Common psychiatric comorbidities in epilepsy: How big of a problem is it?

Salpekar, Jay A.; Mula, Marco

doi:10.1016/j.yebeh.2018.07.023

Cited by 75 publications

(65 citation statements)

References 82 publications

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“…Through a systematic process of adaptation, many EBIs have the potential to extend their reach beyond their original population. Among PWE, depression rates are extremely high, up to 55% [16]. Moreover, there are limited culturally relevant EBIs available to address depression among Blacks and Hispanics with epilepsy.…”

Section: Resultsmentioning

confidence: 99%

“…Depression, a common comorbid psychiatric disorder among PWE, more strongly predicts reduced quality of life than seizure frequency [16][17][18][19]. Suicide rates among PWE are 22% higher than among the general population, with an estimated average annual suicide rate of 16.89/ 100,000 among PWE compared with 13.84/100,00 in the general population [20,21].…”

Section: Epilepsy and Depressionmentioning

confidence: 99%

“…Moreover, people with both epilepsy and depression report higher levels of perceived seizure severity [18]. In addition, attention should be given to the double stigma associated with the comorbid condition of depression with epilepsy among minority populations as an underlying factor in poorer health outcomes [16,18,22,23]. The interaction of these two effects within marginalized populations may be an underlying contributor to poorer health outcomes in these populations.…”

Section: Epilepsy and Depressionmentioning

confidence: 99%

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Depression self-management in people with epilepsy: Adapting project UPLIFT for underserved populations

Quarells

Spruill

Escoffery

et al. 2019

Epilepsy & Behavior

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Data from the 2015 National Health Interview Survey found that the prevalence of active epilepsy has increased to three million adults. Although findings have been mixed, some research indicates that Blacks and Hispanics share a higher burden of epilepsy prevalence compared with non-Hispanic whites. Moreover, depression is a common comorbid condition among people with epilepsy (PWE), affecting up to 55% of the epilepsy population. Widespread use and increased public health impact of evidence-based self-management interventions is critical to reducing disease burden and may require adapting original interventions into more culturally relevant versions for racial and ethnic minority groups. Project UPLIFT provides access to mental health self-management skills training that is distance-delivered, does not interfere with medication management, and has been shown to be effective in reducing depressive symptoms. This paper presents the process of exploring the adaptation of Project UPLIFT for Black and Hispanic PWE and herein suggests that evidence-based interventions can be successfully adapted for new populations or cultural settings through a careful and systematic process. Additional key lessons learned include the importance of community engagement and that language matters. Ultimately, if the adapted Project UPLIFT intervention produces positive outcomes for diverse populations of PWE, it will extend the strategies available to reduce the burden of depression. Implementing evidence-based interventions such as Project UPLIFT is critical to reducing disease burden; however, their delivery may need to be tailored to the needs and culture of the populations of interest.

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Section: Resultsmentioning

confidence: 99%

Section: Epilepsy and Depressionmentioning

confidence: 99%

Section: Epilepsy and Depressionmentioning

confidence: 99%

See 1 more Smart Citation

Depression self-management in people with epilepsy: Adapting project UPLIFT for underserved populations

Quarells

Spruill

Escoffery

et al. 2019

Epilepsy & Behavior

View full text Add to dashboard Cite

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“…This neurological disease is relatively common, afflicting at least 70 million people in the world . Epilepsy is complex in its etiology and clinical manifestations . Compared to the general population, patients with epilepsy have a higher risk for suicidal ideation and psychiatric disorders .…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Epilepsy is complex in its etiology and clinical manifestations. 3 Compared to the general population, patients with epilepsy have a higher risk for suicidal ideation and psychiatric disorders. 4,5 In particular, it is estimated that about 46% of patients with epilepsy has a comorbid anxiety disorder.…”

