Disability patterns over the first year after a diagnosis of epilepsy

Xu, Ying; Neuen, Dennis R.; Glozier, Nick; Nikpour, Armin; Somerville, Ernest; Bleasel, Andrew; Ireland, Carol A.; Anderson, Craig S.; Hackett, Maree L.

doi:10.1016/j.clineuro.2019.02.022

Cited by 4 publications

(11 citation statements)

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“…After adjusting all the potential confounders, greater disability (the highest WHODAS score) was associated with increased odds of having neurological disorders when compared with lower disability (the lower WHODAS score) [OR = 1.30 (95% CI 1.02-1.66)]. Consistent with our finding a recent study found a significant and positive association between greater disability and increased risks of depression [47].…”

Section: Plos Onesupporting

confidence: 89%

Prevalence and correlates of diagnosed and undiagnosed epilepsy and migraine headache among people with severe psychiatric disorders in Ethiopia

Ayano

Demelash

Yohannes³

et al. 2020

PLoS ONE

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Background There is a paucity of research on the prevalence of diagnosed as well as undiagnosed neurological disorders with episodic manifestations such as epilepsy and migraine headaches in people with severe psychiatric disorders (SPD). To the best of our knowledge, this is the first study analyzing and comparing the prevalence of diagnosed and undiagnosed chronic neurological disorders with episodic manifestations including epilepsy and migraine headache in people with SPD. Method This quantitative cross-sectional survey was undertaken among 309 patients with SPD selected by a systematic random sampling technique. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) was used to confirm SPD among the participants. The International Classification of Headache Disorders (ICHD-3) and International League Against Epilepsy (ILAE) were used to define migraine headache and epilepsy, respectively]. Risk factors for chronic neurologic disorders were explored by using logistic regression models. Result In this study, the prevalence of overall neurological disorders, epilepsy, and migraine headache among people with SPD were found to be 5.2% (95%CI 3.2–8.3), 1.6% (95%CI 0.7–3.9), and 3.9% (95%CI 2.2–6.7), respectively. We found that a considerably higher proportion of people with SPD had undiagnosed overall neurological disorder (87.5%; 14/16), epilepsy (60%; 3/5), as well as migraine headaches (100%; 12/12). On the other hand, in this study, 12.5%, 40%, and 0% of patients with overall neurologic disorder, epilepsy, and migraine headaches respectively were diagnosed by the professionals. Higher disability score (WHODAS score) was associated with increased odds of having neurological disorders compared with the lower WHODAS score [OR = 1.30 (95% CI 1.02–1.66)]. Conclusion Whilst the prevalence estimates of neurological disorders with episodic manifestations including epilepsy and migraine headache was high among people with SPD, the vast majority of them remained undiagnosed. The diagnosis rates of those disorders were significantly low, perhaps surprisingly zero for migraine headache. High WHODAS score was associated with increased odds of having neurological disorders. Routine screening and management of epilepsy and migraine headache are imperative among people with SPD.

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Section: Plos Onesupporting

confidence: 89%

Prevalence and correlates of diagnosed and undiagnosed epilepsy and migraine headache among people with severe psychiatric disorders in Ethiopia

Ayano

Demelash

Yohannes³

et al. 2020

PLoS ONE

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“…Fourteen [7][8][9][10][11][12][13][14][15][16][17][18][19][20] were cohort studies and two 21,22 were randomized controlled trials. Three 13,18,19 studies considered first seizure cohorts exclusively (Table 1), eight 17,[23][24][25][26][27][28][29] considered newly diagnosed epilepsy cohorts exclusively (Table 2), and five 21,22,[30][31][32] considered both first seizure and newly diagnosed epilepsy cohorts (Table 3). Nine studies 17,19,[21][22][23]25,[28][29][30] excluded patients with any past psychiatric diagnosis, and six 17,21,[27][28][29]32…”

Section: Description Of Included Studiesmentioning

confidence: 99%

“…The 16 included studies used six different validated instruments to capture anxiety and depressive symptoms in first seizure and newly diagnosed epilepsy cohorts. This included the Hospital Anxiety and Depression Scale (HADS) in eight studies, 13,17,18,[23][24][25][26]31 Generalised Anxiety and Depression (GAD-7) instrument in four studies, 21,[27][28][29] Neurological Disorders Depression Inventory for Epilepsy (NDDIE) in four studies, 21,[27][28][29] the Beck Depression Inventory (BDI) in two studies, [30][31][32] Self-Rating Depression Scale (SRDS) in one study, 19 and Brief Depression Scale (BDS) in one study. 22 Relevant cutoff scores are summarized in Tables 1-3.…”

