy is a major public health concern in low and middle-income countries (LMICs) and comorbidities aggravate the burden associated with the disease. The epidemiology of these comorbidities has not been well described, although, identifying the main comorbidities of epilepsy, and their relative importance, is crucial for improving the quality of care. Comorbidities were defined as disorders coexisting with or preceding epilepsy, or else compounded or directly attributed to epilepsy or to its treatment. A meta-analysis of the proportion of main comorbidities by subcontinent as well as overall was also conducted. Out of the 2,300 papers identified, 109 from 39 countries were included in this systematic review. Four groups of comorbidities were identified: parasitic and infectious diseases (44% of comorbid conditions), somatic comorbidities (37%), psychosocial (11%), as well as psychiatric comorbidities (8%). Heterogeneity was statistically significant for most variables then random effect models were used. The most frequently studied comorbidities were: neurocysticercosis (comorbid proportion: 23%, 95% CI: 18-29), head trauma (comorbid proportion: 9%, 95% CI: 5-15) malnutrition (comorbid proportion: 16%, 95% CI: 28-40), stroke (comorbid proportion: 1.3%, 95% CI: 0.2-7.0), and discrimination for education (comorbid proportion: 34%, 95% CI: 28-40). Many comorbidities of epilepsy were identified in LMICs, most of them being infectious.
Collapse
Affiliation(s)
- Aline Muhigwa
- INSERM, IRD associated unit, U1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, CHU Limoges, GEIST, 87000, Limoges, France
- Faculté de médecine, Université officielle de Bukavu/1, Avenue Kasongo, Commune d'Ibanda, B.P. 570, Bukavu, Democratic Republic of the Congo
| | - Pierre-Marie Preux
- INSERM, IRD associated unit, U1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, CHU Limoges, GEIST, 87000, Limoges, France.
| | - Daniel Gérard
- INSERM, IRD associated unit, U1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, CHU Limoges, GEIST, 87000, Limoges, France
| | - Benoit Marin
- INSERM, IRD associated unit, U1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, CHU Limoges, GEIST, 87000, Limoges, France
| | - Farid Boumediène
- INSERM, IRD associated unit, U1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, CHU Limoges, GEIST, 87000, Limoges, France
| | - Charles Ntamwira
- Faculté de médecine, Université officielle de Bukavu/1, Avenue Kasongo, Commune d'Ibanda, B.P. 570, Bukavu, Democratic Republic of the Congo
| | - Chung-Huang Tsai
- Department of family medicine, Chung-Kang Branch, Cheng Ching hospital, Taiwan No.966.sec. 4, Taiwan Blvd. Xitun Dist., Taichung, Taiwan, ROC
| |
Collapse
|
17
|
Yang Y, Yang M, Shi Q, Wang T, Jiang M. Risk factors for depression in patients with epilepsy: A meta-analysis. Epilepsy Behav 2020; 106:107030. [PMID: 32248060 DOI: 10.1016/j.yebeh.2020.107030] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 02/04/2020] [Accepted: 03/04/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Depression is common and associated with reduced quality of life (QoL) in people with epilepsy (PWE). Although multiple studies have investigated the relevant predictors, the results have been inconsistent. This meta-analysis aimed to investigate the risk factors that might increase the possibility of depression in this population. METHODS Medline, The Cochrane Library, Web of Science, and Embase were comprehensively searched for cross-sectional studies on the occurrence of depression in PWE. A random effects model was used to calculate the pooled hazard ratios (HRs) and 95% confidence intervals (95% CIs). Heterogeneity between the study results and the probability of publication bias were also assessed. RESULTS Fifty-one cross-sectional studies with sample sizes ranging from 36 to 1763 were included in this meta-analysis. The significant factors associated with an