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Published in: Annals of General Psychiatry 1/2007

Open Access 01-12-2007 | Primary research

Depression and anxiety in epilepsy: the association with demographic and seizure-related variables

Authors: Vasilios K Kimiskidis, Nikolaos I Triantafyllou, Eleni Kararizou, Stergios-Stylianos Gatzonis, Konstantinos N Fountoulakis, Anna Siatouni, Panagiotis Loucaidis, Dimitra Pseftogianni, Nikolaos Vlaikidis, George S Kaprinis

Published in: Annals of General Psychiatry | Issue 1/2007

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Abstract

Background

Depression 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.

Methods

We 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.

Results

High 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.

Conclusion

Our 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.
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Literature
1.
go back to reference Lambert MV, Robertson MM: Depression in epilepsy: etiology, phenomenology, and treatment. Epilepsia. 1999, 40 (Suppl 10): 21-47. 10.1111/j.1528-1157.1999.tb00884.x.CrossRef Lambert MV, Robertson MM: Depression in epilepsy: etiology, phenomenology, and treatment. Epilepsia. 1999, 40 (Suppl 10): 21-47. 10.1111/j.1528-1157.1999.tb00884.x.CrossRef
2.
go back to reference Jacoby A, Baker GA, Steen N, Potts P, Chadwick DW: The clinical course of epilepsy and its psychosocial correlates: finding from a U.K. community study. Epilepsia. 1996, 37: 148-161. 10.1111/j.1528-1157.1996.tb00006.x.CrossRefPubMed Jacoby A, Baker GA, Steen N, Potts P, Chadwick DW: The clinical course of epilepsy and its psychosocial correlates: finding from a U.K. community study. Epilepsia. 1996, 37: 148-161. 10.1111/j.1528-1157.1996.tb00006.x.CrossRefPubMed
3.
go back to reference Ettinger AB, Weisbrot DM, Nolan EE, Gadow KD, Vitale SA, Andriola MR, Lenn NJ, Novak GP, Hermann BP: Symptoms of depression and anxiety in pediatric epilepsy patients. Epilepsia. 1998, 39: 595-599. 10.1111/j.1528-1157.1998.tb01427.x.CrossRefPubMed Ettinger AB, Weisbrot DM, Nolan EE, Gadow KD, Vitale SA, Andriola MR, Lenn NJ, Novak GP, Hermann BP: Symptoms of depression and anxiety in pediatric epilepsy patients. Epilepsia. 1998, 39: 595-599. 10.1111/j.1528-1157.1998.tb01427.x.CrossRefPubMed
4.
go back to reference Jones JE, Hermann BP, Barry JJ, Gilliam F, Kanner AM, Meador KJ: Clinical assessment of Axis I psychiatric morbidity in chronic epilepsy: a multicenter investigation. J Neuropsychiatry Clin Neurosci. 2005, 17: 172-179.CrossRefPubMed Jones JE, Hermann BP, Barry JJ, Gilliam F, Kanner AM, Meador KJ: Clinical assessment of Axis I psychiatric morbidity in chronic epilepsy: a multicenter investigation. J Neuropsychiatry Clin Neurosci. 2005, 17: 172-179.CrossRefPubMed
5.
go back to reference Choi-Kwon S, Chung C, Kim H, Lee S, Yoon S, Kho H, Oh J, Lee S: Factors affecting the quality of life in patients with epilepsy in Seoul, South Korea. Acta Neurol Scand. 2003, 108: 428-434. 10.1046/j.1600-0404.2003.00151.x.CrossRefPubMed Choi-Kwon S, Chung C, Kim H, Lee S, Yoon S, Kho H, Oh J, Lee S: Factors affecting the quality of life in patients with epilepsy in Seoul, South Korea. Acta Neurol Scand. 2003, 108: 428-434. 10.1046/j.1600-0404.2003.00151.x.CrossRefPubMed
6.
