Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE

Mateus H. Nogueira, Clarissa L. Yasuda, Ana C. Coan, Andres M Kanner, Fernando Cendes

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective: To investigate whether mood disorders (MD) and anxiety disorders (AD) are associated with seizure control in patients with mesial temporal lobe epilepsy (MTLE). We compared patients without any current psychiatric disorder, patients with current MD and/or AD, patients with subsyndromic depression episodes (SSDE) and anxiety episodes (SSAE), and patients with family psychiatric history. Methods: In a cross-sectional study, we included 144 consecutive patients with MTLE (82 pharmacoresistant and 62 treatment-responsive patients). Every patient underwent a psychiatric evaluation including the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) Axis I (SCID-I), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and Interictal Dysphoric Disorder Inventory (IDDI). Patients were divided into four groups: PsychNeg (G1, n = 61), current SSDE and SSAE (G2, n = 26), Current MD or AD (G3, n = 25), and current mixed MD/AD (G4, n = 32). Results: Among patients with pharmacoresistant MTLE, 68.3% (56/82) experienced symptoms of depression and/or anxiety (G2, G3, and G4) (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.41–5.53, p < 0.01). Patients with mixed MD/AD (G4, n = 24/32) were more likely to have pharmacoresistant MTLE (OR 4.04, 95% CI 1.57–10.42, p < 0.01) than psychiatric asymptomatic patients (G1, n = 26/61), and their seizure frequency was significantly higher (p < 0.01). Positive family psychiatric history was more frequent in pharmacoresistant patients (n = 27/82, OR 2.28, 95% CI 1.02–5.05, p = 0.04). Finally, 31.6% of patients with MD and or AD were not receiving psychiatric treatment. Significance: Identification of comorbid MD/AD and of family psychiatric history is of the essence in patients with MTLE, as they appear to be associated with worse seizure control.

Original languageEnglish (US)
Pages (from-to)1268-1276
Number of pages9
JournalEpilepsia
Volume58
Issue number7
DOIs
StatePublished - Jul 1 2017

Fingerprint

Temporal Lobe Epilepsy
Anxiety Disorders
Mood Disorders
Seizures
Psychiatry
Depression
Anxiety
Equipment and Supplies
Odds Ratio
Confidence Intervals
Diagnostic and Statistical Manual of Mental Disorders
Nervous System Diseases

Keywords

  • Anxiety
  • Depression
  • Epilepsy
  • Family psychiatric history
  • Subsyndromic depression

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE. / Nogueira, Mateus H.; Yasuda, Clarissa L.; Coan, Ana C.; Kanner, Andres M; Cendes, Fernando.

In: Epilepsia, Vol. 58, No. 7, 01.07.2017, p. 1268-1276.

Research output: Contribution to journalArticle

Nogueira, Mateus H. ; Yasuda, Clarissa L. ; Coan, Ana C. ; Kanner, Andres M ; Cendes, Fernando. / Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE. In: Epilepsia. 2017 ; Vol. 58, No. 7. pp. 1268-1276.
@article{39f59d82239049eeb06d21b893876c71,
title = "Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE",
abstract = "Objective: To investigate whether mood disorders (MD) and anxiety disorders (AD) are associated with seizure control in patients with mesial temporal lobe epilepsy (MTLE). We compared patients without any current psychiatric disorder, patients with current MD and/or AD, patients with subsyndromic depression episodes (SSDE) and anxiety episodes (SSAE), and patients with family psychiatric history. Methods: In a cross-sectional study, we included 144 consecutive patients with MTLE (82 pharmacoresistant and 62 treatment-responsive patients). Every patient underwent a psychiatric evaluation including the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) Axis I (SCID-I), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and Interictal Dysphoric Disorder Inventory (IDDI). Patients were divided into four groups: PsychNeg (G1, n = 61), current SSDE and SSAE (G2, n = 26), Current MD or AD (G3, n = 25), and current mixed MD/AD (G4, n = 32). Results: Among patients with pharmacoresistant MTLE, 68.3{\%} (56/82) experienced symptoms of depression and/or anxiety (G2, G3, and G4) (odds ratio [OR] 2.8, 95{\%} confidence interval [CI] 1.41–5.53, p < 0.01). Patients with mixed MD/AD (G4, n = 24/32) were more likely to have pharmacoresistant MTLE (OR 4.04, 95{\%} CI 1.57–10.42, p < 0.01) than psychiatric asymptomatic patients (G1, n = 26/61), and their seizure frequency was significantly higher (p < 0.01). Positive family psychiatric history was more frequent in pharmacoresistant patients (n = 27/82, OR 2.28, 95{\%} CI 1.02–5.05, p = 0.04). Finally, 31.6{\%} of patients with MD and or AD were not receiving psychiatric treatment. Significance: Identification of comorbid MD/AD and of family psychiatric history is of the essence in patients with MTLE, as they appear to be associated with worse seizure control.",
keywords = "Anxiety, Depression, Epilepsy, Family psychiatric history, Subsyndromic depression",
author = "Nogueira, {Mateus H.} and Yasuda, {Clarissa L.} and Coan, {Ana C.} and Kanner, {Andres M} and Fernando Cendes",
year = "2017",
month = "7",
day = "1",
doi = "10.1111/epi.13781",
language = "English (US)",
volume = "58",
pages = "1268--1276",
journal = "Epilepsia",
issn = "0013-9580",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE

