DOI: http://dx.doi.org/10.18203/2349-3933.ijam20183906

Depression and anxiety in patients with epilepsy

Sanyam Gupta, Nitin Sharma, Shantanu Bharti, Ruchita Sharma, Ajay Kohli, Anju Agarwal, Abdul Qadir Jilani, Ritu Shukla

Abstract


Background: Anxiety and depression are commonly found in epileptic patients. However, the etiology behind the mechanism remains multifactorial, mostly because of variability in study settings. In order to fill the knowledge gap, we investigated the prevalence of anxiety and depression among epileptic patients and their correlation with certain demographic variables.

Methods: In a Cross Sectional Out Patient Based Study, a total of 147 patients with epilepsy were recruited and evaluated for inclusion and exclusion criterion. Participants who met the inclusion criterion were assessed using standardized scales HARS and HADS rating scale for anxiety and depressive symptoms respectively.

Results: 100 participants were included with mean age of 33.63 years for men and 30.16 years for females. 27% showed mild to severe anxiety and 21% had mild to moderate depression. Prevalence of both anxiety and depression was found more among females, singles, participants from urban background and having partial epilepsy. Significantly (p-0.020*) higher anxiety was seen in patients with partial epilepsy than those with generalized epilepsy.

Conclusions: Individuals with partial epilepsy are more prone to get affected from comorbid disorder like anxiety and depression, especially females, singles and those from urban domicile.


Keywords


Anxiety, Depression, Demographic factors, Prevalence

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References


Kanner AM, Palac S. Neuropsychiatric complications of epilepsy. Curr Neurol Neurosci Rep. 2002;2(4):365-72.

Loney JC, Wirrell EC, Sherman EM, Hamiwka LD. Anxiety and depressive symptoms in children presenting with a first seizure. Pediatr Neurol. 2008 Oct 1;39(4):236-40.

Ekinci O, Titus JB, Rodopman AA, Berkem M, Trevathan E. Depression and anxiety in children and adolescents with epilepsy: prevalence, risk factors, and treatment. Epilepsy Behavior. 2009 Jan 1;14(1):8-18.

Cramer JA, Blum D, Fanning K, Reed M. The impact of comorbid depression on health resource utilization in a community sample of people with epilepsy. Epilepsy Behavior. 2004 Jun 1;5(3):337-42.

Epilepsy Action Australia. Understanding Epilepsy, 2008. Available at http://www.epilepsy.org.au/understanding_epilepsy.asp.

Jackson M, Turkington D. Depression and anxiety in epilepsy. J Neurol Neurosurg Psychiatry. 2005;76(1):45-7.

Mazza MA, Bria PI, Mazza S. Depression and suicide in epilepsy: fact or artefact?. J Neurol Sci. 2007 Sep 15;260(1):300-1.

Robertson MM. Mood disorders associated with epilepsy. Psychiatric Comorbidity in Epilepsy, Connell HW, Snyder PJ. American Psychiatric Press. 1998;133-67.

Hermann PB, Whitman S. Psychopathology in epilepsy. Oxford Univ Press. 1986:5-37.

Hermann BP, Whitman S. Psychosocial predictors of interictal depression. J Epilepsy. 1989 Jan 1;2(4):231-7.

Onwuekwe IO, Ekenze OS, Bzeala-Adikaibe OS, Ejekwu JU. Depression in patients with epilepsy: a study from Enugu, South East Nigeria. Ann Med Health Sci Res. 2012;2(1):10-3.

Babu CS, Satishchandra P, Sinha S, Subbakrishna DK. Co-morbidities in people living with epilepsy: hospital based case–control study from a resource-poor setting. Epilepsy research. 2009 Oct 1;86(2-3):146-52.

Sharp R. The Hamilton rating scale for depression. Occup Med. 2015 Jun 1;65(4):340.

Thompson E. Hamilton rating scale for anxiety (HAM-A). Occup Med. 2015; 65(7):601.