go back to reference Altshuler LL, Devinsky 0, Post RM, Theodore W: Depression, anxiety, and temporal lobe epilepsy. Laterality of focus and symptoms. Arch Neurol. 1990, 47: 284-288.CrossRefPubMed Altshuler LL, Devinsky 0, Post RM, Theodore W: Depression, anxiety, and temporal lobe epilepsy. Laterality of focus and symptoms. Arch Neurol. 1990, 47: 284-288.CrossRefPubMed
7.
go back to reference Strauss E, Wada J, Moll A: Depression in male and female subjects with complex partial seizures. Arch Neurol. 1992, 49: 391-392.CrossRefPubMed Strauss E, Wada J, Moll A: Depression in male and female subjects with complex partial seizures. Arch Neurol. 1992, 49: 391-392.CrossRefPubMed
8.
go back to reference Standage KF, Fenton GW: Psychiatric symptom profiles of patients with epilepsy: a controlled investigation. Psychol Med. 1973, 5: 152-160.CrossRef Standage KF, Fenton GW: Psychiatric symptom profiles of patients with epilepsy: a controlled investigation. Psychol Med. 1973, 5: 152-160.CrossRef
9.
go back to reference Taylor DC: Mental state and temporal lobe epilepsy, a correlative account of 100 patients treated surgically. Epilepsia. 1972, 13: 727-765.CrossRefPubMed Taylor DC: Mental state and temporal lobe epilepsy, a correlative account of 100 patients treated surgically. Epilepsia. 1972, 13: 727-765.CrossRefPubMed
10.
go back to reference Koch-Weser M, Garron DC, Gilley DW, Bergen D, Bleck TP, Morrell F, Ristanovic R, Whisler WW: Prevalence of psychologic disorders after surgical treatment of seizures. Arch Neurol. 1988, 45: 1308-1311.CrossRefPubMed Koch-Weser M, Garron DC, Gilley DW, Bergen D, Bleck TP, Morrell F, Ristanovic R, Whisler WW: Prevalence of psychologic disorders after surgical treatment of seizures. Arch Neurol. 1988, 45: 1308-1311.CrossRefPubMed
11.
go back to reference Hermann BP, Wyler AR: Depression, locus of control, and the effects of epilepsy surgery. Epilepsia. 1989, 30: 332-338.CrossRefPubMed Hermann BP, Wyler AR: Depression, locus of control, and the effects of epilepsy surgery. Epilepsia. 1989, 30: 332-338.CrossRefPubMed
12.
go back to reference Mendez MF, Cummings JL, Benson DF: Depression in epilepsy. Significance and phenomenology. Arch Neurol. 1986, 43: 766-770.CrossRefPubMed Mendez MF, Cummings JL, Benson DF: Depression in epilepsy. Significance and phenomenology. Arch Neurol. 1986, 43: 766-770.CrossRefPubMed
13.
go back to reference Commission on Classification and Terminology of the International League against Epilepsy: Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia. 1989, 30: 389-399.CrossRef Commission on Classification and Terminology of the International League against Epilepsy: Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia. 1989, 30: 389-399.CrossRef
14.
go back to reference Kanner AM, Stagno S, Kotagal P, Morris HH: Postictal psychiatric events during prolonged video-electroencephalographic monitoring studies. Arch Neurol. 1996, 53: 258-263.CrossRefPubMed Kanner AM, Stagno S, Kotagal P, Morris HH: Postictal psychiatric events during prolonged video-electroencephalographic monitoring studies. Arch Neurol. 1996, 53: 258-263.CrossRefPubMed
15.
go back to reference Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression. Arch Gen Psychiatry. 1961, 4: 561-571.CrossRefPubMed Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression. Arch Gen Psychiatry. 1961, 4: 561-571.CrossRefPubMed
