Patterns of depressive symptoms in epilepsy

Abstract

Occurring in approximately one-third of patients, depression is the most common interictal psychiatric disorder in patients with epilepsy. Moreover, depression is associated with poor scores in health-related quality of life measures in the general population as well as among epileptic patients 1,2 . Given the high prevalence and associated morbidity and mortality, as well as the fact that the use of antidepressants could very often reduce the seizure threshold, recognition and appropriate treatment of depressive symptomatology in patients with epilepsy should be of primary concern in clinical practice 2,3 .The aim of this study was to screen epileptic patients for depressive symptoms, to determine the nature and extent of these symptoms and to examine the possible relationships with the clinical features of epilepsy. METHODSAll patients selected for the study, attending the specialist epilepsy clinics of the Department of Neurology of the University of Athens on self-initiated visits. Patients were evaluated thoroughly by two specialists and then asked to describe their seazures in foul text with details, in order to distinguish seizure types Thorough physical and neurological examinations were also performed. Additionally, all patients were doing laboratory studies including serum tests and EEG (electroencephalograrhy). Finally the diagnosis of the type of epilepsy was given based in all the abovementioned features, as well as further follow-up of patients. ABSTRACTObjective: The purpose of this study was to determine the nature and extent of depressive symptoms among patients with epilepsy. Methods: Ninety patients were investigated over a three-month period: 42 were suffering from generalized epilepsy, 29 from focal epilepsy and 19 from undetermined epilepsy. All completed the Zung self-rating scale for assessment of the depressive symptoms. Results: Sixty-seven patients felt stigmatized because of epilepsy (67%): 73.6% in the undetermined epilepsy group, 55.1% in the focal epilepsy group and 88% in the generalized epilepsy group. Moreover, among the 90 epileptic patients studied, symptoms of irritability, indecisiveness, personal devaluation and emptiness showed a constant increasing trend for their presence from the undetermined epilepsy group through the generalized epilepsy group to the focal epilepsy group. Conclusions: These findings indicate that although the focal epilepsy patients felt less stigmatized, they did not differ greatly in terms of depressive symptoms, in relation to the undetermined epilepsy and generalized epilepsy patients.Key words: epilepsy, depression, Zung self-rating scale. RESUMOObjetivo: O objetivo deste estudo foi determinar a natureza e extensão dos sintomas depressivos entre pacientes com epilepsia. Métodos: Noventa pacientes foram avaliados durante o período de três meses: 42 apresentando epilepsia generalizada, 29 com epilepsia focal e 19 com epilepsia indeterminada. Todos completaram a auto-escala de Zung para avaliação de sintomas depressivos. Resultados: Sessenta e sete...