Engel Jr J. ILAE classification of epilepsy syndromes. Epilepsy Res. 2006 Aug 1;70:5-10.

Todorova KS, Velikova VS. The validity of the Hamilton depression rating scale as a screening and diagnostic instrument for depression in patients with epilepsy. J IMAB Ann Proceed Sci Papers. 2012 Oct 23;18(3):305-7.

Shear MK, Vander Bilt J, Rucci P, Endicott J, Lydiard B, Otto MW, et al. Reliability and validity of a structured interview guide for the Hamilton Anxiety Rating Scale (SIGH‐A). Depression Anxiety. 2001;13(4):166-78.

Aina Y, Susman JL. Understanding comorbidity with depression and anxiety disorders. J Am Osteopath Assoc. 2006 May 1;106(5 Suppl 2):S9-14.

Mendez MF, Cummings JL, Benson DF. Depression in epilepsy: significance and phenomenology. Arch Neurol. 1986 Aug 1;43(8):766-70.

Indaco A, Carrieri PB, Nappi C, Gentile S, Striano S. Interictal depression in epilepsy. Epilepsy Res. 1992 Jun 1;12(1):45-50.

Robertson MM, Channon S, Baker J. Depressive symptomatology in a general hospital sample of outpatients with temporal lobe epilepsy: a controlled study. Epilepsia. 1994 Jul;35(4):771-7.

Jacoby A, Baker GA, Steen N, Potts P, Chadwick DW. The clinical course of epilepsy and its psychosocial correlates: findings from a UK community study. Epilepsia. 1996 Feb;37(2):148-61.

Piazzini A, Canevini MP, Maggiori G, Canger R. Depression and anxiety in patients with epilepsy. Epilepsy Behavior. 2001 Oct 1;2(5):481-9.

Fiordelli EB, Beghi E, Bogliun G, Crespi V. Epilepsy and psychiatric disturbance: a cross-sectional study. Br J Psychiatry. 1993 Oct;163(4):446-50.

Ettinger A, Reed M, Cramer J. Depression and comorbidity in community-based patients with epilepsy or asthma. Neurol. 2004 Sep 28;63(6):1008-14.

Gaitatzis A, Carroll K, Majeed A, Sander JW. The epidemiology of the comorbidity of epilepsy in the general population. Epilepsia. 2004 Dec;45(12):1613-22.

Strine TW, Kobau R, Chapman DP, Thurman DJ, Price P, Balluz LS. Psychological distress, comorbidities, and health behaviors among US adults with seizures: results from the 2002 National Health Interview Survey. Epilepsia. 2005 Jul;46(7):1133-9.

Toth V, Hejjel L, Fogarasi A, Gyimesi C, Orsi G, Szucs A, et al. Periictal heart rate variability analysis suggests long‐term postictal autonomic disturbance in epilepsy. Eur J Neurol. 2010 Jun 1;17(6):780-7.

Perini GI, Tosin C, Carraro C, Bernasconi G, Canevini MP, Canger R, Pellegrini A, Testa G, et al. Interictal mood and personality disorders in temporal lobe epilepsy and juvenile myoclonic epilepsy. J Neurol Neurosurg Psychiatry. 1996 Dec 1;61(6):601-5.

Dikmen S, Hermann BP, Wilensky AJ, Rainwater G. Validity of the Minnesota Multiphasic Personality Inventory (MMPI) to psychopathology in patients with epilepsy. J Nervous Mental Dis. 1983 Feb; 171(2):114-22.

Rodin EA, Katz M, Lennox K. Differences between patients with temporal lobe seizures and those with other forms of epileptic attacks. Epilepsia. 1976 Sep;17(3):313-20.

Shukla GD, Srivastava ON, Katiyar BC, Joshi V, Mohan PK. Psychiatric manifestations in temporal lobe epilepsy: a controlled study. Br J Psychiatry. 1979 Nov;135(5):411-7.