16.
go back to reference Spielberger CD: Manual for the State-Trait Anxiety Inventory. Edited by: Palo Alto, CA. 1983, Consultant Psychologist Press Spielberger CD: Manual for the State-Trait Anxiety Inventory. Edited by: Palo Alto, CA. 1983, Consultant Psychologist Press
17.
go back to reference Folstein MF, Folstein SE, McHugh PR: Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975, 12: 189-198. 10.1016/0022-3956(75)90026-6.CrossRefPubMed Folstein MF, Folstein SE, McHugh PR: Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975, 12: 189-198. 10.1016/0022-3956(75)90026-6.CrossRefPubMed
18.
go back to reference Fountoulakis KN, Iacovides A, Kleanthous S, Samolis S, Gougoulias K, Kaprinis GS, Bech P: The Greek translation of the symptoms rating scale for depression and anxiety: preliminary results of the validation study. BMC Psychiatry. 2003, 3: 21-10.1186/1471-244X-3-21.PubMedCentralCrossRefPubMed Fountoulakis KN, Iacovides A, Kleanthous S, Samolis S, Gougoulias K, Kaprinis GS, Bech P: The Greek translation of the symptoms rating scale for depression and anxiety: preliminary results of the validation study. BMC Psychiatry. 2003, 3: 21-10.1186/1471-244X-3-21.PubMedCentralCrossRefPubMed
19.
go back to reference Kogeorgos J, Fonagy P, Scott DF: Psychiatric symptom patterns of chronic epileptics attending a neurological clinic: a controlled investigation. Br J Psychiatry. 1982, 140: 236-243.CrossRefPubMed Kogeorgos J, Fonagy P, Scott DF: Psychiatric symptom patterns of chronic epileptics attending a neurological clinic: a controlled investigation. Br J Psychiatry. 1982, 140: 236-243.CrossRefPubMed
20.
go back to reference Septien L, Grass P, Giroud M, Didi-Roy R, Brunotte F, Pelletier JL, Dumas R: Depression and temporal lobe epilepsy: the possible role of laterality of the epileptic foci and gender. Neurophysiol Clin. 1993, 23: 327-336. 10.1016/S0987-7053(05)80124-8.CrossRefPubMed Septien L, Grass P, Giroud M, Didi-Roy R, Brunotte F, Pelletier JL, Dumas R: Depression and temporal lobe epilepsy: the possible role of laterality of the epileptic foci and gender. Neurophysiol Clin. 1993, 23: 327-336. 10.1016/S0987-7053(05)80124-8.CrossRefPubMed
22.
go back to reference Victoroff JI, Benson DF, Engel J Jr, Grafton S, Mazziotta JC: Interictal depression in patients with medically intractable complex partial seizures: electroencephalography and cerebral metabolic correlates [abstract]. Ann Neurol. 1990, 28: 221- Victoroff JI, Benson DF, Engel J Jr, Grafton S, Mazziotta JC: Interictal depression in patients with medically intractable complex partial seizures: electroencephalography and cerebral metabolic correlates [abstract]. Ann Neurol. 1990, 28: 221-
23.
go back to reference Robertson MM, Channon S, Baker J: Depressive symptomatology in a general hospital sample of outpatients with temporal lobe epilepsy: a controlled study. Epilepsia. 1994, 35: 771-777. 10.1111/j.1528-1157.1994.tb02510.x.CrossRefPubMed Robertson MM, Channon S, Baker J: Depressive symptomatology in a general hospital sample of outpatients with temporal lobe epilepsy: a controlled study. Epilepsia. 1994, 35: 771-777. 10.1111/j.1528-1157.1994.tb02510.x.CrossRefPubMed
24.
