Research and Clinical Center for Neuropsychiatry, Moscow, Russian Federation.
Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russian Federation.
Epilepsia. 2021 Jun;62(6):1382-1390. doi: 10.1111/epi.16902. Epub 2021 Apr 15.
Interictal dysphoric disorder (IDD) has been regarded as an affective disorder occurring only in people with epilepsy (PWE). Data showing similar characteristics and similar prevalence of IDD in patients with migraine and with psychogenic nonepileptic seizures question the epilepsy-specific nature of IDD. The aim of the study was to investigate the nature of IDD in people with prevalent epilepsy with mood disorders and people with mood disorders who are free of neurological disease.
This is a case-control study, with 142 patients with a confirmed diagnosis of epilepsy and major depressive disorder (MDD; cases) and 222 patients with MDD only (controls). MDD diagnosis was confirmed by a structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (SCID-I-RV). We used the Beck Depression Inventory and the Beck Anxiety Inventory to estimate anxiety and depression levels and the Interictal Dysphoric Disorder Inventory (IDDI) to confirm the presence of IDD. Mann-Whitney U test, Pearson chi-squared, Spearman correlation, and logistic regression were used.
No differences were found in the prevalence of IDD between PWE with MDD and people with MDD alone (88.73% vs. 85.13%, χ2 = .96, p = .32). There were no differences between the groups overall or for any IDDI subscales (all p > .05). In both groups, IDD symptoms were grouped with the same incidence and had the same duration and periodicity. IDD was not associated with epilepsy (odds ratio = .84, 95% confidence interval = .40-1.98, p = .72). No significant correlation was found between epilepsy, demographic characteristics, and all IDDI subscales (all p > .05). Notably, patients with IDD suffered from affective disorders longer (6.68 ± 6.82 years vs. 3.7 ± 3.97 years, p = .001) and also received higher scores on all psychometric scales (all p < .05).
This study does not confirm the specificity of IDD for epilepsy. The presence of IDD symptoms may be associated with a more severe course of MDD and significant anxiety distress.
间发性抑郁障碍（IDD）被认为是仅发生在癫痫患者（PWE）中的一种情感障碍。数据显示偏头痛和非癫痫性精神性发作患者中存在类似的 IDD 特征和相似的患病率，这对 IDD 的癫痫特异性提出了质疑。本研究旨在调查伴有心境障碍的常见癫痫患者和无神经疾病的心境障碍患者中 IDD 的性质。
这是一项病例对照研究，纳入了 142 例确诊为癫痫和重性抑郁障碍（MDD；病例）的患者和 222 例仅患有 MDD 的患者（对照组）。MDD 的诊断通过第四版《精神障碍诊断与统计手册》（DSM-IV）的结构临床访谈（SCID-I-RV）进行确认。我们使用贝克抑郁量表和贝克焦虑量表来评估焦虑和抑郁水平，并用间发性抑郁障碍量表（IDDI）来确认 IDD 的存在。使用曼-惠特尼 U 检验、皮尔逊卡方检验、斯皮尔曼相关分析和逻辑回归进行分析。
PWE 伴 MDD 患者和单纯 MDD 患者的 IDD 患病率无差异（88.73% vs. 85.13%，χ2=0.96，p=0.32）。总体上或在任何 IDDI 分量表上，两组之间均无差异（均 p>0.05）。在两组中，IDD 症状以相同的发生率分组，具有相同的持续时间和周期性。IDID 与癫痫无关（比值比=0.84，95%置信区间=0.40-1.98，p=0.72）。癫痫、人口统计学特征与所有 IDDI 分量表之间未发现显著相关性（均 p>0.05）。值得注意的是，患有 IDD 的患者患有情感障碍的时间更长（6.68±6.82 年 vs. 3.7±3.97 年，p=0.001），且所有心理计量学量表的评分也更高（均 p<0.05）。
本研究不支持 IDD 对癫痫的特异性。IDID 症状的存在可能与更严重的 MDD 病程和明显的焦虑困扰有关。