increased risk of depression were older age (odds ratio [OR]: 1.02, 95% CI: 1.00-1.04; p = 0.019), female gender (OR: 1.58, 95% CI: 1.30-1.93; p < 0.001), low education level (OR: 3.38, 95% CI: 2.86-4.00; p < 0.001), not being employed (OR: 1.61, 95% CI: 1.08-2.38; p = 0.019), poor antiepileptic drug (AED) adherence (OR: 2.84, 95% CI: 1.94-4.16; p < 0.001), polytherapy (OR: 2.25, 95% CI: 1.48-3.41; p < 0.001), stigma (OR: 2.22, 95% CI: 1.71-2.88; p < 0.001), and anxiety (OR: 2.21, 95% CI: 1.66-2.94; p < 0.001). A shorter epilepsy duration was significantly associated with a lower risk of depression (OR: 0.99, 95% CI: 0.99-0.99; p < 0.001), whereas marital status (OR: 1.07, 95% CI: 0.90-1.20; p = 0.684), economic level (OR: 1.01, 95% CI: 0.95-1.08; p = 0.684), age at seizure onset (OR: 0.99, 95% CI: 0.75-1.29; p = 0.912), and seizure control (OR: 1.03, 95% CI: 0.65-1.63; p = 0.900) did not increase the risk of depression. CONCLUSION This meta-analysis defined several factors related to an increased risk of depression in PWE and can contribute to better prevention and screening strategies for depression in this group. The mechanisms behind this comorbidity remain to be further investigated to determine individually appropriate and targeted interventions.
Collapse
Affiliation(s)
- Yanhong Yang
- Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China
| | - Mengyang Yang
- Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Qianling Shi
- The First School of Clinical Medicine, The Cochrane Center of Lanzhou University, Lanzhou University, Lanzhou, China
| | - Tiancheng Wang
- The Epilepsy Center, Department of Neurology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China.
| | - Min Jiang
- Beijing Children's Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
18
|
Tareke M, Birehanu M, Amare D, Abate A. Common mental illness among epilepsy patients in Bahir Dar city, Ethiopia: A cross-sectional study. PLoS One 2020; 15:e0227854. [PMID: 31971965 PMCID: PMC6977727 DOI: 10.1371/journal.pone.0227854] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/31/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Common mental illness has a substantial impact on seizure control and negatively affects the overall quality of life among individuals with epilepsy. However, there is a dearth of studies that examined the associated factors of common mental illness among epilepsy patients in Ethiopia, particularly in the study area. This study aimed to assess the magnitude and factors associated with common mental disorders in epilepsy patients who attended government health institutions in Bahir Dar city, Ethiopia. METHOD Health institution based cross-sectional study was conducted using a systematic sampling technique among people living with epilepsy in Bahir Dar City Administration. Common mental illness was assessed using a self-reporting questionnaire and a semi-structured questionnaire was employed to collect data on socio-demographic and clinical related characteristics. Data were analyzed using descriptive statistics, univariate logistic regression, and multivariable logistic regression. RESULTS The magnitude of comorbid common mental illness among people living with epilepsy was found 35.4%. High magnitude of common mental illness was reported among females (39.9%) when compared to males (32.3%). The most prevalent common mental disorders symptoms include being worried, unhappy feeling, trouble thinking clearly, and difficult to enjoy daily activities. Family history of epilepsy, frequent seizures attacks, side effects of antiepileptic drugs, lack of social support and not adherent to antiepileptic drugs were factors associated with common mental illness. CONCLUSIONS Common mental illness was found to be prevalent among people living with epilepsy. Therefore, it is recommended that great attention should be given to mental illness besides controlling seizure attacks.