AU - Nogueira, Mateus H.

AU - Yasuda, Clarissa L.

AU - Coan, Ana C.

AU - Kanner, Andres M

AU - Cendes, Fernando

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Objective: To investigate whether mood disorders (MD) and anxiety disorders (AD) are associated with seizure control in patients with mesial temporal lobe epilepsy (MTLE). We compared patients without any current psychiatric disorder, patients with current MD and/or AD, patients with subsyndromic depression episodes (SSDE) and anxiety episodes (SSAE), and patients with family psychiatric history. Methods: In a cross-sectional study, we included 144 consecutive patients with MTLE (82 pharmacoresistant and 62 treatment-responsive patients). Every patient underwent a psychiatric evaluation including the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) Axis I (SCID-I), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and Interictal Dysphoric Disorder Inventory (IDDI). Patients were divided into four groups: PsychNeg (G1, n = 61), current SSDE and SSAE (G2, n = 26), Current MD or AD (G3, n = 25), and current mixed MD/AD (G4, n = 32). Results: Among patients with pharmacoresistant MTLE, 68.3% (56/82) experienced symptoms of depression and/or anxiety (G2, G3, and G4) (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.41–5.53, p < 0.01). Patients with mixed MD/AD (G4, n = 24/32) were more likely to have pharmacoresistant MTLE (OR 4.04, 95% CI 1.57–10.42, p < 0.01) than psychiatric asymptomatic patients (G1, n = 26/61), and their seizure frequency was significantly higher (p < 0.01). Positive family psychiatric history was more frequent in pharmacoresistant patients (n = 27/82, OR 2.28, 95% CI 1.02–5.05, p = 0.04). Finally, 31.6% of patients with MD and or AD were not receiving psychiatric treatment. Significance: Identification of comorbid MD/AD and of family psychiatric history is of the essence in patients with MTLE, as they appear to be associated with worse seizure control.

AB - Objective: To investigate whether mood disorders (MD) and anxiety disorders (AD) are associated with seizure control in patients with mesial temporal lobe epilepsy (MTLE). We compared patients without any current psychiatric disorder, patients with current MD and/or AD, patients with subsyndromic depression episodes (SSDE) and anxiety episodes (SSAE), and patients with family psychiatric history. Methods: In a cross-sectional study, we included 144 consecutive patients with MTLE (82 pharmacoresistant and 62 treatment-responsive patients). Every patient underwent a psychiatric evaluation including the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) Axis I (SCID-I), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and Interictal Dysphoric Disorder Inventory (IDDI). Patients were divided into four groups: PsychNeg (G1, n = 61), current SSDE and SSAE (G2, n = 26), Current MD or AD (G3, n = 25), and current mixed MD/AD (G4, n = 32). Results: Among patients with pharmacoresistant MTLE, 68.3% (56/82) experienced symptoms of depression and/or anxiety (G2, G3, and G4) (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.41–5.53, p < 0.01). Patients with mixed MD/AD (G4, n = 24/32) were more likely to have pharmacoresistant MTLE (OR 4.04, 95% CI 1.57–10.42, p < 0.01) than psychiatric asymptomatic patients (G1, n = 26/61), and their seizure frequency was significantly higher (p < 0.01). Positive family psychiatric history was more frequent in pharmacoresistant patients (n = 27/82, OR 2.28, 95% CI 1.02–5.05, p = 0.04). Finally, 31.6% of patients with MD and or AD were not receiving psychiatric treatment. Significance: Identification of comorbid MD/AD and of family psychiatric history is of the essence in patients with MTLE, as they appear to be associated with worse seizure control.

KW - Anxiety

KW - Depression

KW - Epilepsy

KW - Family psychiatric history

KW - Subsyndromic depression

UR - http://www.scopus.com/inward/record.url?scp=85019692401&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019692401&partnerID=8YFLogxK

U2 - 10.1111/epi.13781

DO - 10.1111/epi.13781

M3 - Article

VL - 58

SP - 1268

EP - 1276

JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

IS - 7

ER -