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Panahi P, Zafardoust H, Mirzohreh ST, Khamnian Z, Alizadeh M. The study of mental health status of people with epilepsy during the COVID-19 pandemic: A systematic review and meta-analysis study. Epilepsy Behav 2024; 157:109834. [PMID: 38852496 DOI: 10.1016/j.yebeh.2024.109834] [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: 01/10/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION The COVID-19 pandemic has affected the lives of people with epilepsy (PWE) in various ways. This systematic review and meta-analysis aims to assess the mental health status and prevalence of mental disorders including depression, anxiety, stress, and psychological distress among PWE. Furthermore, this study evaluates changes in sleep patterns and presence of sleep disturbances among them. The findings of this systematic review can help health organizations, policymakers, and health workers to better prepare and respond to future health crises for PWE and other chronic disease patients. METHOD This systematic review was prepared using PRISMA reporting guidelines. We systematically searched PubMed, Web of Science, Scopus and Cochrane Library databases for studies that reported data on mental health parameters including depression, anxiety, stress, psychological distress, quality of life, and sleep quality, during the pandemic until May 2023. The analytical procedures were executed through the utilization of Comprehensive Meta-Analysis (CMA) software. RESULTS In our study, a total of 61 carefully selected studies were analyzed, yielding valuable insights into the prevalence and impact of various mental health indicators among PWE. The findings revealed that a significant proportion of PWE experienced distressing psychological symptoms, with depression being reported by 34% of participants. Additionally, anxiety was prevalent among 43% of individuals, while stress symptoms were reported by 49% of respondents. Moreover, a substantial portion of PWE, approximately 38%, reported experiencing poor sleep quality, further underscoring the multifaceted nature of the challenges faced by this population. These findings highlight the need for targeted interventions and comprehensive support systems to address the mental health concerns and sleep disturbances faced by individuals living with epilepsy. CONCLUSION The findings revealed that a substantial number of PWE experience symptoms of depression, anxiety, stress, and poor sleep quality. These results emphasize the importance of considering mental health and sleep assessments as integral components of care for individuals with epilepsy. The study underscores the need for further research and targeted interventions to address the mental health burden faced by this population. By prioritizing and addressing these challenges, healthcare providers can enhance the overall well-being and quality of life for individuals living with epilepsy.
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Affiliation(s)
| | | | | | - Zhila Khamnian
- Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahasti Alizadeh
- Faculty of Medicine, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Iran.
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Mc Carthy L, Mathew B, Blank LJ, Van Hyfte G, Gotlieb E, Goldstein J, Agarwal P, Kwon CS, Singh A, Fields M, Marcuse L, Yoo JY, Sivarak E, Gururangan K, Navis A, Jetté N. Health care access, psychosocial outcomes and mental health in adults living with epilepsy during the COVID-19 pandemic. Epilepsy Behav 2024; 151:109617. [PMID: 38219607 DOI: 10.1016/j.yebeh.2023.109617] [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: 09/16/2023] [Revised: 12/01/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE People living with epilepsy (PLWE) have a higher prevalence of mental health comorbidities and poorer psychosocial outcomes compared to the general population. The aim of this study was to examine psychosocial outcomes, mental health, healthcare accessibility, and seizure burden in PLWE during the COVID-19 pandemic. METHODS We conducted a cross-sectional study of adults with epilepsy treated in an urban multicenter health system from 2021 to 2022. A standardized questionnaire assessed for COVID-19 history, comorbidities, access to antiseizure medications (ASMs) and neurological care, seizure burden, and psychosocial outcomes (e.g., employment, social and financial support). The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were administered to evaluate for depression and anxiety. Frequency and proportions for categorical variables and median and interquartile ranges for continuous variables were calculated. RESULTS Fifty-five PLWE participated (95 % response rate). Median age was 40 years (IQR 31.5-66.5), 61.8 % were women, 47.3 % had a bachelor's degree or higher and 29.1 % each had Medicaid and Medicare insurance. Race (from highest to lowest %) was: 32.7 % White, 20 % Black, 20 % Latinx, 14.5 % Asian, and 12.7 % selected "other" or "prefer not to say." COVID-19 had been diagnosed in 21.8 % of participants. Symptoms of anxiety and depression were self-reported by 43.6 % and 34.5 % of patients, respectively, with many describing this symptom as new post-pandemic (37.5 % and 31.6 %, respectively). Using validated scales, 52.7 % had depression (PHQ-9 score ≥ 5) with 30.9 % having moderate/severe depression (PHQ-9 score ≥ 10), while 29.1 % had probable generalized anxiety disorder (GAD-7 score ≥ 8). Seizure burden increased in 21.8 % of participants, while 20 % reported fewer seizures and 29.1 % were seizure free since the COVID-19 pandemic. Economic impacts of the pandemic included job loss (25 % amongst those employed at onset of pandemic), new or worsened financial difficulties (40 %), and new or worsened social support issues (30.9 %). Of all participants, 18.2 % reported difficulties accessing ASMs and 25.5 % cancelled visits, but of those with cancelled visits, 78.6 % had their appointments rescheduled as a telehealth visit. CONCLUSION Our cohort of PLWE experienced some challenges during the COVID-19 pandemic including poorer mental health and financial and employment-related stressors. Encouragingly, healthcare access was relatively spared during the COVID-19 crisis, with some patients even reporting a reduction in seizure burden. However, PLWE require ongoing psychosocial support with particular attention to decompensation of mental health and social stressors that may be exacerbated by the COVID-19 pandemic.