Collapse
Affiliation(s)
- Minale Tareke
- Psychiatry Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Minychil Birehanu
- Nursing Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Desalegne Amare
- Nursing Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Andargie Abate
- Nursing Department, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| |
Collapse
|
19
|
Siarava E, Markoula S, Pelidou SH, Kyritsis AP, Hyphantis T. Psychological distress symptoms and illness perception in patients with epilepsy in Northwest Greece. Epilepsy Behav 2020; 102:106647. [PMID: 31785484 DOI: 10.1016/j.yebeh.2019.106647] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/25/2019] [Accepted: 10/06/2019] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The purpose of the present study was to compare psychological distress between patients with epilepsy and healthy controls and to evaluate potentially related factors to psychological distress in patients with epilepsy. Furthermore, we assessed how psychological distress and other potential factors mediate illness perception in patients with epilepsy in an urban area of Northwest Greece. MATERIALS AND METHODS A case-control study was conducted in adult patients with epilepsy followed up at the University Hospital of Ioannina and in healthy controls. The Symptom Checklist-90 Revised (SCL-90R) for symptoms of psychological distress and the overall psychological distress Global Severity Index (GSI) evaluation, the brief illness perception questionnaire (B-IPQ), and the Adverse Event Profile (AEP) questionnaire for the antiepileptic drugs (AEDs) were used. RESULTS Seventy patients with epilepsy and 70 controls were recruited in the study. Somatic, depression, and anxiety symptoms and the GSI were higher in patients than in controls. In patients with epilepsy, the AEP score was significantly associated with psychological distress. Illness perception was associated with the number and the total number of administered AEDs; the AEP score; somatic, obsessive, depressive, and anxiety symptoms; and the GSI. After regression analysis, epilepsy characteristics, AEDs, and psychological distress accounted for 11.7%, 28.7%, and 5.5% of variance in BIP-Q score, respectively. CONCLUSION Screening for psychological distress in patients with epilepsy is of high importance in clinical practice as somatic, depression, and anxiety symptoms and overall psychological distress are more severe in patients with epilepsy than in healthy controls. The symptoms of psychological distress are strongly associated with the adverse effects of AEDs. The epilepsy characteristics, the AEDs, and the psychological distress could determine a large part of illness perception in epilepsy, with the adverse effects of AEDs being the strongest predictor.
Collapse
Affiliation(s)
- Eleftheria Siarava
- Department of Neurology, University of Ioannina, University Hospital of Ioannina, Ioannina 45110, Greece.
| | - Sofia Markoula
- Department of Neurology, University of Ioannina, University Hospital of Ioannina, Ioannina 45110, Greece
| | - Sygkliti-Henrietta Pelidou
- Department of Neurology, University of Ioannina, University Hospital of Ioannina, Ioannina 45110, Greece
| | - Athanassios P Kyritsis
- Department of Neurology, University of Ioannina, University Hospital of Ioannina, Ioannina 45110, Greece
| | - Thomas Hyphantis
- Department of Psychiatry, University of Ioannina, University Hospital of Ioannina, Ioannina 45110, Greece
| |
Collapse
|
20
|
Razzak HA, Harbi A, Ahli S. Depression: Prevalence and Associated Risk Factors in the United Arab Emirates. Oman Med J 2019; 34:274-282. [PMID: 31360314 PMCID: PMC6642715 DOI: 10.5001/omj.2019.56] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
A Depression is a prevalent mental healthcare problem and a common cause of disability worldwide. The purpose of this study was to determine the prevalence and risk factors of depression in individuals living in the UAE. We used a systematic review approach, searching PubMed and Scopus electronic databases to collect studies conducted between 2007 and 2017 on the UAE population (both citizens and expatriates) relating to depression. After evaluating and screening relevant articles, a review of 14 articles was conducted. The prevalence of depression and study populations varied widely across studies with some including students and workers and others limited to those with diabetes. The most common contributing factors were female sex, financial difficulties/low socioeconomic status, stressful life events, lack of social support, serious or chronic illness (e.g., diabetes, obesity, epilepsy, multiple sclerosis), and a history of eating disorders. Vitamin D deficiency was also highlighted as a risk factor for seasonal depression. Even though previous evidence has promulgated the role of numerous causative factors, the epidemiological studies including risk factors such as personal or family history of depression, low academic performance, and the use of alcohol remain lacking. Further research is needed to identify effective strategies for treating and preventing depression in the future.