Section: Introductionmentioning

confidence: 99%

Bilateral anterior capsulotomy enhances medication compliance in patients with epilepsy and psychiatric comorbidities

et al. 2019

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Summary Objectives Patients with epilepsy and refractory comorbid psychiatric disorders often experience functional impairments and a lower quality of life as well as showing a lack of compliance with anti‐epileptic medication regimens. We reasoned that widespread clinical benefits could be gained if the psychiatric comorbidities among these patients were reduced. In this study, we assessed the utility of anterior capsulotomy in managing medication‐refractory comorbid psychotic symptoms and aggression in patients with epilepsy. Methods In this retrospective case series, we evaluated the clinical outcomes of 13 epilepsy patients with severe psychiatric comorbidities who had received bilateral anterior capsulotomy. Clinical outcome assessments were performed at 1 week, 6 months, 1 year, and several years after surgery focusing on: (a) severity of psychotic symptoms, as assessed by the 18‐item Brief Psychiatric Rating Scale and the Positive and Negative Syndrome Scale; (b) severity of impulsivity and aggression, measured by the Barratt Impulsiveness Scale‐11 and the Buss‐Perry Aggression Scale; and (c) social function and quality of life, assessed by the Social Disability Screening Scale and the Quality of Life in Epilepsy. Results After anterior capsulotomy, patients displayed significant improvements of psychotic symptoms, as well as of impulsivity and aggression, along with improvements of social function and quality of life. The clinical benefits to patients were evident within 6 months after surgery and remained stable or continued to improve at a much slower rate thereafter. Furthermore, after anterior capsulotomy all patients complied with epilepsy interventions that they did not comply with prior to surgery. No significant side effects or complications occurred during the study. Conclusion Anterior capsulotomy seems to be a safe and effective treatment for epilepsy patients with otherwise intractable comorbid psychotic symptoms and aggression. Moreover, this neurosurgical treatment may improve the patients' social function, quality of life, and compliance with anti‐epilepsy medication regimens.

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Managing depression and anxiety in people with epilepsy: A survey of epilepsy health professionals by the ILAE Psychology Task Force

et al. 2021

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Summary Objectives The Psychology Task Force of the Medical Therapies Commission of the International League Against Epilepsy (ILAE) has been charged with taking steps to improve global mental health care for people with epilepsy. This study aimed to inform the direction and priorities of the Task Force by examining epilepsy healthcare providers’ current practical experiences, barriers, and unmet needs around addressing depression and anxiety in their patients. Methods A voluntary 27‐item online survey was distributed via ILAE chapters and networks. It assessed practices in the areas of screening, referral, management, and psychological care for depression and anxiety. A total of 445 participants, from 67 countries (68% high income), commenced the survey, with 87% completing all components. Most respondents (80%) were either neurologists or epileptologists. Results Less than half of respondents felt adequately resourced to manage depression and anxiety. There was a lack of consensus about which health professionals were responsible for screening and management of these comorbidities. About a third only assessed for depression and anxiety following spontaneous report and lack of time was a common barrier (>50%). Routine referrals to psychiatrists (>55%) and psychologists (>41%) were common, but approximately one third relied on watchful waiting. A lack of both trained mental health specialists (>55%) and standardized procedures (>38%) was common barriers to referral practices. The majority (>75%) of respondents’ patients identified with depression or anxiety had previously accessed psychotropic medications or psychological treatments. However, multiple barriers to psychological treatments were endorsed, including accessibility difficulties (52%). Significance The findings suggest that while the importance of managing depression and anxiety in patients with epilepsy is being recognized, there are ongoing barriers to effective mental health care. Key future directions include the need for updated protocols in this area and the integration of mental health professionals within epilepsy settings.

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Common psychiatric comorbidities in epilepsy: How big of a problem is it?

Cited by 75 publications

References 82 publications

Depression self-management in people with epilepsy: Adapting project UPLIFT for underserved populations

Depression self-management in people with epilepsy: Adapting project UPLIFT for underserved populations

Bilateral anterior capsulotomy enhances medication compliance in patients with epilepsy and psychiatric comorbidities

Managing depression and anxiety in people with epilepsy: A survey of epilepsy health professionals by the ILAE Psychology Task Force

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