Centre Médical de la Teppe, Tain-l'Hermitage, France; Université de Lorraine, CNRS, CRAN, UMR 7039, Nancy, France; CHRU de Nancy, Département de Neurologie, Nancy, France.
Pôle Hospitalo-Universitaire de Psychiatrie d'Adultes du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France; Université de Lorraine, Faculté de Médecine, Vandœuvre-lès-Nancy, France.
Seizure. 2021 Feb;85:64-69. doi: 10.1016/j.seizure.2020.12.006. Epub 2020 Dec 18.
Fear of having a seizure called anticipatory anxiety of epileptic seizure (AAS), constitutes a daily life burden but has been rarely studied. Our aim was to assess the prevalence and the determining factors of AAS in patients with drug-resistant focal epilepsy, a dimension that has not been thoroughly investigated before.
We conducted an observational, prospective study enrolling patients with drug-resistant focal epilepsy. The psychiatric assessment aimed to evaluate psychiatric comorbidities, trauma history, and quality of life using hetero-evaluation and self-assessment tools. Dimensions of anxiety specifically related to epilepsy (peri-and-inter-ictal) were explored as exhaustively as possible.
AAS was found in 53 % of the 87 patients. We compared the two groups of patients: with or without AAS. Patients with AAS had a significantly shorter duration of epilepsy (p = 0.04). There was no difference between groups with respect to psychiatric disorders, except for cannabis dependence, more frequent in patients with AAS (p = 0.02). Compared to patients without AAS, those with AAS presented more subjective ictal anxiety (p = 0.0003) and postictal anxiety (p = 0.02), were more likely to avoid outdoor social situations due to seizure fear (p = 0.001), and had a poorer quality of life (QOLIE emotional well-being; p = 0.03). Additionally, they had experienced more traumatic events in their lifetime (p = 0.005) and reported more frequently a feeling of being unsafe during their seizures (p = 0.00002).
AAS is a specific dimension of anxiety, possibly linked to trauma history. AAS is strongly linked to subjective ictal anxiety but not to the objective severity of seizures or frequency.
对癫痫发作的恐惧，即癫痫发作预期焦虑（AAS），构成了日常生活负担，但很少有研究对此进行探讨。我们的目的是评估耐药性局灶性癫痫患者的 AAS 患病率及其决定因素，这是一个以前尚未彻底研究过的维度。
我们进行了一项观察性、前瞻性研究，纳入了耐药性局灶性癫痫患者。使用异质评估和自我评估工具评估了精神疾病合并症、创伤史和生活质量。尽可能详尽地探讨了与癫痫相关的焦虑维度（发作前和发作期间）。
87 名患者中发现 AAS 占 53%。我们比较了两组患者：有 AAS 和无 AAS。有 AAS 的患者癫痫发作时间明显更短（p=0.04）。两组在精神障碍方面无差异，除了 AAS 患者更常见的大麻依赖（p=0.02）。与无 AAS 的患者相比，有 AAS 的患者更主观地出现发作期焦虑（p=0.0003）和发作后焦虑（p=0.02），由于害怕发作而更不愿意参加户外社交活动（p=0.001），生活质量更差（QOLIE 情绪健康；p=0.03）。此外，他们一生中经历了更多的创伤性事件（p=0.005），并且更频繁地报告在发作期间感到不安全（p=0.00002）。
AAS 是一种特定的焦虑维度，可能与创伤史有关。AAS 与主观发作期焦虑密切相关，但与发作的客观严重程度或频率无关。