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Affiliation(s)
- L Mc Carthy
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - B Mathew
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - L J Blank
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA; Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - G Van Hyfte
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E Gotlieb
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - J Goldstein
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - P Agarwal
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA; Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C S Kwon
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA; Department of Neurosurgery, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - A Singh
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - M Fields
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - L Marcuse
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - J Y Yoo
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - E Sivarak
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - K Gururangan
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - A Navis
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - N Jetté
- Department of Clinical Neurosciences, Calgary Zone, Alberta Health Services, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2T9, Canada.
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Lu Q, Dun S, Wang QH, Wang YY, Chen HM, Zhang Q, Zou LP. Challenges in the Management of Children and Adolescents With Epilepsy in China During the COVID-19 Pandemic: An Online Survey-Based Study. J Child Neurol 2023; 38:590-596. [PMID: 37624690 DOI: 10.1177/08830738231193229] [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] [Indexed: 08/27/2023]
Abstract
INTRODUCTION To investigate the challenges in the management of children and adolescents with epilepsy in China during the coronavirus disease (COVID-19) pandemic. METHODS We conducted a cross-sectional survey among 845 patients with epilepsy using an online-based questionnaire. The questionnaire focused on sociodemographic characteristics, epilepsy-related conditions, health care access, COVID-19 vaccination, and the mental health of caregivers. Depression was assessed using Patient Health Questionnaire-9. RESULTS During the pandemic, 24.73% of the patients had increased seizures. The majority of patients (68.89%) experienced difficulty obtaining antiseizure medications. In addition, 94.79% of the patients had difficulty consulting a doctor. A total of 52.78% of the patients selected telemedicine services, and most found these services to be helpful. Moreover, 76.11% of the patients failed to complete the COVID-19 vaccination. More than half of the caregivers had anxiety and depressive symptoms. The risk factors for depression comprised irregularity in taking antiseizure medications, difficulty in obtaining antiseizure medications, and failure to consult a doctor on time. CONCLUSIONS The COVID-19 pandemic presented a great challenge in the management of children and adolescents with epilepsy in China. The findings highlight the importance of improving health care systems and medication management and the mental health of their caregivers.
