Abstract
PurposeComorbid anxiety and depression in people with epilepsy (PWE) are highly prevalent and contribute to low quality of life (QOL) and may even lead to poor outcomes of epilepsy. Among the various factors that affect these negative emotional comorbidities, possible gender differences remain poorly understood and are often neglected. This research aimed to determine whether there are discrepancies in the incidence and influence factors of anxiety and depression between men and women with epilepsy in a hospital in northwest China.MethodsA total of 158 adult PWE (female: N = 65; 41.1%) completed self-report questionnaires, including the Self-rating Anxiety Scale (SAS), the Self-rating Depression Scale (SDS), the Chinese version of the Quality of Life in Epilepsy-31 (QOLIE-31) inventory and the Pittsburgh Sleep Quality Inventory (PSQI). The comparison between male and female PWE was made by regression analysis.ResultsFor the prevalence of anxiety and depression in PWE, no gender difference was found in this study. However, the moderating factors of psychiatric comorbidities were significantly different between men and women: male PWE with comorbid anxiety were more likely to be affected by sleep quality, while anxiety symptoms in female PWE were closely associated with the frequency of seizures. Education years and QOL social function were significant indicators of depression in male PWE but not in female PWE. The important and common predictor for anxiety and depressive symptoms in PWE was QOL energy/fatigue, with male patients being more affected.ConclusionFor the PWE included in this study, the incidence of comorbid anxiety and depression in PWE was similar for men and women, but the moderating factors affecting comorbid anxiety and depressive disorders differed between genders: male PWE were more likely to be affected by psychosocial factors, while female PWE were more influenced by epilepsy itself. This exploration suggests that gender-specific health care should be considered in epilepsy therapy to improve the psychiatric condition and QOL of PWE, and different treatments should be conducted for male and female PWE to prevent negative emotional comorbidities.
Highlights
Anxiety and depression as high-rate psychiatric comorbidities are more common in people with epilepsy (PWE) than in the general population [1,2,3,4,5]]
The female PWE had higher Sleep Quality score than the male (p = 0.023), and no significant gender difference was found in terms of any other total or subscale scores of the Pittsburgh Sleep Quality Inventory (PSQI) and QOLIE-31 (Figures 3D–K)
The correlation analysis revealed that anxiety (SAS scores ≥50) in both men and women with epilepsy was positively correlated with the frequency of seizures, the overall QOLIE-31 scores and the PSQI scores
Summary
Anxiety and depression as high-rate psychiatric comorbidities are more common in people with epilepsy (PWE) (prevalence: 20%– 50%) than in the general population (prevalence: 7%–20%) [1,2,3,4,5]]. The relationship between epilepsy and psychiatric disturbance is bidirectional; PWE are more prone to develop psychiatric comorbidities, while patients with certain primary psychiatric disorders are at higher risk of developing epilepsy [6]. This bidirectional relation may be explained by the common pathogenesis of both epilepsy and psychiatric disorders [7]. Psychiatric comorbidities often go unrecognized and untreated in PWE [8]
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