Investigation and analysis of status and risk factors of comorbid anxiety and depression in patients with epilepsy in West China_West China Medical Journal

Authors：

LI Qian ^1,2 , CHEN Deng ¹ , TAN Ge ¹ ,  LIU Ling ¹

1. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurology, 363 Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Ling, Email: zjllxx1968@163.com

Keywords：

Epilepsy; Anxiety; Depression; Risk factors

DOI：

10.7507/1002-0179.201703206

Video：

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Objective To investigate the prevalence of anxiety and depression in patients with epilepsy (PWE) in West China, and to explore the related risk factors. Methods The Chinese version of Generalized Anxiety Disorder (GAD)-7 and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) scales were used to evaluate the anxiety and depression in 176 PWE patients between December 2016 and February 2017. Univariate analysis was used to screen the factors that may cause anxiety and depression in PWE, and then logistic regression analysis was performed on the possible risk factors. Results In the 176 PWE, about 27.3% had anxiety, and about 28.4% had depression. Multivariate logistic regression analysis showed that seizure occurrence in the recent six months [odds ratio (OR)=3.481, 95% confidence interval (CI) (1.292, 9.380),P=0.014], seizure occurring more than once in a month [OR=3.231, 95%CI (1.468, 7.111),P=0.004], and focal seizures with conscious disorders [OR=2.416, 95%CI (1.082, 5.397),P=0.031] were risk factors for anxiety in PWE. Unmarried status [OR=0.428, 95%CI (0.195, 0.940),P=0.035], seizure occurring more than once in a month [OR=2.685, 95%CI (1.206, 5.979),P=0.016], focal seizures with conscious disorders [OR=2.541, 95%CI (1.112, 5.808),P=0.027] and seizure occurrence in the last six months [OR=7.582, 95%CI (2.416, 23.794),P=0.001] were risk factors for depression in PWE. Conclusions Anxiety and depression are common comorbidities in PWE. For patients with risk factors, early identification and intervention should be performed.

Citation： LI Qian, CHEN Deng, TAN Ge, LIU Ling. Investigation and analysis of status and risk factors of comorbid anxiety and depression in patients with epilepsy in West China. West China Medical Journal, 2017, 32(5): 649-654. doi: 10.7507/1002-0179.201703206 Copy

