Prevalence of psychiatric comorbidities in temporal lobe epilepsy in a Southern Brazilian population

Abstract

A great prevalence of psychiatric disorders in epilepsy is well demonstrated, although most studies have used unstructured psychiatric interviews for diagnosis. Here we present a study evaluating the prevalence of psychiatric comorbidities in a cohort of Southern Brazilian patients with temporal lobe epilepsy (TLE) using a structured clinical interview. We analyzed 166 patients with TLE regarding neuropsychiatric symptoms through the Structured Clinical Interview for DSM-IV. One hundred-six patients (63.9%) presented psychiatric comorbidities. Mood disorders were observed in 80 patients (48.2%), anxiety disorders in 51 patients (30.7%), psychotic disorders in 14 (8.4%), and substance abuse in 8 patients (4.8%) respectively. Our results agree with literature data where most authors detected mental disorders in 10 to 60% of epileptic patients. This wide variation is probably attributable to different patient groups investigated and to the great variety of diagnostic methods. Structured psychiatric interviews might contribute to a better evaluation of prevalence of psychiatric comorbidities in TLE. Key words: seizures, epidemiology, behavioral neurology, chronic psychiatric illness, neurology.Prevalência de comorbidades psiquiátricas na epilepsia do lobo temporal em uma população do sul do Brasil RESUMO Embora muitos estudos tenham demonstrado uma alta prevalência de transtornos psiquiátricos em pacientes com epilepsia, a maioria utilizou entrevistas psiquiátricas não-estruturadas para o diagnóstico. Este método pode levar a diferenças significativas nos resultados. Nós estudamos a prevalência de comorbidades psiquiátricas em pacientes com epilepsia do lobo temporal (ELT), utilizando uma entrevista clínica estruturada. Foram estudados 166 pacientes com ELT, aos quais foi aplicada a Entrevista Clínica Estruturada para o DSM-IV (SCID). Cento e seis pacientes (63,9%) apresentaram comorbidades psiquiátricas. Transtornos de humor, observados em 80 pacientes (48,2%), foram o transtorno neuropsiquiátrico mais comum. Transtornos de ansiedade, observados em 51 pacientes (30,7%), foram a segunda comorbidade psiquiátrica mais frequente. Transtornos psicóticos foram encontrados em 14 (8,4%), e abuso de substâncias foram observados em 8 pacientes (4,8%), respectivamente. Nossos resultados estão de acordo com os dados da literatura, que demonstra problemas psiquiátricos em 10-60% dos pacientes com epilepsia. A grande variação dos resultados pode ser atribuída aos diferentes grupos de pacientes estudados e à variabilidade de métodos diagnósticos empregados. Entrevistas psiquiátricas estruturadas podem contribuir para uma avaliação mais adequada da real prevalência de comorbidades psiquiátricas na ELT.

Psychiatric Comorbidities in Patients with Epilepsy: A Cross-sectional Study

“…There are several other studies which show similar prevalence rates of psychiatric disorders in epilepsy, such as 58% by Adams et al, 18 41% by Gaitatzis et al, 7 and 37% by Davies et al 19 Fourteen percent of patients were diagnosed with an anxiety disorder, the most common diagnosis being panic disorder without agoraphobia. In this study, the overall anxiety findings were found to be lower compared with previous published rates of anxiety disorders in large population using SCIDs: 18.4, 20 21.5, 14 and 52.1%. 21 Whereas many patients with epilepsy experience anxiety or panic-type symptoms preictally or as part of an aura, the use of the SCID identifies those with true panic disorder, i.e., panic symptoms occurring unexpectedly and not due to the direct physiological effect of a GMC.…”

Impact of the chronic use of benzodiazepines prescribed for seizure control on the anxiety levels of patients with epilepsy

“…These authors reported that individuals with epilepsy were more likely than individuals without epilepsy to report lifetime anxiety disorders or suicidal thoughts [4]. In our patients with temporal lobe epilepsy (TLE), we observed high levels of psychiatric comorbidities, and our results are comparable to those reported for European populations [5,6]. Some data suggest that genetic and anatomically common neural networks might merge together leading to the development of psychiatric comorbidities in epilepsy [7][8][9][10].…”

Rates of DSM-IV mood, anxiety disorders, and suicidality in Australian adult epilepsy outpatients: A comparison of well-controlled versus refractory epilepsy

“…However, most of this research has been limited to the investigation of selective samples, such as refractory mesial temporal sclerosis (MTS) and juvenile myclonic epilepsy (JME) [9,10], temporal lobe epilepsy (TLE) [11], and refractory focal epilepsy [12][13][14]. Collectively, these more recent studies have reported rates of mood disorders ranging from 25% to 48% and anxiety disorders from 14% to 31%.…”