Abstract
BackgroundDepression and anxiety are common psychiatric symptoms in patients with epilepsy, exerting a profound negative effect on health-related quality of life. Several issues, however, pertaining to their association with psychosocial, seizure-related and medication factors, remain controversial. Accordingly, the present study was designed to investigate the association of interictal mood disorders with various demographic and seizure-related variables in patients with newly-diagnosed and chronic epilepsy.MethodsWe investigated 201 patients with epilepsy (51.2% males, mean age 33.2 ± 10.0 years, range 16–60) with a mean disease duration of 13.9 ± 9.5 years. Depression and anxiety were assessed in the interictal state with the Beck Depression Inventory, 21-item version (BDI-21) and the state and trait subscales of the State-Trait Anxiety Inventory (STAI-S and STAI-T), respectively. The association of mood disorders with various variables was investigated with simple and multiple linear regression analyses.ResultsHigh seizure frequency and symptomatic focal epilepsy (SFE) were independent determinants of depression, together accounting for 12.4% of the variation of the BDI-21. The STAI-S index was significantly associated with the type of epilepsy syndrome (SFE). Finally, high seizure frequency, SFE and female gender were independent determinants of trait anxiety accounting for 14.7% of the variation of the STAI-T.ConclusionOur results confirm the prevailing view that depression and anxiety are common psychological disorders in epileptics. It is additionally concluded that female gender, high seizure frequency and a symptomatic epilepsy syndrome are independent risk factors for the development of anxiety and/or depression.
Highlights
Depression and anxiety are common psychiatric symptoms in patients with epilepsy, exerting a profound negative effect on health-related quality of life
Of particular clinical importance is the recent finding that depression and anxiety exert a profound negative effect on the health-related quality of life (HRQOL) in patients with epilepsy
BDI-21 was positively associated with symptomatic focal epilepsy (β = 3.60, p < 0.001) and negatively with idiopathic generalized epilepsy (β = -3.35, p = 0.007) (Figure 1)
Summary
Depression and anxiety are common psychiatric symptoms in patients with epilepsy, exerting a profound negative effect on health-related quality of life. Despite the fact that some patients with epilepsy lead normal lives, devoid of cognitive or emotional problems, a significant number of them experience psychiatric disturbances, including mood disorders Amongst the latter, depression is the most extensively studied with a large number of controlled studies reporting prevalence rates ranging from 3–55% [1]. Gender [6,7,8] and seizure etiology [9,10,11,12] have been variously reported as being significantly or non-significantly associated with mood disorders, most likely due to methodological differences amongst relevant studies The resolution of these controversies is of theoretical and of practical importance, as a clear understanding of the complex pathogenesis of mood disorders in epilepsy is a prerequisite for the development of effective intervention strategies
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