Generalized anxiety disorder and major depressive episode in patients with drug-resistant epilepsies
Keywords:
drug-resistant epilepsies, generalized anxiety disorder, major depressive episode, quality of lifeAbstract
Objective: To evaluate the behavior of generalized anxiety disorder and major depressive episode among patients with drug-resistant epilepsies.
Methods: An observational descriptive study was carried out. 29 patients participated (9 with frontal lobe epilepsy and 20 with temporal lobe epilepsy) and 15 healthy controlled subjects, evaluated in the Neuropsychology Services of the International Center for Neurological Restoration, between January 2018 and December 2020. Variables were analyzed. demographic, type of epilepsy, generalized anxiety disorder (GAD) and major depressive episode (MDE) from the application of a structured interview, GAD-7 generalized anxiety disorder scale, NDDI-E major depressive episode scale. Non-parametric statistics were produced (Spearman Test, Mann Whitney U test) with statistical significance p≤0.05.
Results: 40% of patients with temporal lobe epilepsy present generalized anxiety disorder and 35% major depressive episode. Differences in generalized anxiety disorder and major depressive episode were identified between temporal lobe epilepsy vs. control. Differences were found between frontal lobe epilepsy vs. control in the major depressive episode. In the temporal lobe epilepsy group, a positive relationship was obtained between generalized anxiety disorder and major depressive episode (R=0.83).
Conclusions: It is confirmed that patients with temporal lobe epilepsy present generalized anxiety disorder and major depressive episode. The generalized anxiety disorder scale and major depressive episode scale are useful screening tools that offer practical information to redirect the comprehensive care of this group of patients.
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References
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31. Bertram EH. Temporal lobe epilepsy: where do the seizures really begin? Epilepsy Behav. 2009;14(1):32–7.
32. Zinchuk M, Kustov G, Pashnin E, Gersamia A, Rider F, Yakovlev A, et al. Validation of the Russian version of neurological disorders depression inventory for epilepsy (NDDI-E). Epilepsy Behav. 2020;113:107549. DOI: 10.1016/j.yebeh.2020.107549
33. Budikayanti A, Larasari A, Malik K, Syeban Z, Indrawati LA, Octaviana F. Screening of generalized anxiety disorder in patients with epilepsy: Using a valid and reliable Indonesian version of generalized anxiety disorder-7 (GAD-7). Neurol Res Int. 2019;2019.
34. Tong X, An D, McGonigal A, Park S-P, Zhou D. Validation of the Generalized Anxiety Disorder-7 (GAD-7) among Chinese people with epilepsy. Epilepsy Res. 2016;120:31–6.
35. Bermúdez MZ, Chacón LMM, Martín MMB, González JG, Fernández RG, Alfonso MA. Comportamiento de la ansiedad, depresión y disociación en pacientes con crisis epilépticas y crisis psicógenas no epilépticas. Rev Cuba Neurol y Neurocir. 2020;10(2):1–19.
2. Gilliam FG, Barry JJ, Hermann BP, Meador KJ, Vahle V, Kanner AM. Rapid detection of major depression in epilepsy: a multicentre study. Lancet Neurol. 2006;5(5):399–405.
3. di Capua Sacoto DR. Validación al castellano del Inventario de depresión en trastornos neurológicos en paciente con epilepsia: un instrumento para la detección de depresión mayor en pacientes con epilepsia. [Tesis]. Facultad de Medicina, Universidad Complutense de Madrid; 2014.
4. Morales L, Kochen S. Epilepsias en el primer nivel de atención de salud. Buenos Aires; 2017.
5. Kanner AM. Psychiatric comorbidities in new onset epilepsy: should they be always investigated? Seizure. 2017;49:79–82.
6. Dhiman V, Sinha S, Rawat VS, Harish T, Chaturvedi SK, Satishchandra P. Semiological characteristics of adults with psychogenic nonepileptic seizures (PNESs): an attempt towards a new classification. Epilepsy Behav. 2013;27(3):427–32.