Collapse
Affiliation(s)
- Hira Abdul Razzak
- Statistics and Research Center, Ministry of Health and Prevention, Dubai, UAE
| | - Alya Harbi
- Statistics and Research Center, Ministry of Health and Prevention, Dubai, UAE
| | - Shaima Ahli
- Statistics and Research Center, Ministry of Health and Prevention, Dubai, UAE
| |
Collapse
|
21
|
Depression and quality of life in patients with epilepsy in Northwest Greece. Seizure 2019; 66:93-98. [PMID: 30818183 DOI: 10.1016/j.seizure.2019.02.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The purpose of the present study was to compare depression and QoL between patients with epilepsy and healthy controls, evaluating potentially related factors to depression and QoL in patients with epilepsy in Northwest Greece. METHODS A case study was conducted in adult patients with epilepsy followed up at the University Hospital of Ioannina and in healthy controls. The Patient Health Questionnaire (PHQ-9) for depression's severity evaluation, the WHOQOL-BREF questionnaire for the QoL estimation and the Adverse Event Profile (AEP) questionnaire for the Antiepileptic Drugs (AEDs) adverse effects assessment were used. RESULTS Seventy patients with epilepsy and 70 controls were recruited. The PHQ-9 score was higher in patients compared to controls and slightly higher than reported in patients with epilepsy. PHQ-9 was significantly associated with the AEP score. Our patients had a poorer QoL compared to controls. The level of education, the AEP and the PHQ-9 scores were associated to QoL, the last two being the most powerful predictors of QoL. CONCLUSION Patients with epilepsy in Northwest Greece had higher rates of depression than reported in patients with epilepsy and poorer QoL compared to controls. The adverse effects of AEDs were related to depression in our study, while the adverse effects of AEDs and depression were more powerful predictors of QoL compared to demographics and other characteristics of epilepsy.
Collapse
|
22
|
Alsaadi T, Kassie S, Mohamed Ali O, Mozahem K, Al Fardan S, Ahmed AM. Psychiatric Comorbidity in Neurological Disorders: Towards a Multidisciplinary Approach to Illness Management in the United Arab Emirates. Front Psychiatry 2019; 10:263. [PMID: 31073293 PMCID: PMC6495369 DOI: 10.3389/fpsyt.2019.00263] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 04/08/2019] [Indexed: 01/03/2023] Open
Abstract
Aim: To determine the prevalence of mood and anxiety disorders in undiagnosed patients attending neurological services, and detect rates of referral to and attendance of psychiatric services. Methods: Depressive symptoms and anxiety were assessed in 395 adult patients with primary diagnoses of neurological disorders. The Patient Health Questionnaire nine-item depression scale (PHQ-9), and Generalized Anxiety Disorder seven-item scale (GAD-7) were administered. Demographic details of the patients were recorded. Referral to and attendance of psychiatric services were recorded for patients scoring within the clinical range of depression and anxiety disorders (scores > 10). Results: There was a 39% prevalence rate of depressive symptoms, 34% rate of anxiety, and 35.4% concurrent rate of both disorders in this cohort. The referral rate to psychiatric services was 33.6%, and attendance rate was 47.8%. There was significant association between severity of psychiatric symptoms and referral to psychiatric services, as well as significant association between comorbid psychiatric symptoms and attendance to psychiatric services. Conclusion: Our results indicate similar prevalence rates of comorbid psychiatric symptoms to studies carried out in the Middle East and North Africa (MENA) region and relatively high attendance and referral rates to psychiatric services. Implications: The results shed light on the clinical profile of patients in this region and support the need for integrated collaborative medical services. Moreover, findings have important implications for health care policies pertaining to resource distribution and funding.
