Psychiatric symptoms predict drug-resistant epilepsy in newly treated patients

Literature on the complex interrelationships between psychiatric symptoms and drug resistance in newly treated patients with epilepsy (PWE) is lacking. We aimed to determine whether psychiatric symptoms are predictive of the development of drug-resistant epilepsy (DRE) in newly treated patients.

Newly treated PWE were psychiatrically evaluated at enrolment and were followed for 24 months to determine the occurrence of DRE. The impacts of depressive and anxiety symptoms on the development of DRE were investigated using the Cox proportional hazard model.

A total of 217 patients were included in the final analysis. DRE was diagnosed in 26.7% of patients (n=58). In univariate analysis, depressive and anxiety symptoms were identified as risk factors for the development of DRE. In multivariate analyses, depressive symptoms were a significant independent predictor of DRE (HR: 3.253, 95% CI: 1.643-6.441; p = 0.001). Additionally, the probability of developing DRE was 5.219 times higher in patients with both depressive and anxiety symptoms than in patients without depressive or anxiety symptoms (HR: 5.219, 95% CI: 2.716-10.029; p<0.001).

In conclusion, psychiatric symptoms provide prognostic information regarding the occurrence of DRE in patients newly treated with ASMs. Our findings support the need for prospective studies to investigate whether psychiatric treatment reduces the risk of developing DRE in these patients.