7. Morales Chacón LM, Batista García-Ramo K, González González J, Bender del Busto JE, Báez Martin MM, Estupiñán Díaz B, et al. Estrategia para la evaluación y tratamiento quirúrgico de las epilepsias farmacorresistentes en Cuba. An la Acad Ciencias Cuba. 2021;11(1).
8. Han S-H, Kim KT, Ryu HU, Lee S-A, Cho Y-J, Kim JH, et al. Factors associated with social anxiety in South Korean adults with epilepsy. Epilepsy Behav. 2019;101:106569. DOI: 10.1016/j.yebeh.2019.106569
9. Forthoffer N, Tarrada A, Brissart H, Maillard L, Hingray C. Anxiety and Depression in Newly Diagnosed Epilepsy: A Matter of Psychological History? Front Neurol. 2021;1664.
10. Liu X, Chen H, Zheng X. Effects of seizure frequency, depression and generalized anxiety on suicidal tendency in people with epilepsy. Epilepsy Res. 2020;160:106265. DOI: 10.1016/j.eplepsyres.2020.106265
11. Lu E, Pyatka N, Burant CJ, Sajatovic M. Systematic literature review of psychiatric comorbidities in adults with epilepsy. J Clin Neurol. 2021;17(2):176. DOI: 10.3988.jcn.2021.17.2.176
12. Zhong R, Chen Q, Li M, Li N, Zhang X, Lin W. Sex differences in anxiety in patients with epilepsy: Status and risk factors analysis. Epilepsy Behav. 2021;116:107801. DOI: 10.1016/j.yebeh.2021.107801
13. Reyes-Ticas JA. Trastornos de Ansiedad guía práctica para diagnóstico y tratamiento. Bibl virtual en salud. 2021; [acceso: 22/1/2022]. Disponible en: http://www.bvs.hn/Honduras/pdf/TrastornoAnsiedad.pdf
14. Association AP. Manual diagnóstico y estadístico de los trastornos mentales (DSM-5). Madrid: Editorial Médica Panamericana; 2015. Salud Colect. 2019;15:e1952.
15. Phillips KA, Friedman MJ, Stein DJ, Craske M. Special DSM-V issues on anxiety, obsessive-compulsive spectrum, posttraumatic, and dissociative disorders. Depress Anxiety. 2010;27(2):91–2.
16. Labre Tarco VE. Alteraciones de las funciones ejecutivas en pacientes con epilepsia del lóbulo frontal. Quito: UCE; 2016.
17. Blanco Beregaña M. Alteraciones neuropsicológicas en epilepsia del lóbulo frontal en niños. [Tesis]. Universidad Complutense de Madrid; 2017.
18. Shulman MB. The frontal lobes, epilepsy, and behavior. Epilepsy Behav. 2000;1(6):384–95.
19. Helmstaedter C. Behavioral aspects of frontal lobe epilepsy. Epilepsy Behav. 2001;2(5):384–95.
20. Bermúdez MZ, Martín MMB, Rizo CM, Cuesta HV, Gonzalez JG, Hernández TM, et al. Función ejecutiva en pacientes con epilepsia del lóbulo temporal y extra-temporal tratados con cirugía: reporte comparativo preliminar. Investig Medicoquirúrgicas. 2020 [acceso: 22/1/2022];12(1). Diponible en: http://www.revcimeq.sld.cu/index.php/imq/article/view/578
21. Gopinath M, Sarma PS, Thomas S V. Gender-specific psychosocial outcome for women with epilepsy. Epilepsy Behav. 2011;20(1):44–7.
22. Calle López Y, Bedoya Rodríguez P, Solarte Mila RA, Aguirre Acevedo DC. Semiología de crisis en probable epilepsia del lóbulo frontal. Revista de Medicina. 2018 [acceso: 22/1/2022]; 40(3). Disponible en: https://www.revistamedicina.net/index.php/Medicina/article/view/1367
23. Scott AJ, Sharpe L, Loomes M, Gandy M. Systematic review and meta-analysis of anxiety and depression in youth with epilepsy. J Pediatr Psychol. 2020;45(2):133–44.
