Hajder Dragica, Sekulić Slobodan, Ignjatović Vojislava Bugarski, Popović Sanela, Popović Nemanja, Nikolašević Željka, Bukurov Ksenija Gebauer
Clinic of Neurology, University Clinical Center Vojvodina, 1 Hajduk Veljkova St, Novi Sad, 21 000, Serbia.
Faculty of Medicine, University of Novi Sad, 3 Hajduk Veljkova St, Novi Sad, 21 000, Serbia.
Acta Neurol Belg. 2025 Feb;125(1):89-98. doi: 10.1007/s13760-024-02632-8. Epub 2024 Sep 5.
The purpose of this cross-sectional study was to determine the frequency of depressive symptoms in patients with epilepsy (PWE) in a tertiary epilepsy center and to analyse possible predictors of depression in several domains, including clinical characteristics of epilepsy and sociodemographic factors.
PWE patients who visited our epilepsy clinic during the 6th month in 2020 and 2021 were enrolled in our study. To collect the data, structured scales were created for the clinical characteristics of the disease and for the sociodemographic data. All participants completed the Back Depression Inventory II (BDI-II). Univariate analysis and binary logistic regression were also conducted to identify the factors associated with depressive symptoms in PWE.
A total of 131 PWE were recruited for this study. It was determined that depressive symptoms were present in 51.1% of PWE. Of these, 49.25% manifested severe depressive symptoms. Approximately 18% of PWE use antidepressant medications, which is significantly less than that of PWE who are currently depressed. Univariate regression analysis revealed that female sex (p = 0.013), severe seizure frequency in the past year (p = 0.001), the use of the antiseizure medication polytherapy (p = 0.018), the presence of side effects of antiseizure medications (p = 0.001), a history of febrile seizures (p = 0.015), focal impaired awareness seizures (p = 0,051), and a combination of focal aware seizures with focal impaired awareness seizures combined with bilateral tonic‒clonic seizures (p = 0,006) may be associated with depressive symptoms in PWE patients. Binary logistic regression analysis demonstrated that side effects of antiseizure medications (OR = 3.01; 95% CI = 1.09-8.32), history of febrile seizures (OR = 3.75; 95% CI = 1.07-13.11), female sex (OR = 2.16; 95% CI = 0.984-4.73), and combination of focal aware seizures to focal impaired awareness seizures to bilateral tonic‒clonic seizures (OR = 7.32; 95% CI = 0.830-64.59) were unique, independent predictors of depressive symptoms in patients with epilepsy.
Depressive symptoms in PWE are frequent, severe, undiagnosed, and mostly untreated. The side effects of antiseizure medications, history of febrile seizures, female sex, and combination of focal awareness seizures and focal impaired awareness seizures combined with bilateral tonic‒clonic seizures are unique, independent predictors of depressive symptoms in PWE.
本横断面研究旨在确定三级癫痫中心癫痫患者（PWE）抑郁症状的发生率，并分析癫痫临床特征和社会人口学因素等多个领域中抑郁的可能预测因素。
纳入2020年和2021年第6个月期间到我们癫痫门诊就诊的PWE患者。为收集疾病临床特征和社会人口学数据创建了结构化量表。所有参与者均完成贝克抑郁量表第二版（BDI-II）。还进行了单因素分析和二元逻辑回归，以确定与PWE抑郁症状相关的因素。
本研究共招募了131名PWE。确定51.1%的PWE存在抑郁症状。其中，49.25%表现为严重抑郁症状。约18%的PWE使用抗抑郁药物，这显著低于当前抑郁的PWE。单因素回归分析显示，女性（p = 0.013）、过去一年严重癫痫发作频率（p = 0.001）、使用抗癫痫药物联合治疗（p = 0.018）、抗癫痫药物副作用的存在（p = 0.001）、热性惊厥病史（p = 0.015）、局灶性意识障碍发作（p = 0.051）以及局灶性意识发作与局灶性意识障碍发作合并双侧强直阵挛发作（p = 0.006）可能与PWE患者的抑郁症状相关。二元逻辑回归分析表明，抗癫痫药物副作用（OR = 3.01；95%CI = 1.09 - 8.32）、热性惊厥病史（OR = 3.75；95%CI = 1.07 - 13.11）、女性（OR = 2.16；95%CI = 0.984 - 4.73）以及局灶性意识发作到局灶性意识障碍发作再到双侧强直阵挛发作的组合（OR = 7.32；95%CI = 0.830 - 64.59）是癫痫患者抑郁症状的独特、独立预测因素。
PWE的抑郁症状常见、严重、未被诊断且大多未得到治疗。抗癫痫药物副作用、热性惊厥病史、女性以及局灶性意识发作和局灶性意识障碍发作合并双侧强直阵挛发作的组合是PWE抑郁症状的独特、独立预测因素。
