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Concurrent mood and anxiety disorders are associated with pharmacoresistant seizures in patients with MTLE

Mateus H Nogueira1, Clarissa L Yasuda1,2, Ana C Coan1,2

  • 1Laboratory of Neuroimaging, University of Campinas, UNICAMP, Campinas, SP, Brazil.

Epilepsia
|May 31, 2017
PubMed
Abstract

Insights

Mood and anxiety disorders (MD/AD) are linked to poorer seizure control in mesial temporal lobe epilepsy (MTLE). Identifying these conditions and family psychiatric history is crucial for managing MTLE patients effectively.

Area of Science:

  • Neurology
  • Psychiatry
  • Epileptology

Background:

  • Mesial temporal lobe epilepsy (MTLE) is a common epilepsy syndrome.
  • Comorbid mood disorders (MD) and anxiety disorders (AD) are frequently observed in epilepsy patients.
  • The association between MD/AD and seizure control in MTLE requires further investigation.

Purpose of the Study:

  • To determine if mood disorders (MD) and anxiety disorders (AD) are associated with seizure control in patients with mesial temporal lobe epilepsy (MTLE).
  • To compare seizure control among MTLE patients with no psychiatric disorders, those with current MD/AD, subsyndromic episodes, and a family psychiatric history.

Main Methods:

  • A cross-sectional study included 144 consecutive MTLE patients (82 pharmacoresistant, 62 treatment-responsive).
  • Psychiatric evaluations utilized SCID-I, BDI, BAI, NDDI-E, and IDDI.
  • Patients were categorized into four groups based on psychiatric status: PsychNeg, subsyndromic episodes, current MD/AD, and mixed MD/AD.

Main Results:

  • 68.3% of pharmacoresistant MTLE patients experienced depression and/or anxiety symptoms (OR 2.8, p < 0.01).
  • Patients with mixed MD/AD had higher rates of pharmacoresistant MTLE (OR 4.04, p < 0.01) and significantly higher seizure frequency.
  • A positive family psychiatric history was more common in pharmacoresistant patients (OR 2.28, p = 0.04).

Conclusions:

  • Comorbid mood and anxiety disorders are significantly associated with poorer seizure control in MTLE.
  • Identifying psychiatric comorbidities and family psychiatric history is essential for optimizing MTLE management.
  • A notable percentage of MTLE patients with MD/AD were not receiving psychiatric treatment, highlighting a potential gap in care.
Keywords:
AnxietyDepressionEpilepsyFamily psychiatric historySubsyndromic depression

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