Author:
Kanner Andres M.,Saporta Anita S.,Kim Dong H.,Barry John J.,Altalib Hamada,Omotola Hope,Jette Nathalie,O'Brien Terence J.,Nadkarni Siddhartha,Winawer Melodie R.,Sperling Michael,French Jacqueline A.,Abou-Khalil Bassel,Alldredge Brian,Bebin Martina,Cascino Gregory D.,Cole Andrew J.,Cook Mark J.,Detyniecki Kamil,Devinsky Orrin,Dlugos Dennis,Faught Edward,Ficker David,Fields Madeline,Gidal Barry,Gelfand Michael,Glynn Simon,Halford Jonathan J.,Haut Sheryl,Hegde Manu,Holmes Manisha G.,Kalviainen Reetta,Kang Joon,Klein Pavel,Knowlton Robert C.,Krishnamurthy Kaarkuzhali,Kuzniecky Ruben,Kwan Patrick,Lowenstein Daniel H.,Marcuse Lara,Meador Kimford J.,Mintzer Scott,Pardoe Heath R.,Park Kristen,Penovich Patricia,Singh Rani K.,Somerville Ernest,Szabo Charles A.,Szaflarski Jerzy P.,Lin Thio K. Liu,Trinka Eugen,Burneo Jorge G.,
Abstract
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 thettest, χ2statistics, 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.
Publisher
Ovid Technologies (Wolters Kluwer Health)