Labudda Kirsten, Illies Dominik, Bien Christian G, Neuner Frank
Bielefeld University, Department of Psychology, Bielefeld, Germany; Epilepsy Center Bethel, Mara Hospital, Bielefeld, Germany.
Bielefeld University, Department of Psychology, Bielefeld, Germany; Epilepsy Center Bethel, Mara Hospital, Bielefeld, Germany.
Epilepsy Res. 2018 Mar;141:13-18. doi: 10.1016/j.eplepsyres.2018.01.020. Epub 2018 Feb 3.
The interictal dysphoric disorder (IDD) is a proposed epilepsy-specific psychiatric condition characterized by a conglomerate of symptoms such as depression, irritability, euphoria, and anxiety. However, there are doubts about IDD as an independent entity and about its presumed epilepsy-specific nature.
Here, we investigated the association between psychiatric disorders and IDD in 120 patients with epilepsy, also analyzing potential associations between IDD symptoms and epilepsy-related variables. To test the epilepsy-specificity of IDD, we also studied IDD rates in 28 patients with pure psychogenic non-epileptic seizures. For the assessment of psychopathology, we used a structured clinical interview to determine the presence and nature of Axis I disorders and clinical questionnaires to assess psychopathological symptoms (anxiety, depression and severity of global distress). In accordance with most previous studies, we used the Interictal Dysphoric Disorder Inventory to assess IDD symptoms.
In our epilepsy group, we observed an IDD in 33% (42 of 120) of the patients. We diagnosed IDD in 39% (11 of 28) of the patients with psychogenic non-epileptic seizures without epilepsy. The majority of the patients with epilepsy with IDD have or had a psychiatric disorder (33 with a current, 6 with a past Axis I diagnosis). Patients with epilepsy with IDD had higher scores on all psychopathology questionnaires compared to the epilepsy patients without IDD.
Our findings suggest that IDD is not epilepsy-specific in nature, but occurs with the same frequency and the same pattern of symptoms in a purely psychiatric sample. We found a large overlap of IDD and common psychiatric comorbidities, mainly depression and anxiety disorders. This result calls the presumed nosological independency of IDD into question.
发作间期烦躁症（IDD）是一种拟议的癫痫特异性精神疾病，其特征为抑郁、易怒、欣快和焦虑等一系列症状。然而，对于IDD作为一个独立实体及其假定的癫痫特异性本质存在疑问。
在此，我们调查了120例癫痫患者中精神疾病与IDD之间的关联，还分析了IDD症状与癫痫相关变量之间的潜在关联。为检验IDD的癫痫特异性，我们还研究了28例单纯心因性非癫痫性发作患者的IDD发生率。为评估精神病理学，我们使用结构化临床访谈来确定轴I障碍的存在和性质，并使用临床问卷来评估精神病理症状（焦虑、抑郁和总体痛苦严重程度）。与大多数先前研究一致，我们使用发作间期烦躁症量表来评估IDD症状。
在我们的癫痫组中，我们观察到33%（120例中的42例）的患者患有IDD。我们在无癫痫的心因性非癫痫性发作患者中诊断出39%（28例中的11例）患有IDD。大多数患有IDD的癫痫患者有或曾有精神疾病（33例目前有轴I诊断，6例过去有轴I诊断）。与无IDD的癫痫患者相比，患有IDD的癫痫患者在所有精神病理学问卷上的得分更高。
我们的研究结果表明，IDD本质上并非癫痫特异性的，而是在纯精神科样本中以相同的频率和相同的症状模式出现。我们发现IDD与常见精神科共病有很大重叠，主要是抑郁症和焦虑症。这一结果使IDD假定的疾病分类独立性受到质疑。