go back to reference Beyenburg S, Mitchell AJ, Schmidt D, Elger CE, Reuber M: Anxiety in patients with epilepsy: systematic review and suggestions for clinical management. Epilepsy Behav. 2005, 7: 161-171. 10.1016/j.yebeh.2005.05.014.CrossRefPubMed Beyenburg S, Mitchell AJ, Schmidt D, Elger CE, Reuber M: Anxiety in patients with epilepsy: systematic review and suggestions for clinical management. Epilepsy Behav. 2005, 7: 161-171. 10.1016/j.yebeh.2005.05.014.CrossRefPubMed
25.
go back to reference Fountoulakis KN, Papadopoulou M, Kleanthous S, Papadopoulou A, Bizeli V, Nimatoudis I, Iacovides A, Kaprinis GS: Reliability and psychometric properties of the Greek translation of the State-Trait Anxiety Inventory form Y: preliminary data. Ann Gen Psychiatry. 2006, 5: 2-10.1186/1744-859X-5-2.PubMedCentralCrossRefPubMed Fountoulakis KN, Papadopoulou M, Kleanthous S, Papadopoulou A, Bizeli V, Nimatoudis I, Iacovides A, Kaprinis GS: Reliability and psychometric properties of the Greek translation of the State-Trait Anxiety Inventory form Y: preliminary data. Ann Gen Psychiatry. 2006, 5: 2-10.1186/1744-859X-5-2.PubMedCentralCrossRefPubMed
26.
go back to reference Andrade L, Gorenstein C, Vieira Filho AH, Tung TC, Artes R: Psychometric properties of the Portuguese version of the State-Trait Anxiety Inventory applied to college students: factor analysis and relation to the Beck Depression Inventory. Braz J Med Biol Res. 2001, 34: 367-374. 10.1590/S0100-879X2001000300011.CrossRefPubMed Andrade L, Gorenstein C, Vieira Filho AH, Tung TC, Artes R: Psychometric properties of the Portuguese version of the State-Trait Anxiety Inventory applied to college students: factor analysis and relation to the Beck Depression Inventory. Braz J Med Biol Res. 2001, 34: 367-374. 10.1590/S0100-879X2001000300011.CrossRefPubMed
27.
go back to reference Depaulis A, Helfer V, Deransart C, Marescaux C: Anxiogenic-like consequences in animal models of complex partial seizures. Neurosci Biobehav Rev. 1997, 21: 767-774. 10.1016/S0149-7634(96)00060-7.CrossRefPubMed Depaulis A, Helfer V, Deransart C, Marescaux C: Anxiogenic-like consequences in animal models of complex partial seizures. Neurosci Biobehav Rev. 1997, 21: 767-774. 10.1016/S0149-7634(96)00060-7.CrossRefPubMed
28.
go back to reference Moore PM, Baker GA: The neuropsychological and emotional consequences of living with intractable temporal lobe epilepsy: implications for clinical management. Seizure. 2002, 11: 224-230. 10.1053/seiz.2001.0668.CrossRefPubMed Moore PM, Baker GA: The neuropsychological and emotional consequences of living with intractable temporal lobe epilepsy: implications for clinical management. Seizure. 2002, 11: 224-230. 10.1053/seiz.2001.0668.CrossRefPubMed
29.
go back to reference Gilliam F, Hecimovic H, Sheline Y: Psychiatric comorbidity, health, and function in epilepsy. Epilepsy Behav. 2003, 4 (Suppl 4): 26-30. 10.1016/j.yebeh.2003.10.003.CrossRef Gilliam F, Hecimovic H, Sheline Y: Psychiatric comorbidity, health, and function in epilepsy. Epilepsy Behav. 2003, 4 (Suppl 4): 26-30. 10.1016/j.yebeh.2003.10.003.CrossRef
30.
go back to reference Boylan LS, Flint LA, Labovitz DL, Jackson SC, Starner K, Devisnky O: Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy. Neurology. 2004, 62: 258-261.CrossRefPubMed Boylan LS, Flint LA, Labovitz DL, Jackson SC, Starner K, Devisnky O: Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy. Neurology. 2004, 62: 258-261.CrossRefPubMed
