Background. Over the past decades many Russian and foreign authors have devoted their studies to psychiatric comorbidity and suicidal behaviour in people with epilepsy. It is particularly important to find risk factors to develop suicidal ideation in this group of patients. According to the World Health Organisation, suicide is the second cause of death among patients with epilepsy, especially those under 29 years. Social maladaptation and deviant reactions to isolation within the framework of personality disorder and frustrating elements necessitate strategy development to prevent suicide intentions in this group of patients. Objective: to find risk factors contributing to suicidal behaviour in patients with epilepsy. Material and methods. We examined 102 patients diagnosed with epilepsy and divided them into two groups consistent with the available relevant suicide ideators: Group 1 (reference group) – without suicide ideators (n=73), Group 2 (study group) – with suicide ideators at the time of the study (n=29). We conducted a pathopsychological study using scales and questionnaires. Results. Patients with epilepsy and suicidal ideation are more vulnerable to a wide range of mental health disorders. Behavioural and mood disorders predominate. Risk factors for suicide in this patient cohort relate to a darker outlook on the future and emotional instability. All limits of the antisuicidal behaviour pattern reduced uniformly, except for the Family responsibility. Amidst the severe course of the underlying medical conditions, disharmony is formed in attitude towards the disease. Conclusion. Assessment of the risk factors for the development of suicidal ideation in patients with epilepsy is a challenging multidisciplinary task. Even with relative mental well-being, it is worth focusing on all aspects of quality of life.
Introduction The average time between epilepsy onset and epilepsy surgery is currently approximately 20 years. In epilepsy, research on the problem of late referral for neurosurgical treatment is crucial. We aimed to investigate gender differences in the willingness of patients to undergo epilepsy surgery for focal drug-resistant epilepsy (DRE). Methods. It was a single-centre retrospective, observational, longitudinal cohort study in the outpatient and functional neurosurgery departments. We developed a structured questionnaire to examine patients' demographic data, disease history, and perceptions of neurosurgical treatment (duration of epilepsy and optimal age for neurosurgery) in two gender groups. We examined data from 53 patients; eight people were dropped out from the research. Results. Ninety-four point three per cent of outpatients and inpatients answered in the affirmative form the question about their willingness to undergo epilepsy surgery for focal DRE. There were 26 men in group one and 19 women in group two. The disease had been present for 19.26 ± 1.35 years before epilepsy surgery or the decision to undergo surgery. Patients with no significant gender differences between groups considered that the ideal age for neurosurgery was 18.66 ± 1.3 years and that the optimal duration of the disease was 6.94 ± 1.02 years, which was two point eight times shorter than the actual duration of epilepsy. Conclusions. No gender differences in willingness to undergo surgical management of focal DRE were found. The subjective time in which a patient decides to undergo epilepsy surgery is much shorter than the objective time from epilepsy onset to neurosurgery. This could be one of the solutions to the problem of late referral for epilepsy surgery.
Background. Pharmacoresistant epilepsy, i.e. failure to achieve adequate seizure control with antiepileptic drugs develops in 30–40 % of patients. The surgical treatment for these patients are of particular importance. The relevance of studying the emotional sphere of neurosurgical patients with drug-resistant epilepsy stems from the high incidence of this pathology and its impact on patients’ quality of life.Objective. To investigate comorbidity indicators: depression and anxiety in neurosurgical patients with drug-resistant epilepsy during the preoperative and postoperative periods of epilepsy treatment.Design and methods. In 2019–2020, Polenov Neurosurgical Institute studied comorbid affective pathology in 46 neurosurgical patients with drug-resistant epilepsy in 2 groups: Group 1 — preoperative and Group 2 — postoperative patients, using HADS for screening.Results. The study included 46 patients in 2 groups. Group1 — 56.5 %, Group2 — 43.5 %. The mean age of the participants in the study was 30.8 ± 1.1 years. The sex ratio in the cohort was 1.7 males to 1 female. In the cohort, no anxiety was observed in 71.7 % and depression in 84.8 %, severe anxiety in 13 % and depression in 8.7 %.Conclusion. Among the neurosurgical patients with drug-resistant epilepsy, patients without symptoms of anxiety and depression predominated. There is a need to expand the sample and investigate further.
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