Department of Psychiatry, Medical University of Gdańsk, Gdańsk, Poland.
Psychiatr Danub. 2012 Sep;24 Suppl 1:S44-50.
Mood disorders are common in people with epilepsy (PWE) with prevalence rates ranging from 11% to 62%. The variation in epidemiological data results probably from the diversity of methodologies employed and selection of the populations across the studies. Moreover, the symptomathology of mood disorders in epilepsy is often atypical, intermittent and pleomorphic and fails to meet DSM-IV-TR categories. Several studies suggested the existence of distinct interictal dysphoric disorder (IDD) in patients with epilepsy. The majority of research studies in mood disorders in epilepsy were based on screening instruments in the diagnosis of mood disorders in PWE. However, the results in validity and reliability in detecting major depression in epilepsy using self-report inventories of mood symptoms is vague. The aim of this study was to review studies on mood disorders in epilepsy with particular focus on diagnostic methods.
The focus of this Review was on patient studies on mood disorders in epilepsy (2000-2012). We searched PubMed using the following search terms (effective date: 20th May 2012): (epilepsy (Title/Abstract) OR seizure (Title/Abstract)) AND depression (Title/Abstract) OR Dysthymia OR mania OR bipolar disorder OR affective disorder OR Interictal Dysphoric Disorder OR AND (humans (MeSH Terms) AND English (lang) AND (2000/01/01(PDAT): 2012/04/31(PDAT)).
Depression is the most frequent comorbid psychiatric disorder in epilepsy. Recent studies pointed out that bipolar disorders are not rare in epilepsy. Most of the research in PWE did not rely on standardized psychiatric measures and only about 18% of studies were based on diagnostic psychiatric interviews (mainly MINI and SCID-I). Mood disorders in epilepsy excluding the ictal or periictal symptoms can be categorized using standardized measures.
Common self-report depression measures may be used to screen for depression in clinical settings. The use of screening instruments in epilepsy must be followed by structured psychiatric interviews designed to establish a DSM-IV-TR diagnoses. Standardized psychiatric interview procedures based on DSM criteria like SCID-I or MINI provide a comprehensive way to diagnose mood disorders in patients with epilepsy.
情绪障碍在癫痫患者中很常见，患病率在 11%到 62%之间。流行病学数据的差异可能是由于研究中使用的方法多样性和人群选择不同所致。此外，癫痫患者的情绪障碍症状通常是非典型的、间歇性的和多形性的，不符合 DSM-IV-TR 分类。一些研究表明，癫痫患者存在独特的癫痫间期抑郁障碍（IDD）。癫痫患者情绪障碍的大多数研究都是基于筛查工具进行的。然而，使用情绪症状自评量表检测癫痫患者重度抑郁症的有效性和可靠性的结果尚不清楚。本研究的目的是综述癫痫患者情绪障碍的研究，特别关注诊断方法。
本综述的重点是癫痫患者情绪障碍的患者研究（2000-2012 年）。我们使用以下搜索词在 PubMed 中搜索（有效日期：2012 年 5 月 20 日）：（epilepsy（标题/摘要）或 seizure（标题/摘要））AND depression（标题/摘要）或 dysthymia 或 mania 或 bipolar disorder 或 affective disorder 或 Interictal Dysphoric Disorder 或 AND（humans（MeSH Terms）AND English（lang）AND（2000/01/01（PDAT）：2012/04/31（PDAT））。
抑郁症是癫痫最常见的合并症。最近的研究指出，双相情感障碍在癫痫中并不罕见。癫痫患者的大多数研究都没有依赖于标准化的精神科措施，只有约 18%的研究基于诊断性精神科访谈（主要是 MINI 和 SCID-I）。不包括发作期或发作间期症状的癫痫患者的情绪障碍可以使用标准化的措施进行分类。
常见的自评抑郁量表可用于临床筛查。在癫痫中使用筛查工具后，必须进行结构化的精神病访谈，以建立 DSM-IV-TR 诊断。基于 DSM 标准的标准化精神病访谈程序，如 SCID-I 或 MINI，为诊断癫痫患者的情绪障碍提供了一种全面的方法。