Section: Instrumentsmentioning

confidence: 99%

“…The most used tool was the HADS, with all studies setting the cutoff at >7. 13,17,18,[23][24][25][26]31 The HADS is a well-established screening tool for detecting clinically significant anxiety and depression symptoms, with a clear correlation between increasing scores and symptom severity. Reported sensitivity and specificity are approximately 80%.…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

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Anxiety and depressive symptoms in adults with new‐onset seizures: A scoping review

2023

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ObjectiveAnxiety and depression are common comorbidities in people living with epilepsy. Emerging research suggests that these conditions may even predate epilepsy onset. This review aimed to summarize the prevalence of clinically significant anxiety and depressive symptoms in people with first seizures and newly diagnosed epilepsy, as well as clinicodemographic factors associated with these symptoms.MethodsA scoping literature review was performed. OVID Medline and Embase were searched from January 1, 2000, through May 1, 2022. Articles of interest were selected based on predetermined inclusion and exclusion criteria.ResultsFrom 1836 studies identified on screening, 16 met eligibility criteria and were included in the review. Clinically significant anxiety and depressive symptoms, as determined by validated cutoff scores for anxiety and depression screening instruments, were common in people with first seizures (range 13–28%) and newly diagnosed epilepsy (range 11–45%). They were associated with a range of clinicodemographic factors including past psychiatric history and trauma, personality traits, self‐esteem, and stigma profiles.SignificanceThere is substantial evidence that clinically significant anxiety and depressive symptoms are often present at the time and shortly following the first seizure or epilepsy diagnosis. Future research is needed to better understand the complex interactions between these common psychiatric comorbidities, new‐onset seizure disorders, and certain clinicodemographic characteristics. This knowledge may inform targeted and holistic treatment approaches.

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“…SEISMIC is registered on the Australia New Zealand Clinical Trial Registration database, and the protocol and main results are published [14][15][16][17]. In brief, people of all ages with a new diagnosis of epilepsy were identified and enrolled through a geographically based multi-site ascertainment process in Sydney, Australia from July 2008 to December 2013.…”

Section: Study Design and Patientmentioning

confidence: 99%

Course and impact of sleep disturbance in newly diagnosed epilepsy: A prospective registry study

Hackett

Nikpour

et al. 2020

Clinical Neurology and Neurosurgery

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Objective: To determine the course of sleep distrurbance (insomnia symptoms and short sleep duration) after a diagnosis of epilepsy and their associations with seizure control, mood, disability, and quality of life. Patients andMethods: One hundred and sixty-nine adults were drawn from the Sydney Epilepsy Incidence Study to Measure Illness Consequences (SEISMIC), a prospective, multicenter, community-wide study in Sydney, Australia. Sociodemographic, psychosocial, clinical characteristics, and information on sleep disturbance were obtained early (median 48 [IQR15-113] days) after a diagnosis of epilepsy, and at 12 months. Logistic regression models were used to determine associations between patterns of sleep disturbance with outcomes at 12 months. Results: Insomnia symptoms and/or short sleep duration were present in 18-23% of participants at both time points, with over half (54-61%) showing a chronic pattern. There was no association of sleep disturbance pattern with recurrent seizures, medication use or disability. Chronic insomnia symptoms and short sleep duration were strongly associated with worse mental health (aOR 3.76, 95% CI 1.28-11.06; and aOR 5.41, 95% CI 1.86-15.79) and poorer quality of life at 12 months (aOR 3.02, 95% CI 1.03-8.84; and aOR 3.11, 95% CI 1.10-8.82), after adjusting for clinical features of epilepsy and comorbidity. Those whose sleep disturbance remitted had no adverse outcomes. Conclusions: Insomnia symptoms and short sleep duration are less common in people with recently-diagnosed than chronic epilepsy. The temporal association with poor psycholosocial outcomes supports specific interventions addressing sleep disturbance.

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Disability patterns over the first year after a diagnosis of epilepsy

Cited by 4 publications

References 50 publications

Prevalence and correlates of diagnosed and undiagnosed epilepsy and migraine headache among people with severe psychiatric disorders in Ethiopia

Prevalence and correlates of diagnosed and undiagnosed epilepsy and migraine headache among people with severe psychiatric disorders in Ethiopia

Anxiety and depressive symptoms in adults with new‐onset seizures: A scoping review

Course and impact of sleep disturbance in newly diagnosed epilepsy: A prospective registry study

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