Depressive symptoms in patients with epilepsy and clinically associated features in a single tertiary center

Abstract

Although depressive symptoms are the most common psychiatric comorbidity in epilepsy, they remain underestimated and untreated in a large proportion of patients. The purpose of this study was to evaluate depression severity and related clinical features in people with epilepsy using a well-reliable self-report index of mood, the Beck Depression Inventory-II (BDI-II). One-hundred seventeen adult patients with epilepsy were recruited from a tertiary epilepsy center and completed the BDI-II. A single-item analysis of the 21 questions of the BDI-II was computed and differences between women and men in each depressive symptom were evaluated. Correlation and regression analyses were used to identify clinical features associated with the severity of depression. Results showed gender differences in some items, with women reporting overall higher depression severity than men. The most common symptoms regarded domains of sleeping patterns, tiredness, and loss of energy. Regression evidence suggested that being female, having an epilepsy duration < 10 years, as well as being treated with psychotropic drugs and reporting generalized seizure, were associated with higher depression severity. Despite its cross-sectional nature, this study reinforces the importance of investigating and possibly treating depressive symptoms in adult patients with epilepsy, since they negatively impact well-being, daytime activities, and sleep. Further studies identifying pharmacological and non-pharmacological treatments for depression in epilepsy need to be planned.

A unified hypothesis of SUDEP: Seizure‐induced respiratory depression induced by adenosine may lead to SUDEP but can be prevented by autoresuscitation and other restorative respiratory response mechanisms mediated by the action of serotonin on the periaqueductal gray

“…Comorbid major depressive disorder is commonly observed in PWE, and a number of PWE have been treated with antidepressant drugs that enhance the action of 5-HT. 190 These findings led to the evaluation of clinical evidence regarding the effects of modifying 5-HT action on postictal depression in PWE. The retrospective clinical study of Bateman et al 191 showed that the degree of postictal respiratory depression in PWE who were taking SSRIs was significantly less than that in PWE who were not taking these drugs.…”

“…As noted above, postictal respiratory depression is a common event in PWE, and death was precipitated by respiratory failure in most witnessed cases of human SUDEP. Comorbid major depressive disorder is commonly observed in PWE, and a number of PWE have been treated with antidepressant drugs that enhance the action of 5‐HT 190 . These findings led to the evaluation of clinical evidence regarding the effects of modifying 5‐HT action on postictal depression in PWE.…”

The Prevalence of Depression in Patients With Epilepsy in the Kingdom of Saudi Arabia

“…Common symptoms included sleeping patterns, tiredness, and energy loss. Factors such as being female, having epilepsy for less than 10 years, being treated with psychotropic drugs, and reporting generalized seizures were associated with greater depression severity [ 13 ].…”

Depression as comorbidity in Sundanese epilepsy patients

“…A longer duration of epilepsy might reflect a greater period available to face stressful difficulties posed by the disease. 38 Moreover, PWE with uncontrolled seizures exhibited a higher risk of depression. Frequent seizures negatively affected seizure worry, emotional well-being, and social function.…”