Collapse
Affiliation(s)
- Taoufik Alsaadi
- Department of Neurology, Psychiatry, American Center for Psychiatry and Neurology, Abu Dhabi, United Arab Emirates
| | - Seada Kassie
- Department of Neurology, Psychiatry, American Center for Psychiatry and Neurology, Abu Dhabi, United Arab Emirates
| | - Ola Mohamed Ali
- Department of Neurology, Psychiatry, American Center for Psychiatry and Neurology, Abu Dhabi, United Arab Emirates
| | - Khaldoun Mozahem
- Department of Neurology, Psychiatry, American Center for Psychiatry and Neurology, Abu Dhabi, United Arab Emirates
| | - Safana Al Fardan
- Department of Education - Medical Affairs, Shaikh Khalifa Medical Center, Abu Dhabi, United Arab Emirates
| | - Ahmed M Ahmed
- Department of Neurology, Psychiatry, American Center for Psychiatry and Neurology, Abu Dhabi, United Arab Emirates
| |
Collapse
|
23
|
Baker DA, Caswell HL, Eccles FJR. Self-compassion and depression, anxiety, and resilience in adults with epilepsy. Epilepsy Behav 2019; 90:154-161. [PMID: 30557784 DOI: 10.1016/j.yebeh.2018.11.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Research suggests that people with epilepsy (PWE) are more likely to experience depression and anxiety than the general population. Given the adversity associated with the condition, resilience may also be important. However, to date, resilience has been largely overlooked in the epilepsy literature. Self-compassion has been widely associated with improved psychological wellbeing and, to a lesser extent, resilience. However, the relationship between self-compassion and depression, anxiety, and resilience in PWE has not been examined. OBJECTIVES Using a quantitative cross-sectional survey design, the aim of the present study was to examine the extent to which self-compassion predicted depression, anxiety, and resilience when controlling for demographic and illness-related variables. METHODS Adults with epilepsy were invited to take part in a survey online or in epilepsy or neurology clinics. Two-hundred and seventy participants completed the survey, and data were analyzed using hierarchical multiple regression models. RESULTS In this sample of PWE, self-compassion significantly predicted lower depression and anxiety and higher resilience when other significant sociodemographic and illness-related variables had been taken into account. CONCLUSIONS The findings of the present study indicate that self-compassion could be an important factor in determining psychological outcomes for adults with epilepsy, and its role is worthy of further exploration to help improve psychological outcomes for PWE.
Collapse
Affiliation(s)
- David A Baker
- Division of Health Research, Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster LA1 4YG, UK
| | - Helen L Caswell
- Department of Clinical Neuropsychology, Clinical Sciences Building, Salford Royal NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
| | - Fiona J R Eccles
- Division of Health Research, Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster LA1 4YG, UK.
| |
Collapse
|
24
|
Wang HJ, Tan G, Deng Y, He J, He YJ, Zhou D, Liu L. Prevalence and risk factors of depression and anxiety among patients with convulsive epilepsy in rural West China. Acta Neurol Scand 2018; 138:541-547. [PMID: 30125939 DOI: 10.1111/ane.13016] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 07/25/2018] [Accepted: 08/06/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To explore the prevalence and risk factors of depression and anxiety in patients with convulsive epilepsy (PWE) in rural West China. METHODS PWE from rural West China were evaluated for depression and anxiety with the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E; Chinese version) and the Generalized Anxiety Disorder-7 (GAD-7; Chinese version). We also assessed their quality of life using the Quality of Life in Epilepsy Inventory (QOLIE-31) and their level of social support using the Social Support Rating Scale (SSRS). We used logistic regression analysis to identify independent risk factors of depression and anxiety and analysis of variance (ANOVA) to investigate the association between quality of life and depression and anxiety. RESULTS Of the 458 PWE in our study, 33.4% have anxiety and 52.6% have depression. SSRS (P = 0.03) and seizure frequency (P = 0.007) are independent risk factors of anxiety, and annual income of the patients (P < 0.001) is an independent risk factor of depression. PWE with both depression and anxiety have significantly lower QOLIE-31 total and subtotal scores. CONCLUSIONS PWE have a high prevalence of depression and anxiety in rural West China, which may be impacting their quality of life. PWE with depression and anxiety got a worse quality of life, and depression had a greater impact on quality of life for PWE than anxiety. The risk factors of depression and anxiety include seizure frequency and social support, while annual income is an additional risk factor of depression. Identifying risk factors early may be helpful in the timely management of these symptoms.