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Affiliation(s)
- Qian Lu
- Medical School of Chinese PLA, Beijing, China
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shuo Dun
- Medical School of Chinese PLA, Beijing, China
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qiu-Hong Wang
- Medical School of Chinese PLA, Beijing, China
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yang-Yang Wang
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hui-Min Chen
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Qi Zhang
- Medical School of Chinese PLA, Beijing, China
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Li-Ping Zou
- Medical School of Chinese PLA, Beijing, China
- Department of Pediatrics, the First Medical Center of Chinese PLA General Hospital, Beijing, China
- Beijing Institute for Brain Disorders, Center for Brain Disorders Research, Capital Medical University, Beijing, China
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Bonakdarpour B, Zhou G, Huang D, Vidano CT, Schuele S, Zelano C, Takarabe C. Calming effect of Clinically Designed Improvisatory Music for patients admitted to the epilepsy monitoring unit during the COVID-19 pandemic: a pilot study. Front Neurol 2023; 14:1206171. [PMID: 37731858 PMCID: PMC10507627 DOI: 10.3389/fneur.2023.1206171] [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: 04/15/2023] [Accepted: 08/04/2023] [Indexed: 09/22/2023] Open
Abstract
Background Epilepsy monitoring requires simulating seizure-inducing conditions which frequently causes discomfort to epilepsy monitoring unit (EMU) patients. COVID-19 hospital restrictions added another layer of stress during hospital admissions. The purpose of this pilot study was to provide evidence that live virtual Clinically Designed Improvisatory Music (CDIM) brings relief to EMU patients for their psychological distress. Methods Five persons with epilepsy (PWEs) in the EMU during the COVID-19 lockdown participated in the study (average age ± SD = 30.2 ± 6 years). Continuous electroencephalogram (EEG) and electrocardiogram (EKG) were obtained before, during, and after live virtual CDIM. CDIM consisted of 40 minutes of calming music played by a certified clinical music practitioner (CMP) on viola. Post-intervention surveys assessed patients' emotional state on a 1-10 Likert scale. Alpha/beta power spectral density ratio was calculated for each subject across the brain and was evaluated using one-way repeated analysis of variance, comparing 20 minutes before, during, and 20 minutes after CDIM. Post-hoc analysis was performed using paired t-test at the whole brain level and regions with peak changes. Results Patients reported enhanced emotional state (9 ± 1.26), decrease in tension (9.6 ± 0.49), decreased restlessness (8.6 ± 0.80), increased pleasure (9.2 ± 0.98), and likelihood to recommend (10 ± 0) on a 10-point Likert scale. Based on one-way repeated analysis of variance, alpha/beta ratio increased at whole-brain analysis (F3,12 = 5.01, P = 0.018) with a peak in midline (F3,12 = 6.63, P = 0.0068 for Cz) and anterior medial frontal region (F3,12 = 6.45, P = 0.0076 for Fz) during CDIM and showed a trend to remain increased post-intervention. Conclusion In this pilot study, we found positive effects of CDIM as reported by patients, and an increased alpha/beta ratio with meaningful electroencephalographic correlates due to the calming effects in response to CDIM. Our study provides proof of concept that live virtual CDIM offered demonstrable comfort with biologic correlations for patients admitted in the EMU during the COVID-19 pandemic.
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Affiliation(s)
- Borna Bonakdarpour
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
| | - Guangyu Zhou
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Daniel Huang
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
| | - Catherine T. Vidano
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
| | - Stephan Schuele
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Christina Zelano
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Clara Takarabe
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Feinberg School of Medicine, Mesulam Center for Cognitive Neurology and Alzheimer’s Disease, Northwestern University, Chicago, IL, United States
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Gómez-Restrepo C, Cepeda M, Torrey WC, Suarez-Obando F, Uribe-Restrepo JM, Park S, Acosta MPJ, Camblor PM, Castro SM, Aguilera-Cruz J, González L, Chaparro N, Gómez-Gamez AM, Bell K, Marsch LA. Perceived access to general and mental healthcare in primary care in Colombia during COVID-19: A cross-sectional study. Front Public Health 2022; 10:896318. [PMID: 36159257 PMCID: PMC9490130 DOI: 10.3389/fpubh.2022.896318] [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: 03/14/2022] [Accepted: 08/19/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction The COVID-19 pandemic has had an impact both in general and mental healthcare, challenged the health systems worldwide, and affected their capacity to deliver essential health services. We aimed to describe perceived changes in ease of access to general and mental healthcare among patients with a diagnosis of depression and/or unhealthy alcohol use in Colombia. Methods This study is embedded in the DIADA project, a multicenter implementation research study aimed at evaluating the integration of mental healthcare in primary care in Colombia. Between November 2020 and August 2021, we conducted a COVID-19 pandemic impact assessment in a cohort of participants with newly diagnosed depression and/or unhealthy alcohol use part of DIADA project. We assessed the ease of access and factors related to perceived ease of access to general or mental healthcare, during the COVID-19 pandemic. Results 836 participants completed the COVID-19 pandemic impact assessment. About 30% of participants considered their mental health to be worse during the pandemic and 84.3% perceived access to general healthcare to be worse during the pandemic. Most of participants (85.8%) were unable to assess access to mental health services, but a significant proportion considered it to be worse. Experiencing worse ease of access to general healthcare was more frequent among women, patients with diagnosis of depression, and patients with comorbidities. Experiencing worse ease of access to mental healthcare was more frequent among patients aged between 30 and 49.9 years, from socioeconomic status between 4 and 6, affiliated to the contributive social security regime, attending urban study sites, and those who perceived their mental health was worse during the pandemic. Discussion Despite the overall perception of worse mental health during the pandemic, the use of mental healthcare was low compared to general healthcare. Ease of access was perceived to be worse compared to pre-pandemic. Ease of access and access were affected by geographical study site, socioeconomic status, age and gender. Our findings highlight the need for improved communication between patients and institutions, tailored strategies to adapt the healthcare provision to patients' characteristics, and continued efforts to strengthen the role of mental healthcare provision in primary care.
