Grzegorzewska Agata Maria, Wiglusz Mariusz Stanisław, Jakuszkowiak-Wojten Katarzyna, Cubała Wiesław Jerzy, Włodarczyk Adam, Szarmach Joanna
Department of Psychiatry, Medical University of Gdansk, Faculty of Medicine, Gdansk, Poland.
Psychiatry Clin Psychopharmacol. 2024 Jun 1;34(2):191-196. doi: 10.5152/pcp.2023.22546. eCollection 2024 Jun.
Patients with epilepsy present a variety of psychiatric comorbidities, with mood disorders and anxiety disorders as well as interictal dysphoric disorder as the most frequent and often associated with comorbid mental conditions. Interictal dysphoric disorderand ictal and peri-ictal changes may contribute to overall clinical symptomatology in epilepsy, as well as subjective and objective adverse effects of anti-epileptic drugs. We performed a post-hoc analysis to verify the relation of interictal dysphoric disorder with specific clinical and demographic variables in people with epilepsy, including the correlation between interictal dysphoric disorder and anti-epileptic drugs. We found no correlation between the incidence of interictal dysphoric disorder and drug-resistant epilepsy, and no correlation between the incidence of interictal dysphoric disorder and sex was observed. The results of our analysis indicate that patients with interictal dysphoric disorder, compared with those with no interictal dysphoric disorder, had epilepsy onset at a later age, had had a history of psychiatric treatment and had distinctly lower, but not statistically significant, percentage of active employment status. Another finding was the frequent suicide attempts in people with epilepsy (11.5%). However, there was no relationship with interictal dysphoric disorder. We also did not find any evidence supporting the impact of epileptic medication on the incidence of interictal dysphoric disorder nor did the data contribute to support the evidence of interictal dysphoric disorder as a standing-alone phenomenon. An essential issue in epilepsy is awareness and understanding of interictal dysphoric disorder and concomitant mental health abnormalities as this is crucial for clinical practice and may significantly determine the progression and management of epilepsy if it remains ignored, and hence lead to a severe decline in life quality.
癫痫患者存在多种精神共病，其中情绪障碍、焦虑障碍以及发作间期烦躁症最为常见，且常与共病性精神状况相关。发作间期烦躁症以及发作期和发作期周围的变化可能导致癫痫的整体临床症状，以及抗癫痫药物的主观和客观不良反应。我们进行了一项事后分析，以验证癫痫患者发作间期烦躁症与特定临床和人口统计学变量之间的关系，包括发作间期烦躁症与抗癫痫药物之间的相关性。我们发现发作间期烦躁症的发生率与耐药性癫痫之间没有相关性，且未观察到发作间期烦躁症的发生率与性别之间存在相关性。我们的分析结果表明，与无发作间期烦躁症的患者相比，有发作间期烦躁症的患者癫痫发病年龄较晚，有精神科治疗史，且在职状态的百分比明显较低，但无统计学意义。另一个发现是癫痫患者中频繁出现自杀未遂情况（11.5%）。然而，这与发作间期烦躁症无关。我们也没有找到任何证据支持癫痫药物对发作间期烦躁症发生率的影响，数据也无法支持发作间期烦躁症作为一种独立现象的证据。癫痫中的一个重要问题是对发作间期烦躁症以及伴随的心理健康异常的认识和理解，因为这对临床实践至关重要，如果被忽视，可能会显著影响癫痫的进展和管理，进而导致生活质量严重下降。
