Society for Epilepsy Research, Bethel Epilepsy Center, Bielefeld, Germany; Department of Psychology, Bielefeld University, Bielefeld, Germany.
Society for Epilepsy Research, Bethel Epilepsy Center, Bielefeld, Germany.
Seizure. 2017 Dec;53:103-109. doi: 10.1016/j.seizure.2017.11.008. Epub 2017 Nov 13.
Depressive and anxiety disorders are frequent among people with epilepsies. There are, however, only few longitudinal studies, which examine the relationship between these comorbid psychiatric disorders and epilepsy-related variables. Thus, we investigated the interrelationships of depression and anxiety symptoms with seizure frequency across time.
Before admittance to an epilepsy center (T1) and six months after discharge (T2), patients (n=198) with mainly difficult-to-treat epilepsies completed the Hospital Anxiety and Depression Scale (HADS). Correlation and path analyses were conducted.
Depression and anxiety symptoms (HADS) as well as seizure frequency significantly decreased from baseline to follow-up. Both at T1 and T2, seizure frequency was slightly, but significantly correlated with depression and anxiety levels (r=0.17-.32). Cross-lagged-analyses showed that baseline (T1) level of depression significantly predicted frequency of seizures at follow-up (T2). However, anxiety at T1 was not a significant predictor of seizure frequency at T2 and seizure frequency at T1 did not predict either depressive or anxiety symptoms at T2.
The present findings emphasize the importance of psychiatric comorbidities, especially depression, for seizure frequency and its progress in patients with difficult-to-treat epilepsies referred to a specialized epilepsy center. Thus, comorbid psychiatric disorders need specific consideration as part of a comprehensive diagnostic and therapeutic treatment approach.
癫痫患者中常伴有抑郁和焦虑障碍。然而，仅有少数纵向研究探讨了这些共病精神障碍与癫痫相关变量之间的关系。因此，我们研究了抑郁和焦虑症状与随时间变化的癫痫发作频率之间的相互关系。
在进入癫痫中心（T1）之前和出院后 6 个月（T2）时，主要患有难治性癫痫的患者（n=198）完成了医院焦虑和抑郁量表（HADS）。进行了相关性和路径分析。
抑郁和焦虑症状（HADS）以及癫痫发作频率均从基线显著下降到随访时。在 T1 和 T2 时，癫痫发作频率与抑郁和焦虑水平均呈轻度但显著相关（r=0.17-0.32）。交叉滞后分析表明，基线（T1）时的抑郁水平显著预测了随访时（T2）的癫痫发作频率。然而，T1 时的焦虑并不是 T2 时癫痫发作频率的显著预测因素，T1 时的癫痫发作频率也不能预测 T2 时的抑郁或焦虑症状。
本研究结果强调了精神病共病，尤其是抑郁，对难治性癫痫患者癫痫发作频率及其进展的重要性。因此，共病性精神障碍需要作为综合诊断和治疗方法的一部分进行专门考虑。