24. Brandt C, Schoendienst M, Trentowska M, May TW, Pohlmann-Eden B, Tuschen-Caffier B, et al. Prevalence of anxiety disorders in patients with refractory focal epilepsy—a prospective clinic based survey. Epilepsy Behav. 2010;17(2):259–63.
25. Goicochea A, Andrade R, García A, Cornejo Ochoa JW, Toro Pérez ME. Epilepsia del lóbulo temporal: trastornos afectivos, uso de fármacos antiepilépticos y personalidad. Epilepsias del lóbulo temporal Medellín Comun Vis SAS; 2011.
26. Seo J-G, Cho YW, Lee S-J, Lee J-J, Kim J-E, Moon H-J, et al. Validation of the generalized anxiety disorder-7 in people with epilepsy: a MEPSY study. Epilepsy Behav. 2014;35:59–63.
27. Pérez-Montoto A, Andrade-Machado R, García-Espinosa A, Toledo-Sotomayo G, Borges-Gonzáles AS. Tipificación del Trastorno Afectivo en Pacientes con Epilepsia del Lóbulo Temporal. Rev Ecuat Neurol. 2009;18(3).
28. Alonso NB, de Albuquerque M, Vidal-Dourado M, Cavicchioli LH, Mazetto L, de Araújo Filho GM, et al. Revisiting personality in epilepsy: Differentiation of personality in two epilepsies starting in adolescence. Epilepsy Behav. 2019;97:75–82.
29. Zinchuk M, Kustov G, Pashnin E, Gersamia A, Rider F, Yakovlev A, et al. Validation of the Generalized Anxiety Disorder-7 (GAD-7) in Russian people with epilepsy. Epilepsy Behav. 2021;123:108269. DOI: 10.1016/j.yebeh.2021.108269
30. De Oliveira GNM, Kummer A, Salgado JV, Portela EJ, Sousa-Pereira SR, David AS, et al. Psychiatric disorders in temporal lobe epilepsy: an overview from a tertiary service in Brazil. Seizure. 2010;19(8):479–84.
31. Bertram EH. Temporal lobe epilepsy: where do the seizures really begin? Epilepsy Behav. 2009;14(1):32–7.
32. Zinchuk M, Kustov G, Pashnin E, Gersamia A, Rider F, Yakovlev A, et al. Validation of the Russian version of neurological disorders depression inventory for epilepsy (NDDI-E). Epilepsy Behav. 2020;113:107549. DOI: 10.1016/j.yebeh.2020.107549
33. Budikayanti A, Larasari A, Malik K, Syeban Z, Indrawati LA, Octaviana F. Screening of generalized anxiety disorder in patients with epilepsy: Using a valid and reliable Indonesian version of generalized anxiety disorder-7 (GAD-7). Neurol Res Int. 2019;2019.
34. Tong X, An D, McGonigal A, Park S-P, Zhou D. Validation of the Generalized Anxiety Disorder-7 (GAD-7) among Chinese people with epilepsy. Epilepsy Res. 2016;120:31–6.
35. Bermúdez MZ, Chacón LMM, Martín MMB, González JG, Fernández RG, Alfonso MA. Comportamiento de la ansiedad, depresión y disociación en pacientes con crisis epilépticas y crisis psicógenas no epilépticas. Rev Cuba Neurol y Neurocir. 2020;10(2):1–19.
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2022-12-04
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Zaldivar Bermúdez M, Morales Chacón LM, González González J, Maragoto Rizo C, Cabrera Muñoz A, Mendoza R. Generalized anxiety disorder and major depressive episode in patients with drug-resistant epilepsies. Rev. Hosp. Psiq. Habana [Internet]. 2022 Dec. 4 [cited 2025 Aug. 20];19(1):e218. Available from: https://revhph.sld.cu/index.php/hph/article/view/218
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