Prevalence of Psychopathology in Dutch Epilepsy Inpatients: A Comparative Study

Stichting Epilepsie Instellingen Nederland, Heemstede, The Netherlands
Epilepsy & Behavior (Impact Factor: 2.26). 11/2001; 2(5):441-447. DOI: 10.1006/ebeh.2001.0242
Source: PubMed


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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Available from: Richard van Dyck, Aug 20, 2015
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    • "Furthermore, in the large epidemiological study by Qin et al., patients with localization related epilepsy were only slightly over-represented among those who were psychotic and this difference fell short of statistical significance [29]. Several studies have failed to confirm the commonly held view that there is a specific association between temporal lobe epilepsy and psychopathology which is in contrast to commonly accepted clinical practice [51-53]. "
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    ABSTRACT: Epilepsy has long been considered to be a risk factor for psychosis. However there is a lack of consistency in findings across studies on the effect size of this risk which reflects methodological differences in studies and changing diagnostic classifications within neurology and psychiatry. The aim of this study was to assess the prevalence of psychosis in epilepsy and to estimate the risk of psychosis among individuals with epilepsy compared with controls. A systematic review and meta-analysis was conducted of all published literature pertaining to prevalence rates of psychosis in epilepsy using electronic databases PUBMED, OVIDMEDLINE, PsychINFO and Embase from their inception until September 2010 with the following search terms: prevalence, incidence, rate, rates, psychosis, schizophrenia, schizophreniform illness, epilepsy, seizures, temporal lobe epilepsy. The literature search and search of reference lists yielded 215 papers. Of these, 58 (27%) had data relevant to the review and 157 were excluded following a more detailed assessment. 10% of the included studies were population based studies. The pooled odds ratio for risk of psychosis among people with epilepsy compared with controls was 7.8. The pooled estimate of prevalence of psychosis in epilepsy was found to be 5.6% (95% CI: 4.8-6.4). There was a high level of heterogeneity. The prevalence of psychosis in temporal lobe epilepsy was 7% (95% CI: 4.9-9.1). The prevalence of interictal psychosis in epilepsy was 5.2% (95% CI: 3.3-7.2). The prevalence of postictal psychosis in epilepsy was 2% (95% CI: 1.2-2.8). Our systematic review found that up to 6% of individuals with epilepsy have a co-morbid psychotic illness and that patients have an almost eight fold increased risk of psychosis. The prevalence rate of psychosis is higher in temporal lobe epilepsy (7%). We suggest that further investigation of this association could give clues to the aetiology of psychosis.
    Full-text · Article · Mar 2014 · BMC Psychiatry
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    • "Epilepsy not only is a neurological disorder and a disorder of consciousness, but also it is associated with a wide range of psychological disorders. Some of them are cognitive, personality and mood disorders (4), and no doubt, depression is the most common psychiatric disorder in patients with epilepsy (5-8). Different mechanisms have been found for depression in epilepsy, and the following problems can cause depression: "
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    ABSTRACT: Background: Depression disorder is the most prevalent neuropsychiatric disorder associated with epilepsy, and a correlation has been detected between depression and suicide. There is a relationship between suicidal behavior and coping mechanisms; therefore, it is important to undertake psychoanalytic psychotherapy to reduce depressive symptoms. Objectives: To evaluate the Coping Mechanisms, Depression and Suicidal Risk among Patients Suffering from Idiopathic Epilepsy. Materials and Methods: The present study is a cross-sectional pilot study in which 93 Iranian patients with idiopathic epilepsy were selected from Qaem hospital and neurological clinics. They answered three questionnaires: BDI, SSI, and a questionnaire of coping mechanisms. Patients were then interviewed and divided into two groups: patients with depression and suicidal ideation, and patients without depression and suicidal ideation. The two groups were compared in terms of coping mechanisms. Results: Among the patients who filled the questionnaires, only 74 were selected for the interview. 58.9% of the patients did not have depression or suicidal ideation and 23.3% of them had either depression or suicidal ideation. Findings of the study showed that the two groups had a significant difference in terms of repressive coping method efficiency (P = 0.022). However, there was no significant difference between the two groups in terms of problem-focused coping method (P = 0.25) and the emotion-focused coping method efficacy (P = 0.31). Conclusions: Iranian patients with idiopathic epilepsy and with either depression or suicidal ideation, make significant improvement using repressive coping method in comparison to patients with idiopathic epilepsy who did not suffer from depression or suicidal ideation. The effect of other coping mechanisms was not significantly different between the two groups. Keywords: Suicide; Epilepsy; Depression; Coping Skills
    Full-text · Article · Feb 2014
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    • "These methodological differences may account for the variability in prevalence estimates which makes accurate prevalence rates difficult to be confident about. Of the 12 studies that used diagnostic interviews, 11 have either assessed only those with refractory epilepsy [4,12–14] or did not specify the sample's level of seizure control [3] [4] [5] [6] [7] [8]. While it is generally accepted that PWE are at a higher risk of depression and anxiety, regardless of seizure control, it is also often stated that those most at risk of developing these conditions are those with a refractory epilepsy condition [e.g., 11,13,15] despite the lack of empirical evidence to support this assumption . "
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    ABSTRACT: Despite recent research into the impact of seizure control on mood disorders in epilepsy, it is often assumed that rates of psychiatric disorders are higher in people with refractory rather than well-controlled epilepsy. We assessed the point prevalence of mood and anxiety disorders and suicide risk using the Mini International Neuropsychiatric Interview (MINI) in a consecutive sample of epilepsy outpatients from a tertiary referral center. One hundred and thirty patients, whose epilepsy was categorized as well-controlled versus drug-treatment-refractory epilepsy (69; 53% well-controlled epilepsy) were recruited. High rates of mood disorders (n=34; 26%), anxiety disorders (n=37; 29%) and suicide risk (n=43; 33%) were found. However, there was no difference in rates of disorders or suicide risk for those with refractory versus well-controlled epilepsy. These results underscore the importance of assessment and management of psychopathology in all people with epilepsy, regardless of their seizure control.
    Full-text · Article · Nov 2012 · Epilepsy & Behavior
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