1.	Kwon OY, Park SP. Depression and anxiety in people with epilepsy. J Clin Neurol, 2014, 10(3): 175-188.
2.	Tellez-Zenteno JF, Patten SB, Jetté N, et al. Psychiatric comorbidity in epilepsy: a population-based analysis. Epilepsia, 2007, 48(12): 2336-2344.
3.	Swinkels WA, Kuyk J, van Dyck R, et al. Psychiatric comorbidity in epilepsy. Epilepsy Behav, 2005, 7(1): 37-50.
4.	Fiest KM, Dykeman J, Patten SB, et al. Depression in epilepsy: a systematic review and meta-analysis. Neurology, 2013, 80(6): 590-599.
5.	Kanner AM, Barry JJ, Gilliam F, et al. Anxiety disorders, subsyndromic depressive episodes, and major depressive episodes: do they differ on their impact on the quality of life of patients with epilepsy? Epilepsia, 2010, 51(7): 1152-1158.
6.	Boylan LS, Flint LA, Labovitz DL, et al. Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy. Neurology, 2004, 62(2): 258-261.
7.	Gilliam F, Kuzniecky R, Faught E, et al. Patient-validated content of epilepsy-specific quality-of-life measurement. Epilepsia, 1997, 38(2): 233-236.
8.	Gandy M, Sharpe L, Perry KN, et al. Rates of DSM-Ⅳ mood, anxiety disorders, and suicidality in Australian adult epilepsy outpatients: a comparison of well-controlledversus refractory epilepsy. Epilepsy Behav, 2013, 26(1): 29-35.
9.	Verrotti A, Cicconetti A, Scorrano B, et al. Epilepsy and suicide: pathogenesis, risk factors, and prevention. Neuropsychiatr Dis Treat, 2008, 4(2): 365-370.
10.	Salgado PC, Yasuda CL, Cendes F. Neuroimaging changes in mesial temporal lobe epilepsy are magnified in the presence of depression. Epilepsy Behav, 2010, 19(3): 422-427.
11.	Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.
12.	Robert S, Fisher J, Helen C, et al. 2016 年国际抗癫痫联盟癫痫发作分类的更新及介绍. 癫痫杂志, 2017, 3(1): 60-69.
13.	Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder-The GAD-7. Arch Intern Med, 2006, 166(10): 1092-1097.
14.	Seo JG, Cho YW, Lee SJ, et al. Validation of the generalized anxiety disorder-7 in people with epilepsy: a MEPSY study. Epilepsy Behav, 2014, 35(3): 59-63.
15.	Tong X, An D, Mcgonigal A, et al. Validation of the generalized anxiety disorder-7 (GAD-7) among Chinese people with epilepsy. Epilepsy Res, 2016, 120: 31-36.
16.	Gill SJ, Lukmanji S, Fiest KM, et al. Depression screening tools in persons with epilepsy: a systematic review of validated tools. Epilepsia, 2017. (2017-01-08)[2017-03-05]. .
17.	Tong X, An D, Lan L, et al. Validation of the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E) in West China. Epilepsy Behav, 2015, 47: 6-10.
18.	梁艳玲, 薛峥, 康慧聪, 等. 56 例成年癫痫患者抑郁、焦虑的临床评估及危险因素分析. 神经损伤与功能重建, 2014, 9(1): 31-35.
19.	唐伟, 王威, 邹飒枫, 等. 108 例成人癫痫患者生活质量与焦虑、抑郁相关性研究. 中国医药指南, 2009, 7(14): 47-48.
20.	佟晓燕, 王玉平. 成年癫痫患者抑郁、焦虑状况及生活质量调查. 脑与神经疾病杂志, 2009, 17(2): 123-126.
21.	de Oliveira GN, Lessa JM, Gonçalves AP, et al. Screening for depression in people with epilepsy: comparative study among neurological disorders depression inventory for epilepsy (NDDI-E), hospital anxiety and depression scale depression subscale (HADS-D), and Beck depression inventory (BDI). Epilepsy Behav, 2014, 34: 50-54.
22.	Munger Clary HM. Anxiety and epilepsy: what neurologists and epileptologists should know. Curr Neurol Neurosci Rep, 2014, 14(5): 445.
23.	Kanner AM. Depression in epilepsy: prevalence, clinical semiology, pathogenic mechanisms, and treatment. Biol Psychiatry, 2003, 54(3): 388-398.
24.	Kanner AM. Anxiety disorders in epilepsy: the forgotten psychiatric comorbidity. Epilepsy Curr, 2011, 11(3): 90-91.
25.	常亮, 常靖, 冯石献, 等. 癫痫患者伴发焦虑状况及其影响因素研究. 中华流行病学杂志, 2012, 33(10): 1098-1099.
26.	Kimiskidis VK, Triantafyllou NI, Kararizou E, et al. Depression and anxiety in epilepsy: the association with demographic and seizure-related variables. Ann Gen Psychiatry, 2007, 6(1): 28.
27.	Kwon OY, Park SP. Frequency of affective symptoms and their psychosocial impact in Korean people with epilepsy: a survey at two tertiary care hospitals. Epilepsy Behav, 2013, 26(1): 51-56.
28.	Kimiskidis VK, Valeta T. Epilepsy and anxiety: epidemiology, classification, aetiology, and treatment. Epileptic Dis, 2012, 14(3): 248-256.
29.	Quiske A, Helmstaedter C, Lux S, et al. Depression in patients with temporal lobe epilepsy is related to mesial temporal sclerosis. Epilepsy Res, 2000, 39(2): 121-125.
30.	de Oliveira GN, Kummer A, Salgado JV, et al. Psychiatric disorders in temporal lobe epilepsy: an overview from a tertiary service in Brazil. Seizure, 2010, 19(8): 479-484.
31.	肖剑文, 张明. 癫痫患者情绪障碍共病的影响因素. 赣南医学院学报, 2015, 35(1): 161-164.
32.	Wang FL, Gu XM, Hao BY, et al. Influence of marital status on the quality of life of Chinese adult patients with epilepsy. Chin Med J (Engl), 2017, 130(1): 83-87.
33.	凌小林. 癫痫患者婚姻生育情况国内研究现状. 现代医药卫生, 2013, 29(14): 2160-2163.
34.	Zis P, Yfanti P, Siatouni A, et al. Determinants of depression among patients with epilepsy in Athens, Greece. Epilepsy Behav, 2014, 33(4): 106-109.
35.	Pennell PB, Thompson P. Gender-specific psychosocial impact of living with epilepsy. Epilepsy Behav, 2009, 15(Suppl 1): S20-S25.