Collapse
Affiliation(s)
- Hai-Jiao Wang
- Department of Neurology; West China Hospital; Sichuan University; Chengdu China
| | - Ge Tan
- Department of Neurology; West China Hospital; Sichuan University; Chengdu China
| | - Ying Deng
- Sichuan Center of Disease Control and Prevention; Chengdu Sichuan China
| | - Jun He
- Sichuan Center of Disease Control and Prevention; Chengdu Sichuan China
| | - Yu-Jin He
- Sichuan Center of Disease Control and Prevention; Chengdu Sichuan China
| | - Dong Zhou
- Department of Neurology; West China Hospital; Sichuan University; Chengdu China
| | - Ling Liu
- Department of Neurology; West China Hospital; Sichuan University; Chengdu China
| |
Collapse
|
25
|
Munger Clary HM, Snively BM, Hamberger MJ. Anxiety is common and independently associated with clinical features of epilepsy. Epilepsy Behav 2018; 85:64-71. [PMID: 29908386 PMCID: PMC6093217 DOI: 10.1016/j.yebeh.2018.05.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/12/2018] [Accepted: 05/12/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to assess for independent association of anxiety symptoms with epilepsy localization and other epilepsy-related and demographic factors in a large tertiary care adult epilepsy population. METHODS Among 540 adults, anxiety was measured by the Symptom Checklist 90-R (SCL-90R) anxiety subscale, and detailed demographics, epilepsy localization, and depression scores (SCL-90R) were collected. High anxiety was defined by SCL-90R anxiety T-score ≥ 60. Stepwise multiple logistic regression was carried out to assess for independent association of high anxiety scores with demographic and clinical factors. RESULTS High anxiety symptoms were present in 46.1% of participants (N = 250). Focal or unknown epilepsy type and depression scores were independently associated with high anxiety (adjusted odds ratios (OR): 2.89 (95% confidence interval [CI] = 1.33-6.29, p = 0.007) and 2.12 (95% CI = 1.83-2.45, p < 0.001), respectively; depression odds per 5-point increase in scale). Among the focal epilepsy subpopulation, mesial temporal sclerosis was also independently associated with high anxiety, with adjusted OR: 2.12 (95% CI = 1.11-4.04, p = 0.023). Lower education, non-white race/ethnicity, Spanish native language, prior head trauma, antiseizure drug polytherapy, and left focus or bilateral foci (in focal epilepsy) were associated with high anxiety in simple logistic regression, but these associations were not independent. A total of 46 individuals (18.4% of those with high anxiety) scored high for anxiety but not depression. Only 26% of those with high anxiety symptoms were taking a potentially anxiolytic medication. CONCLUSION Anxiety symptoms, often without concomitant depression, were highly prevalent in this epilepsy sample and independently associated with focal/unknown epilepsy and mesial temporal sclerosis. These results strongly support the value of screening specifically for anxiety in the epilepsy clinic, to direct patients to appropriate treatment.