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Affiliation(s)
- Carlos Gómez-Restrepo
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia,Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Magda Cepeda
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia,*Correspondence: Magda Cepeda
| | - William C. Torrey
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | | | | | - Sena Park
- Center for Technology and Behavioral Health, Dartmouth College, Lebanon, NH, United States
| | - María Paula Jassir Acosta
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Pablo Martínez Camblor
- Center for Technology and Behavioral Health, Dartmouth College, Lebanon, NH, United States
| | - Sergio M. Castro
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Jeny Aguilera-Cruz
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Lilian González
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Natalia Chaparro
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Ana María Gómez-Gamez
- Departamento de Epidemiología Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Kathleen Bell
- Center for Technology and Behavioral Health, Dartmouth College, Lebanon, NH, United States
| | - Lisa A. Marsch
- Center for Technology and Behavioral Health, Dartmouth College, Lebanon, NH, United States
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Karakas C, Ward R, Hegazy M, Skrehot H, Haneef Z. Seizure control during the COVID-19 pandemic: Correlating Responsive Neurostimulation System data with patient reports. Clin Neurophysiol 2022; 139:106-113. [PMID: 35598434 PMCID: PMC9090858 DOI: 10.1016/j.clinph.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 04/13/2022] [Accepted: 05/02/2022] [Indexed: 01/08/2023]
Abstract
Objective To understand the impact of the Coronavirus Disease-2019 (COVID-19) pandemic on seizure frequency in persons with epilepsy with a Responsive Neurostimulation (RNS) system implanted. Methods Weekly long episode counts (LEC) were used as a proxy for seizures for six months pre-COVID-19 and during the COVID-19 period. Telephone surveys and chart reviews were conducted to assess patient mental health during the pandemic. The change in LEC between the two time periods was correlated to reported stressors. Results Twenty patients were included. Comparing the pre-COVID-19 period to the COVID-19 period, we found that only 5 (25%) patients had increased seizures, which was positively correlated with change in anti-seizure medications (ASM, p = 0.03) and bitemporal seizures (p = 0.03). Increased seizures were not correlated to anxiety (p = 1.00), depression (p = 0.58), and sleep disturbances (p = 1.00). The correlation between RNS-detected and patient-reported seizures was poor (p = 0.32). Conclusions Most of our patients did not have an increase in seizures following the COVID-19 pandemic. Changes in ASM and bitemporal seizures were positively correlated to increased LEC. There was no correlation between pandemic-related stress and seizures in those found to have increased seizures. Significance This is the first study correlating RNS-derived objective LECs with patient self-reports and potential seizure risk factors during the COVID-19 pandemic.
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Affiliation(s)
- Cemal Karakas
- Division of Pediatric Neurology, Department of Neurology, University of Louisville, Louisville, KY 40202, USA; Norton Children's Medical Group, Louisville, KY 40202, USA.