1. Kwon OY, Park SP. Depression and anxiety in people with epilepsy. J Clin Neurol, 2014, 10(3): 175-188.
2. Tellez-Zenteno JF, Patten SB, Jetté N, et al. Psychiatric comorbidity in epilepsy: a population-based analysis. Epilepsia, 2007, 48(12): 2336-2344.
3. Swinkels WA, Kuyk J, van Dyck R, et al. Psychiatric comorbidity in epilepsy. Epilepsy Behav, 2005, 7(1): 37-50.
4. Fiest KM, Dykeman J, Patten SB, et al. Depression in epilepsy: a systematic review and meta-analysis. Neurology, 2013, 80(6): 590-599.
5. Kanner AM, Barry JJ, Gilliam F, et al. Anxiety disorders, subsyndromic depressive episodes, and major depressive episodes: do they differ on their impact on the quality of life of patients with epilepsy? Epilepsia, 2010, 51(7): 1152-1158.
6. Boylan LS, Flint LA, Labovitz DL, et al. Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy. Neurology, 2004, 62(2): 258-261.
7. Gilliam F, Kuzniecky R, Faught E, et al. Patient-validated content of epilepsy-specific quality-of-life measurement. Epilepsia, 1997, 38(2): 233-236.
8. Gandy M, Sharpe L, Perry KN, et al. Rates of DSM-Ⅳ mood, anxiety disorders, and suicidality in Australian adult epilepsy outpatients: a comparison of well-controlledversus refractory epilepsy. Epilepsy Behav, 2013, 26(1): 29-35.
9. Verrotti A, Cicconetti A, Scorrano B, et al. Epilepsy and suicide: pathogenesis, risk factors, and prevention. Neuropsychiatr Dis Treat, 2008, 4(2): 365-370.
10. Salgado PC, Yasuda CL, Cendes F. Neuroimaging changes in mesial temporal lobe epilepsy are magnified in the presence of depression. Epilepsy Behav, 2010, 19(3): 422-427.
11. Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.
12. Robert S, Fisher J, Helen C, et al. 2016 年国际抗癫痫联盟癫痫发作分类的更新及介绍. 癫痫杂志, 2017, 3(1): 60-69.
13. Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder-The GAD-7. Arch Intern Med, 2006, 166(10): 1092-1097.
14. Seo JG, Cho YW, Lee SJ, et al. Validation of the generalized anxiety disorder-7 in people with epilepsy: a MEPSY study. Epilepsy Behav, 2014, 35(3): 59-63.
15. Tong X, An D, Mcgonigal A, et al. Validation of the generalized anxiety disorder-7 (GAD-7) among Chinese people with epilepsy. Epilepsy Res, 2016, 120: 31-36.
16. Gill SJ, Lukmanji S, Fiest KM, et al. Depression screening tools in persons with epilepsy: a systematic review of validated tools. Epilepsia, 2017. (2017-01-08)[2017-03-05]. .
17. Tong X, An D, Lan L, et al. Validation of the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E) in West China. Epilepsy Behav, 2015, 47: 6-10.
18. 梁艳玲, 薛峥, 康慧聪, 等. 56 例成年癫痫患者抑郁、焦虑的临床评估及危险因素分析. 神经损伤与功能重建, 2014, 9(1): 31-35.
