Anxiety in adolescent epilepsy. A clinimetric analysis

Abstract

Background Anxiety and depression have been considered to be neglected disorders in epilepsy. Because panic disorder is one of the most important anxiety disorders, it has been problematic to use very comprehensive anxiety questionnaires in epilepsy patients, as panic attacks and epileptic seizures, although two distinct clinical entities from a diagnostic point of view, show a significant overlap of symptoms. Aims We have focused on single items for anxiety and depression as screening candidates in adolescent epilepsy. Methods The individual panic attack item in the Screen for Children Anxiety Related Emotional Disorders Scale (SCARED) and the single depression item in the Kellner Symptom Questionnaire were tested. Our samples consisted of adolescent patients with epilepsy and a matched control group with healthy participants, as well as two numerical groups acting as controls. Results The single panic attack item identified panic anxiety in 24.1% in the group of patients with epilepsy and 0.0% in the matched control group (p = 0.01). The single depression item identified 52.2% with depression in the epilepsy group and 6.2% in the matched control group (p = 0.001). Conclusion As screening instruments, single items of panic attack and depression are sufficient to screen for these affective states in adolescent epilepsy. The clinical implications are that it is important to be quite specific when screening for depression and panic attacks in adolescent patients with epilepsy.

Efficacy and safety of oxcarbazepine in the treatment of children with epilepsy: a meta-analysis of randomized controlled trials

“…Heterogeneity across the included studies was assessed by using I 2 statistic and Cochran’s Q χ 2 test 16. An I 2 value >50%, or the value of P <0.10 indicated significant heterogeneity 16.…”

“…Heterogeneity across the included studies was assessed by using I 2 statistic and Cochran’s Q χ 2 test 16. An I 2 value >50%, or the value of P <0.10 indicated significant heterogeneity 16. When significant heterogeneity was identified, a random-effects model (DerSimonian–Laird method)17 was used to pool the estimates; otherwise, a fixed-effects model (Mantel–Haenszel method)18 was applied.…”

“…Semiologically, it is classified as partial or generalized 2. The clinical manifestations can occur through sensitive, sensory, psychological, vegetative, and motor signs and symptoms of simple or complex nature depending on the neural system involved in the genesis of the disease 2–4. It has been estimated that 50 million patients around the world suffer from epilepsy 1.…”

Is a Single-Item Measure of Self-Rated Mental Health Useful from a Clinimetric Perspective?

“…Bech and his colleagues demonstrated that a single-item screening for depression had as good or better sensitivity than other screening tools, although its specificity suggested that it should be followed up by a thorough diagnostic interview [3]. Bech and his research group also demonstrated that single items were more valid than long questionnaires in discriminating between the symptoms of panic attack and epilepsy seizures [4]. Very often indeed long questionnaires include redundant items that can lower sensibility, while independence of items can preserve it, and Bech focused on the evaluation of single items as independent indicators of a symptom.…”

Epilepsy and Psychiatric Disorders: Is There a Common Genetic Susceptibility?

“…According to epidemiological data, 25-48% of PWE suffer from mood disorders, and 14-31% from anxiety [2]. Moreover, depression represents one of the most common psychiatric disorders in PWE, with a point prevalence ranging from 12-37% in community settings [3].…”