Interictal dysphoric disorder in people with and without epilepsy
Mikhail Zinchuk1, Georgii Kustov1, Evgenii Pashnin1
1Research and Clinical Center for Neuropsychiatry, Moscow, Russian Federation.
Epilepsia
|April 15, 2021
Summary
Interictal dysphoric disorder (IDD) is not specific to epilepsy. This study found similar IDD prevalence in epilepsy patients and those with major depressive disorder (MDD) alone, suggesting IDD may indicate a more severe mood disorder.
Area of Science:
- Neurology
- Psychiatry
- Clinical Psychology
Background:
- Interictal dysphoric disorder (IDD) has historically been considered exclusive to people with epilepsy (PWE).
- Emerging data suggest IDD may also occur in patients with migraine and psychogenic nonepileptic seizures, questioning its epilepsy-specific nature.
- This study aimed to clarify the nature of IDD in individuals with epilepsy and mood disorders compared to those with mood disorders without neurological conditions.
Purpose of the Study:
- To investigate the prevalence and characteristics of Interictal Dysphoric Disorder (IDD) in people with epilepsy and major depressive disorder (MDD).
- To compare IDD in epilepsy patients with MDD against a control group of individuals with MDD but no neurological disease.
- To determine if IDD is specifically associated with epilepsy or if it indicates a more severe course of mood disorders.
Main Methods:
- A case-control study involving 142 patients with epilepsy and MDD (cases) and 222 patients with MDD only (controls).
- Diagnosis of MDD confirmed using the Structured Clinical Interview for DSM-IV (SCID-I-RV).
- Assessment of depression and anxiety levels using the Beck Depression Inventory and Beck Anxiety Inventory; IDD presence confirmed with the Interictal Dysphoric Disorder Inventory (IDDI).
Main Results:
- No significant difference in IDD prevalence was found between people with epilepsy and MDD (88.73%) and those with MDD alone (85.13%).
- IDD symptoms, including incidence, duration, and periodicity, were similar across both groups.
- IDD was not significantly associated with epilepsy (OR = 0.84, p = 0.72), and no correlations were found between epilepsy, demographics, and IDDI subscales.
- Patients with IDD experienced longer durations of affective disorders (6.68 years vs. 3.7 years) and higher scores on psychometric scales, irrespective of epilepsy status.
Conclusions:
- The study does not support the hypothesis that Interictal Dysphoric Disorder (IDD) is specific to epilepsy.
- The findings suggest that IDD may be linked to a more severe presentation of major depressive disorder (MDD).
- Significant anxiety distress appears to be associated with the presence of IDD symptoms, regardless of epilepsy.
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