19. 唐伟, 王威, 邹飒枫, 等. 108 例成人癫痫患者生活质量与焦虑、抑郁相关性研究. 中国医药指南, 2009, 7(14): 47-48.
20. 佟晓燕, 王玉平. 成年癫痫患者抑郁、焦虑状况及生活质量调查. 脑与神经疾病杂志, 2009, 17(2): 123-126.
21. de Oliveira GN, Lessa JM, Gonçalves AP, et al. Screening for depression in people with epilepsy: comparative study among neurological disorders depression inventory for epilepsy (NDDI-E), hospital anxiety and depression scale depression subscale (HADS-D), and Beck depression inventory (BDI). Epilepsy Behav, 2014, 34: 50-54.
22. Munger Clary HM. Anxiety and epilepsy: what neurologists and epileptologists should know. Curr Neurol Neurosci Rep, 2014, 14(5): 445.
23. Kanner AM. Depression in epilepsy: prevalence, clinical semiology, pathogenic mechanisms, and treatment. Biol Psychiatry, 2003, 54(3): 388-398.
24. Kanner AM. Anxiety disorders in epilepsy: the forgotten psychiatric comorbidity. Epilepsy Curr, 2011, 11(3): 90-91.
25. 常亮, 常靖, 冯石献, 等. 癫痫患者伴发焦虑状况及其影响因素研究. 中华流行病学杂志, 2012, 33(10): 1098-1099.
26. Kimiskidis VK, Triantafyllou NI, Kararizou E, et al. Depression and anxiety in epilepsy: the association with demographic and seizure-related variables. Ann Gen Psychiatry, 2007, 6(1): 28.
27. Kwon OY, Park SP. Frequency of affective symptoms and their psychosocial impact in Korean people with epilepsy: a survey at two tertiary care hospitals. Epilepsy Behav, 2013, 26(1): 51-56.
28. Kimiskidis VK, Valeta T. Epilepsy and anxiety: epidemiology, classification, aetiology, and treatment. Epileptic Dis, 2012, 14(3): 248-256.
29. Quiske A, Helmstaedter C, Lux S, et al. Depression in patients with temporal lobe epilepsy is related to mesial temporal sclerosis. Epilepsy Res, 2000, 39(2): 121-125.
30. de Oliveira GN, Kummer A, Salgado JV, et al. Psychiatric disorders in temporal lobe epilepsy: an overview from a tertiary service in Brazil. Seizure, 2010, 19(8): 479-484.
31. 肖剑文, 张明. 癫痫患者情绪障碍共病的影响因素. 赣南医学院学报, 2015, 35(1): 161-164.
32. Wang FL, Gu XM, Hao BY, et al. Influence of marital status on the quality of life of Chinese adult patients with epilepsy. Chin Med J (Engl), 2017, 130(1): 83-87.
33. 凌小林. 癫痫患者婚姻生育情况国内研究现状. 现代医药卫生, 2013, 29(14): 2160-2163.
34. Zis P, Yfanti P, Siatouni A, et al. Determinants of depression among patients with epilepsy in Athens, Greece. Epilepsy Behav, 2014, 33(4): 106-109.
35. Pennell PB, Thompson P. Gender-specific psychosocial impact of living with epilepsy. Epilepsy Behav, 2009, 15(Suppl 1): S20-S25.

West China Medical Journal

Investigation and analysis of status and risk factors of comorbid anxiety and depression in patients with epilepsy in West China

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