Collapse
Affiliation(s)
- Heidi M. Munger Clary
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A
| | - Beverly M. Snively
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A
| | - Marla J. Hamberger
- Department of Neurology, Columbia University Medical Center, New York, New York, U.S.A
| |
Collapse
|
26
|
Asadi-Pooya AA, Kanemoto K, Kwon OY, Taniguchi G, Dong Z, Chinvarun Y, Yu HY, McGonigal A, Kanner AM, Park SP. Depression in people with epilepsy: How much do Asian colleagues acknowledge it? Seizure 2018; 57:45-49. [DOI: 10.1016/j.seizure.2018.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/08/2018] [Accepted: 03/10/2018] [Indexed: 10/17/2022] Open
|
27
|
Alsaadi T, Kassie S, El Hammasi K, Shahrour TM, Shakra M, Turkawi L, Nasreddine W, Raoof M. Potential factors impacting health-related quality of life among patients with epilepsy: Results from the United Arab Emirates. Seizure 2017; 53:13-17. [PMID: 29096164 DOI: 10.1016/j.seizure.2017.10.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 10/18/2017] [Accepted: 10/21/2017] [Indexed: 11/17/2022] Open
Abstract
PURPOSE to investigate potential factors impacting HRQOL among PWE at a medical facility in the UAE. METHODS Depression, anxiety, and health-related quality of life were assessed in 160 adult patients with epilepsy from September 2014 to January 2015 at Sheikh Khalifa Medical City (SKMC). The World Health Organization Quality of Life abbreviated scale (WHOQOL-BREF), the Patient Health Questionnaire nine-item (PHQ-9) depression scale, and Generalized Anxiety Disorder seven-item (GAD-7) scale were administered. Demographic details including psychosocial factors were also obtained. Clinical details including seizure freedom, epilepsy type, epilepsy duration, and magnetic resonance imaging (MRI) results were recorded. Multivariate analysis was used to look at significant variables associated with HRQOL. RESULTS Depression, anxiety, seizure freedom, and the use of anti-depressants had significant positive correlation with HRQOL in univariate analysis. However, depression, followed by seizure freedom, had the strongest association with HRQOL in a multivariate regression analysis. CONCLUSION Depression and seizure freedom, followed by anxiety and anti-depressants use, were significantly correlated with HRQOL. These results underscore the importance of screening for psychiatric comorbidities in patients with epilepsy. IMPLICATIONS Screening for comorbid psychiatric disorders should be an essential component of the standard of care, and incorporated in the treatment plan for all patients with epilepsy. Factors contributing to psychiatric symptoms among PWE, such as maladaptive illness perceptions, non-adherence to anti-epileptic drugs (AED), and social stigma should be carefully addressed to achieve an optimal health-care plan.
Collapse
Affiliation(s)
- Taoufik Alsaadi
- American Center for Psychiatry & Neurology, Abu Dhabi, United Arab Emirates.
| | - Seada Kassie
- American Center for Psychiatry & Neurology, Abu Dhabi, United Arab Emirates
| | - Khadija El Hammasi
- Department of Psychiatry, Sheikh Khalifa Medical City (SKMC), Abu Dhabi, United Arab Emirates
| | - Tarek M Shahrour
- Department of Psychiatry, Sheikh Khalifa Medical City (SKMC), Abu Dhabi, United Arab Emirates
| | - Mustafa Shakra
- Department of Neurology, Sheikh Khalifa Medical City (SKMC), Abu Dhabi, United Arab Emirates
| | - Lamya Turkawi
- Department of Neurology, Sheikh Khalifa Medical City (SKMC), Abu Dhabi, United Arab Emirates
| | - Wassim Nasreddine
- Department of Neurology, American University of Beirut-Medical center 7, Lebanon, Lebanon
| | - Mufeed Raoof
- Department of Psychiatry, Sheikh Khalifa Medical City (SKMC), Abu Dhabi, United Arab Emirates
| |
Collapse
|
28
|
Factors predictive of late remission in a cohort of Chinese patients with newly diagnosed epilepsy. Seizure 2016; 37:20-4. [PMID: 26921482 DOI: 10.1016/j.seizure.2016.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/05/2016] [Accepted: 02/12/2016] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Limited data have focused on predictive factors of late remission in patients with newly diagnosed epilepsy. We are aiming to identify prognostic predictors of late remission in a prospective cohort of Chinese patients. METHODS Patients with newly diagnosed epilepsy were included from 2009 to September 2012 at a tertiary hospital, with follow-up of at least two years. Early remission was defined by seizure free either immediately or within six months of treatment initiation, late remission was defined by seizure free achieved after more than six months. All analyses were performed with SPSS 13.0 software. RESULTS A total of 223 patients were included, and followed for an average of 43 months. 115 patients (51.6%) achieved early remission and 39 patients (17.5%) achieved late remission. Multivariable logistic regression analysis demonstrated more than 3 seizures prior to treatment (OR=3.12, 95% CI 1.39-7.04, p=0.006) and multiple seizure types (OR=2.49, 95% CI 1.02-6.11, p=0.046) may predict late remission. However, nonadherence was not significantly associated with late remission. CONCLUSION Patients with a high frequency of seizures prior to treatment or multiple seizure types may achieve late remission. Particular consideration should be given to these patients.