31.
go back to reference O'Donoghue MF, Goodridge DM, Redhead K, Sander JW, Duncan JS: Assessing the psychosocial consequences of epilepsy: a community-based study. Br J Gen Pract. 1999, 49: 211-214.PubMedCentralPubMed O'Donoghue MF, Goodridge DM, Redhead K, Sander JW, Duncan JS: Assessing the psychosocial consequences of epilepsy: a community-based study. Br J Gen Pract. 1999, 49: 211-214.PubMedCentralPubMed
32.
go back to reference Gilliam FG, Santos J, Vahle V, Carter J, Brown K, Hecimovic H: Depression in epilepsy: ignoring clinical expression of neuronal network dysfunction?. Epilepsia. 2004, 45 (Suppl 2): 28-34. 10.1111/j.0013-9580.2004.452005.x.CrossRefPubMed Gilliam FG, Santos J, Vahle V, Carter J, Brown K, Hecimovic H: Depression in epilepsy: ignoring clinical expression of neuronal network dysfunction?. Epilepsia. 2004, 45 (Suppl 2): 28-34. 10.1111/j.0013-9580.2004.452005.x.CrossRefPubMed
33.
go back to reference Smith DF, Baker GA, Dewey M, Jacoby A, Chadwick DW: Seizure frequency, patient perceived seizure severity and the psychosocial consequences of intractable epilepsy. Epilepsy Res. 1991, 9: 231-241. 10.1016/0920-1211(91)90057-M.CrossRefPubMed Smith DF, Baker GA, Dewey M, Jacoby A, Chadwick DW: Seizure frequency, patient perceived seizure severity and the psychosocial consequences of intractable epilepsy. Epilepsy Res. 1991, 9: 231-241. 10.1016/0920-1211(91)90057-M.CrossRefPubMed
34.
go back to reference Quiske A, Helmstaedter C, Lux S, Elger CE: Depression in patients with temporal lobe epilepsy is related to mesial temporal sclerosis. Epilepsy Research. 2000, 39: 121-125. 10.1016/S0920-1211(99)00117-5.CrossRefPubMed Quiske A, Helmstaedter C, Lux S, Elger CE: Depression in patients with temporal lobe epilepsy is related to mesial temporal sclerosis. Epilepsy Research. 2000, 39: 121-125. 10.1016/S0920-1211(99)00117-5.CrossRefPubMed
35.
go back to reference Marsh L, Rao V: Psychiatric complications in patients with epilepsy: a review. Epilepsy Res. 2002, 49: 11-33. 10.1016/S0920-1211(02)00008-6.CrossRefPubMed Marsh L, Rao V: Psychiatric complications in patients with epilepsy: a review. Epilepsy Res. 2002, 49: 11-33. 10.1016/S0920-1211(02)00008-6.CrossRefPubMed
36.
go back to reference Goldstein MA, Harden CL: Epilepsy and anxiety. Epilepsy Behav. 2000, 1: 228-234. 10.1006/ebeh.2000.0080.CrossRefPubMed Goldstein MA, Harden CL: Epilepsy and anxiety. Epilepsy Behav. 2000, 1: 228-234. 10.1006/ebeh.2000.0080.CrossRefPubMed
37.
go back to reference Vazquez B, Devinsky O: Epilepsy and anxiety. Epilepsy Behav. 2003, 4 (Suppl 4): 20-25. 10.1016/j.yebeh.2003.10.005.CrossRef Vazquez B, Devinsky O: Epilepsy and anxiety. Epilepsy Behav. 2003, 4 (Suppl 4): 20-25. 10.1016/j.yebeh.2003.10.005.CrossRef
Metadata
Title
Depression and anxiety in epilepsy: the association with demographic and seizure-related variables
Authors
Vasilios K Kimiskidis
Nikolaos I Triantafyllou
Eleni Kararizou
Stergios-Stylianos Gatzonis
Konstantinos N Fountoulakis
Anna Siatouni
Panagiotis Loucaidis
Dimitra Pseftogianni
Nikolaos Vlaikidis
George S Kaprinis
Publication date
01-12-2007
Publisher
BioMed Central
Published in
Annals of General Psychiatry / Issue 1/2007
Electronic ISSN: 1744-859X
DOI
https://doi.org/10.1186/1744-859X-6-28

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