Article

Prevalence of Psychopathology in Dutch Epilepsy Inpatients: A Comparative Study.

Stichting Epilepsie Instellingen Nederland, Heemstede, The Netherlands
Epilepsy & Behavior (Impact Factor: 2.06). 11/2001; 2(5):441-447. DOI: 10.1006/ebeh.2001.0242
Source: PubMed

ABSTRACT The purpose of this study was to determine the prevalence of psychiatric disorders in Dutch patients with epilepsy in comparison with epidemiological data on a representative sample of the Dutch population. The Composite International Diagnostic Interview (CIDI) was used to determine the prevalence of psychiatric disorders in 209 epilepsy patients and compared with findings in the general Dutch population. The prevalence in temporal lobe epilepsy (TLE) and extra-temporal lobe epilepsy (extra-TLE) was also compared. Psychiatric disorders most frequently found in patients with epilepsy were anxiety and mood disorders. The last-year prevalence of these disorders was 25% for anxiety disorders and 19% for mood disorders. Compared with the general Dutch population, the prevalence of these disorders was significantly higher in epilepsy. No differences were found between patients with TLE and extra-TLE. It can be concluded that patients with epilepsy admitted to a tertiary epilepsy center suffer more often from mood and anxiety disorders than the general population.

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    ABSTRACT: Although there has been increasing recognition of psychiatric comorbidity in epilepsy, most research and attention in this area has focused on depression. However, comorbid anxiety in epilepsy is highly prevalent, affecting more than 40 % of patients in some reports. Many important outcomes are significantly impacted by anxiety in epilepsy, including quality of life, mortality, and seizure status. Recent evidence from epidemiologic studies suggests a bidirectional association of anxiety and epilepsy, and there is mounting evidence for possible common pathophysiology underlying anxiety and epilepsy. Despite this importance, anxiety is under-recognized and undertreated in clinical practice. A variety of anxiety symptoms are seen in epilepsy, including symptoms exclusively before, during or after seizures (peri-ictal anxiety), symptoms resembling primary anxiety disorders, and anxiety directly related to epilepsy or its treatment. Key therapeutic approaches include pharmacotherapy or cognitive behavioral therapy for most forms of interictal anxiety and better seizure control for peri-ictal anxiety.
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    ABSTRACT: INTRODUCTION: Several psychiatric comorbidities linked to epilepsy are prevalent, and they can reduce the people with epilepsy (PE) health-related quality of life (HRQOL). OBJECTIVES: To approach the magnitude of the psychiatric comorbidities, their distribution, according to the distribution by age and gender. To recognize: the risk factors for them, and their classification/diagnosis; the indexes of multimorbididity of potential use in epileptology, and their applicability in HRQOL; repercussion in the clinical practice of the approach of the mentioned comorbidities. METHODS: Narrative revision on psychiatric comorbidities, mainly based on population based studies published in the last 10 years. RESULTS: The psychiatric disorders are more prevalent in the PE than in the general population, being the humor disorder, anxiety, psychoses, schizophrenia, personality disorder, and alcoholic dependence the most common. Several of them are more prevalent in any age group of the PE than in the general population, and more in the women than in the men, and they tend to echo negatively in their socioeconomic level. The diagnosis of these comorbidities is limited: it is not common the distinction between general psychiatric disorders and those related to the epilepsy. CONCLUSIONS: The psychiatric disorders are common in the PE, mainly of humor, but the rates are diversified as well as the used methodologies, and there is need of better approach of them to the patients' better clinical control, improvement of their HRQOL and reduction of health care costs.
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