| | - Ryan Ward
- Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Mohamed Hegazy
- Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Henry Skrehot
- Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Zulfi Haneef
- Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA; Neurology Care Line, VA Medical Center, Houston, TX 77030, USA
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Sehlo MG, Mohamed WS, Youssef UM, Lotfi SE, El-deen GMS. Prevalence and determinants of depression in patients with epilepsy during the COVID-19 pandemic. MIDDLE EAST CURRENT PSYCHIATRY 2022. [PMCID: PMC8921700 DOI: 10.1186/s43045-022-00190-4] [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: 12/04/2022] Open
Abstract
Background Epilepsy is one of the commonest and most serious neurological conditions. It is frequently associated with one or more medical or psychiatric comorbidities. Depression is one of the most common comorbidities. Patients with epilepsy (PWE) are expected to suffer from a high level of depression during the COVID-19 pandemic. This cross-sectional study was applied to 290 PWE. Data was collected by personal interviews with each patient using the Patient Health Questionnaire 9 (PHQ 9) scale for the diagnosis of depression and assessing its severity. We aimed to assess the prevalence and the risk factors of depression in PWE during the COVID-19 pandemic. Results We found that 70.3% of PWE suffered from depression. Low financial status, refractory seizures, fear of infection and death by COVID-19, had close relatives died by COVID-19, had a sleep disturbance, a decreased family support, increased seizure rate during the pandemic, increased ER visits during the pandemic, lack of drug adherence, and decreased epilepsy-related follow-up visits during the pandemic were significantly associated with increased risk of depression in PWE during the pandemic. Conclusions The COVID-19 pandemic has a serious effect on the psychological and physical well-being of PWE. There was an increased rate of depression during the COVID-19 pandemic in PWE with its subsequent burden on those patients. So, these patients are in a high need of care and support during the pandemic.
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Sammarra I, Martino I, Caligiuri ME, Giugno A, Fortunato F, Labate A, Gambardella A. The impact of one-year COVID-19 containment measures in patients with mesial temporal lobe epilepsy: A longitudinal survey-based study. Epilepsy Behav 2022; 128:108600. [PMID: 35151188 PMCID: PMC8801317 DOI: 10.1016/j.yebeh.2022.108600] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND We assessed levels of depression, anxiety, stress, anhedonia, somatization, psychological distress, sleep, and life quality in patients with mesial temporal lobe epilepsy (MTLE) after one year of containment measures started in Italy to stem the COVID-19 pandemic. METHODS We consecutively enrolled 51 patients with MTLE, administering an online survey that compared the year before and after the COVID-19 propagation. We analyzed clinical data (e.g., seizure frequency, life quality) and neuropsychological assessment through Somatic Symptom Scale-8 (SSS-8), Beck Depression Inventory (BDI-2), State-Trait Anxiety Inventory (STAI-Y), Depression, Anxiety and Stress Scale (DASS-21), Pittsburgh Sleep Quality Index (PSQI), Snaith-Hamilton Pleasure Scale (SHAPS), Impact of Event Scale-Revised (IES-R). The BDI-2 and STAI-Y scores were compared to those acquired in the same patients before the COVID-19 outbreak. RESULTS Comparing our population with MTLE before and after COVID-19 outbreak, we found a significant worsening in life quality (p = 0.03), SSS-8 (p = 0.001), BDI-2 (p = 0.032), and STAI-Y scores (p < 0.001). After one year of pandemic, 88.2% of patients obtained pathological scores at PSQI, 19.6% at SHAPS, 29.4% at IES-R. Reduction of life quality correlated with anxiety, depression, stress, and somatization. Higher levels of anhedonia correlated with stress, depression, and anxiety. Somatization correlated with depression, anxiety, and sleep quality. Distress levels correlated with anxiety, somatization, and depression. CONCLUSIONS We demonstrated a significant worsening of depression, anxiety, life quality, and somatization in patients with MTLE after one year of COVID-19 beginning. Concomitantly, results suggest that the pandemic had a negative impact on sleep quality, psychological distress, and anhedonia, but not on epilepsy itself.
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Affiliation(s)
- Ilaria Sammarra
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Iolanda Martino
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Alessia Giugno
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Francesco Fortunato
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy.
| | - Angelo Labate
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy.