Collapse
|
29
|
Wiglusz MS, Landowski J, Michalak L, Cubała WJ. Reevaluating the prevalence and diagnostic subtypes of depressive disorders in epilepsy. Epilepsy Behav 2015; 53:15-9. [PMID: 26515153 DOI: 10.1016/j.yebeh.2015.09.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/20/2015] [Accepted: 09/21/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Depressive disorders are common among patients with epilepsy (PWE). The aim of this study was to estimate the prevalence of different forms of depressive disorders among PWE treated in the outpatient setting. METHODS A group of consecutive PWE that visited the epilepsy outpatient clinic was invited to participate in the study. Ninety-six patients met inclusion criteria and were examined by a trained psychiatrist using standardized measures. RESULTS A diagnosis of a current major depression was established in 21 (22.3%) out of 96 participants. Furthermore, almost 20% of the study group fulfilled criteria for mood disorder categories other than MDD, adding up to over 40% of PWE suffering from any mood disorder category. Older age and later age at seizure onset, as well as unemployment, were associated with an increase in the odds of MDD diagnosis. STUDY LIMITATIONS A number of limitations are to be considered: the sample size is relatively small, and the findings may not be representative of PWE in general because our population represents a sample coming from a single outpatient clinic with a higher ratio of drug-resistant epilepsy. CONCLUSIONS Major depression as well as other forms of depressive disorders are common among PWE. Unemployment, age, and age at seizure onset are important factors associated with major depression among PWE.
Collapse
Affiliation(s)
| | - Jerzy Landowski
- Department of Psychiatry, Medical University of Gdańsk, Poland
| | - Lidia Michalak
- Regional Epilepsy Outpatient Unit, Copernicus Hospital, Gdańsk, Poland
| | | |
Collapse
|
30
|
Depression and Anxiety among Patients with Epilepsy and Multiple Sclerosis: UAE Comparative Study. Behav Neurol 2015; 2015:196373. [PMID: 26576071 PMCID: PMC4631862 DOI: 10.1155/2015/196373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/02/2015] [Accepted: 10/13/2015] [Indexed: 11/18/2022] Open
Abstract
Depression and anxiety are highly prevalent in patients with epilepsy (PWE), with prevalence rates ranging from 20% to 55%. The cause of this increased rate is multifactorial. Depression and epilepsy are thought to share the same pathogenic mechanism. Anxiety, on the other hand, seems to have a prevalence rate among PWE comparable to, or even higher than, those reported for depression, and it is closely linked to epilepsy. To test this hypothesis, we screened for depression and anxiety 186 and 160 patients attending the epilepsy and MS clinics, respectively, using standardized screening tools to determine the rates of both depression and anxiety, comparing these rates to 186 age, sex matched controls. Among the three groups, only patients with epilepsy were at increased risk of having depression (OR = 1.9), whereas anxiety was not. This finding could point to the shared pathogenic mechanisms hypothesis between depression and epilepsy.
Collapse
|