Mood and Anxiety Disorders and Suicidality in Patients With Newly Diagnosed Focal Epilepsy An Analysis of a Complex Comorbidity

被引：28

作者：

Kanner, Andres M. ^{[1
]}

Saporta, Anita S. ^{[1
]}

Kim, Dong H. ^{[1
]}

Barry, John J. ^{[2
]}

Altalib, Hamada ^{[3
]}

Omotola, Hope ^{[4
]}

Jette, Nathalie ^{[5
]}

O'Brien, Terence J. ^{[6
]}

Nadkarni, Siddhartha ^{[7
]}

Winawer, Melodie R. ^{[8
]}

Sperling, Michael ^{[9
]}

French, Jacqueline A. ^{[7
]}

Abou-Khalil, Bassel ^{[10
]}

Alldredge, Brian ^{[11
]}

Bebin, Martina ^{[12
]}

Cascino, Gregory D. ^{[13
]}

Cole, Andrew J. ^{[14
]}

Cook, Mark J. ^{[15
]}

Detyniecki, Kamil ^{[3
]}

Devinsky, Orrin ^{[7
]}

Dlugos, Dennis ^{[16
]}

Faught, Edward ^{[17
]}

Ficker, David ^{[18
]}

Fields, Madeline ^{[5
]}

Gidal, Barry ^{[19
]}

Gelfand, Michael ^{[16
]}

Glynn, Simon ^{[20
]}

Halford, Jonathan J. ^{[21
]}

Haut, Sheryl ^{[22
]}

Hegde, Manu ^{[11
]}

Holmes, Manisha G. ^{[7
]}

Kalviainen, Reetta ^{[23
]}

Kang, Joon ^{[24
]}

Klein, Pavel ^{[25
]}

Knowlton, Robert C. ^{[11
]}

Krishnamurthy, Kaarkuzhali

Kuzniecky, Ruben

Kwan, Patrick ^{[6
]}

Lowenstein, Daniel H. ^{[11
]}

Marcuse, Lara ^{[5
]}

Meador, Kimford J. ^{[2
]}

Mintzer, Scott ^{[9
]}

Pardoe, Heath R.

Park, Kristen ^{[26
]}

Penovich, Patricia ^{[27
]}

Singh, Rani K. ^{[28
]}

Somerville, Ernest ^{[29
]}

Szabo, Charles A. ^{[30
]}

Szaflarski, Jerzy P. ^{[12
]}

Lin Thio, K. Liu ^{[31
]}

机构：

[1] Univ Miami, Miller Sch Med, Miami, FL 33136 USA

[2] Stanford Univ, Sch Med, Stanford, CA USA

[3] Yale Univ, Sch Med, New Haven, CT USA

[4] Univ Texas Houston, Sch Med, Houston, TX USA

[5] Icahan Sch Med Mt Sinai, New York, NY USA

[6] Monash Univ, Sch Med, Clayton, Australia

[7] NYU, Grossman Sch Med, New York, NY USA

[8] Columbia Univ, Coll Phys & Surg, New York, NY USA

[9] Thomas Jefferson Univ, Sidney Kimmel Med Coll, Philadelphia, PA USA

[10] Vanderbilt Univ, Sch Med, Nashville, TN USA

[11] Univ Calif San Francisco, Sch Med, San Francisco, CA USA

[12] Univ Alabama Birmingham, Sch Med, Birmingham, AL USA

[13] Mayo Clin, Sch Med, Arizona, FL USA

[14] Harvard Med Sch, Boston, MA USA

[15] Univ Melbourne, Sch Med, Melbourne, Australia

[16] Univ Penn, Pearlman Sch Med, Philadelphia, PA USA

[17] Eory Univ, Sch Med, Atlanta, GA USA

[18] Univ Cincinnati, Sch Med, Cincinnati, OH USA

[19] Univ Wisconsin, Sch Med, Madison, WI USA

[20] Univ Michigan, Sch Med, Ann Arbor, MI USA

[21] Med Univ South Carolina, Charleston, SC USA

[22] Albert Einstein Coll Med, New York, NY USA

[23] Univ Eastern Finland, Sch Med, Kuopio, Finland

[24] Johns Hopkins Sch Med, Baltimore, MD USA

[25] Midatlant Epilepsy & Sleep Ctr, Bethesda, MD USA

[26] Univ Colorado, Sch Med, Aurora, CO USA

[27] Minnesota Epilepsy Grp, Roseville, MN USA

[28] Carolinas Pediat Neurol Care, Charlotte, NC USA

[29] New South Wales Hosp, Randwick, Australia

[30] Univ Texas San Antonio, Sch Med, San Antonio, TX USA

[31] Washington Univ St Louis, Sch Med, St Louis, MO USA

[32] Paracelsus Med Univ, Salzburg, Austria

[33] Univ Western Ontario, Sch Med, London, ON, Canada

来源：

NEUROLOGY | 2023年 / 100卷 / 11期

关键词：

INTERICTAL DYSPHORIC DISORDER; BIPOLAR SPECTRUM DISORDER; RISK-FACTORS; PSYCHIATRIC-DISORDERS; DSM-IV; DEPRESSION; PREVALENCE; ASSOCIATION; VALIDATION; SYMPTOMS;

D O I：

10.1212/WNL.0000000000201671

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and ObjectivesMood, anxiety disorders, and suicidality are more frequent in people with epilepsy than in the general population. Yet, their prevalence and the types of mood and anxiety disorders associated with suicidality at the time of the epilepsy diagnosis are not established. We sought to answer these questions in patients with newly diagnosed focal epilepsy and to assess their association with suicidal ideation and attempts.MethodsThe data were derived from the Human Epilepsy Project study. A total of 347 consecutive adults aged 18-60 years with newly diagnosed focal epilepsy were enrolled within 4 months of starting treatment. The types of mood and anxiety disorders were identified with the Mini International Neuropsychiatric Interview, whereas suicidal ideation (lifetime, current, active, and passive) and suicidal attempts (lifetime and current) were established with the Columbia Suicidality Severity Rating Scale (CSSRS). Statistical analyses included the t test, chi(2) statistics, and logistic regression analyses.ResultsA total of 151 (43.5%) patients had a psychiatric diagnosis; 134 (38.6%) met the criteria for a mood and/or anxiety disorder, and 75 (21.6%) reported suicidal ideation with or without attempts. Mood (23.6%) and anxiety (27.4%) disorders had comparable prevalence rates, whereas both disorders occurred together in 43 patients (12.4%). Major depressive disorders (MDDs) had a slightly higher prevalence than bipolar disorders (BPDs) (9.5% vs 6.9%, respectively). Explanatory variables of suicidality included MDD, BPD, panic disorders, and agoraphobia, with BPD and panic disorders being the strongest variables, particularly for active suicidal ideation and suicidal attempts.DiscussionIn patients with newly diagnosed focal epilepsy, the prevalence of mood, anxiety disorders, and suicidality is higher than in the general population and comparable to those of patients with established epilepsy. Their recognition at the time of the initial epilepsy evaluation is of the essence.

引用

页码：E1123 / E1134

页数：12

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