| | - Antonio Gambardella
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy; Neuroscience Research Center, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
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Neshige S, Aoki S, Takebayashi Y, Shishido T, Yamazaki Y, Iida K, Maruyama H. A longitudinal seizure outcome following the COVID-19 pandemic in 2020 and 2021: Transient exacerbation or sustainable mitigation. J Neurol Sci 2021; 434:120100. [PMID: 34952346 PMCID: PMC8689575 DOI: 10.1016/j.jns.2021.120100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/05/2021] [Accepted: 12/14/2021] [Indexed: 01/08/2023]
Abstract
Objective To study the longitudinal seizure outcomes of people with epilepsy (PWE) following the acute and chronic phases of the coronavirus disease 2019 (COVID-19) pandemic. Methods Consecutive PWE who were treated at the epilepsy center of Hiroshima University Hospital between 2018 and 2021 were enrolled. We evaluated the incidence of seizure frequency increase or decrease following the pandemic during observational periods in 2020 and 2021. Data between 2018 and 2019 were used as a control set. The sustainability of the altered seizure frequency condition was evaluated throughout the study period. We analyzed the clinical, psychological, and social factors associated with PWE with seizure exacerbation or amelioration. Results Among the 223 PWE who were evaluated (mean age 37.8 ± 16.3 years), seizure frequency increased for 40 (16.8%) and decreased for 34 (15.2%) after the pandemic began. While seizure exacerbation tended to be a transient episode during 2020, seizure amelioration was likely to maintain excellent status over the observation periods; the sustainability of the altered seizure frequency condition was more prominent for amelioration than exacerbation (p < 0.001). Seizure exacerbation was significantly associated with “no housemate” (odds ratio [OR] 3.37; p = 0.045) and “comorbidity of insomnia” (OR 5.80; p = 0.004). Conversely, “structural abnormality of MRI” (OR 2.57; p = 0.039) and “two-generation householding” (OR 3.70; p = 0.004) were independently associated with seizure amelioration. Conclusion This longitudinal observation confirmed that seizure exacerbation and amelioration emerged during the COVID-19 pandemic. The COVID-19 pandemic has shed light on the stark difference that social support systems can make on outcomes for PWE.
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Affiliation(s)
- Shuichiro Neshige
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan; Epilepsy Center, Hiroshima University Hospital, Japan.
| | - Shiro Aoki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Yoshiko Takebayashi
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Takeo Shishido
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Yu Yamazaki
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Koji Iida
- Epilepsy Center, Hiroshima University Hospital, Japan; Department of Neurosurgery, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical and Health Sciences, Japan; Epilepsy Center, Hiroshima University Hospital, Japan
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Zhong R, Chen Q, Zhang X, Li N, Lin W. Depressive and Anxiety Symptoms Are Predictors of Seizure Recurrence in Adults With Newly Diagnosed Epilepsy. Front Psychiatry 2021; 12:784737. [PMID: 34899438 PMCID: PMC8653777 DOI: 10.3389/fpsyt.2021.784737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate whether emerging depressive and anxiety symptoms are predictors of seizure recurrence in a cohort of patients with newly diagnosed epilepsy (PWNDE) who did not have a history of psychiatric diagnosis. Methods: A cohort of 283 PWNDE were psychiatrically assessed before antiseizure medication (ASM) therapy and were followed for 12 months to assess seizure recurrence. The influence of depressive and anxiety symptoms score on seizure recurrence was assessed using univariate and multivariate binary logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was utilized. Results: A total of 283 individuals were included in final analysis, and 115 patients (40.6%) experienced seizure recurrence during follow-up. In multivariate logistic regression analysis, NDDI-E and GAD-7 score were associated with an increased risk of seizure recurrence with an adjusted OR of 1.360 (CI: 1.176-1.572; P < 0.001) and 1.101 (CI: 1.004-1.209; P = 0.041), respectively. Additionally, the adjusted OR and 95% CI of seizure recurrence for the "high NDDI-E score and high GAD-7 score" vs. "not high NDDI-E score and not high GAD-7 score" was 7.059 (3.521-14.149) (P for trend < 0.001). Conclusion: We found that an emergence of new psychiatric symptoms including depressive and anxiety symptoms were predictors of seizure recurrence in adults with newly diagnosed epilepsy who did not have psychiatric history.
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Affiliation(s)
- Rui Zhong
- Department of Neurology, First Hospital, Jilin University, Changchun, China
| | - Qingling Chen
- Department of Hepatology, Tianjin Medical University, Tianjin Second People's Hospital, Tianjin, China
| | - Xinyue Zhang
- Department of Neurology, First Hospital, Jilin University, Changchun, China
| | - Nan Li
- Department of Neurology, First Hospital, Jilin University, Changchun, China
| | - Weihong Lin
- Department of Neurology, First Hospital, Jilin University, Changchun, China
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