Depression in epilepsy is associated with lack of seizure control

Dias, Robert; Bateman, Lisa M.; Farias, Sarah E Tomaszewski; Li, Chin‐Shang; Lin, Ting‐Yi; Jorgensen, Julie; Seyal, Masud

doi:10.1016/j.yebeh.2010.08.029

Cited by 42 publications

(34 citation statements)

References 11 publications

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“…From this group only 32% of the pre-operatory group and 69% of the pos-operatory group was taking antidepressants. In the same line of previous studies, 51,52 our data showed that PWE using antidepressants were significantly more likely to have more symptoms of depression. It may be due to the fact that the ones who were receiving antidepressants were the ones with the most severe depression, but treatment was either ineffective or they were too early in treatment that could not show its benefit.…”

Section: Discussionsupporting

confidence: 91%

Screening symptoms of depression and suicidal ideation in people with epilepsy using the Beck depression inventory

Salgado

Nogueira

Yasuda

et al. 2012

J. epilepsy clin. neurophysiol.

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Objective: To measure the severity of symptoms of depression and suicidal ideation in people with epilepsy (PWE) before and after epilepsy surgery using the Beck Depression Inventory (BDI). We aimed to determine the factors associated to depression in PWE. Methods: PWE, regardless of epilepsy type, seizure type, duration or frequency of seizures, and AEDs were investigated. The sample (n=468) was divided into two groups: preoperatory (n=346) and pos-operatory (n=122). Results: Before epilepsy surgery female gender, unemployment and high seizure frequency were associated factors for the occurrence of symptoms of depression. After epilepsy surgery, the only factor associated to high level of depression symptoms was the lack of seizure remission. Suicidal ideation was associated to seizure frequency before and after epilepsy surgery. Conclusion: Our results confirm the generally held view that depression is common in PWE and provide further insight to the association of depression with certain socio-demographic and seizure-related factors before and after epilepsy surgery.Keywords: epilepsy, seizures, depression, suicidal ideation. RESUMO Rastreamento de sintomas de depressão e ideação suicida em pessoas com epilepsia usando o inventário de depressão de BeckObjetivo: Avaliar a gravidade dos sintomas de depressão e ideação suicida em pessoas com epilepsia (PCE), antes e após o tratamento cirúrgico utilizando o Inventário de Depressão de Beck (BDI). Nosso objetivo foi determinar os fatores associados à depressão em PCE. Métodos: PCE, independentemente do tipo de epilepsia, tipo de crises, duração ou frequência das crises, e DAEs, foram investigados. Os pacientes (n=468) foram divididos em dois grupos: pré-operatório (n=346) e de pós-operatório (n=122). Resultados: Antes do tratamento cirúrgico, o sexo feminino, o desemprego e a alta frequência de crises foram fatores associados à ocorrência de sintomas de depressão. Após a cirurgia de epilepsia, o único fator associado ao alto nível de sintomas de depressão foi a falta de remissão de crises. Ideação suicida foi associada à frequência de crises antes e após a cirurgia de epilepsia. Conclusão: Nossos resultados confirmam a opinião generalizada de que a depressão é comum nas PCE e proporcionam mais evidência para a associação de depressão com alguns fatores sócio demográficos e relacionados às crises antes e após o tratamento cirúrgico das epilepsias.Unitermos: epilepsia, crises epilépticas, depressão, ideação suicida.

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Section: Discussionsupporting

confidence: 91%

Screening symptoms of depression and suicidal ideation in people with epilepsy using the Beck depression inventory

Salgado

Nogueira

Yasuda

et al. 2012

J. epilepsy clin. neurophysiol.

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“…In one study, patients were given the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), and there was a correlation between higher NDDI-E scores, which denotes major depression, and frequency of seizures 91 . This is important because frequency of seizures is a critical predictor of SUDEP.…”

Section: Cellular Mechanismsmentioning

confidence: 99%

Mechanisms of sudden unexpected death in epilepsy: the pathway to prevention

et al. 2014

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Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in patients with refractory epilepsy, and yet many physicians do not know about this high risk of sudden death. It has been widely believed that SUDEP is due to cardiac abnormalities during the post-ictal period. However, recent studies have demonstrated that respiratory depression is common following a seizure, and can be severe enough to cause a substantial decrease in oxygen saturation. In this review we summarize evidence for cardiac, respiratory, and arousal abnormalities during the ictal and post-ictal period and potential mechanisms for these abnormalities. We discuss mouse models of seizure-induced death and how these models are useful for understanding the mechanisms that underlie SUDEP. Some of these are due to genetic mutations that have counterparts in human syndromes. Controversy remains regarding the relative importance of cardiac failure versus respiratory arrest as the primary cause of death. Resolving this controversy will require simultaneous monitoring of cardiac and respiratory parameters during cases of near SUDEP in humans and detailed pathophysiological data from animal models during seizure-induced death. Effective preventive strategies in high-risk patients will rely on defining the mechanisms that initiate the sequence of events that lead from seizures to death.

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“…Depressive disorders are the most frequent comorbid psychological conditions in persons with epilepsy (PWEs), with lifetime prevalence rates of 30–35% . Patients with uncontrolled seizures are diagnosed with major depression twice as often as patients with controlled seizures . Depressive symptoms, as well as seizure worry, have a major impact on the quality of life of affected individuals, irrespective of the type of recent epileptic seizures …”

Section: Trial Objectivementioning

confidence: 99%

Efficacy of a psychological online intervention for depression in people with epilepsy: A randomized controlled trial

et al. 2014

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Johanna Schr€ oder is a PhD candidate studying novel modes in delivering psychotherapy. SUMMARYObjective: Depression is the most prevalent psychiatric disorder in persons with epilepsy (PWEs). Despite its major impact on quality of life and risk of suicide, most PWEs are not treated for depression. A current challenge in mental health care is how to close this treatment gap and increase access to psychological services. Psychological online interventions (POIs) have shown efficacy in improving depression among individuals without neurologic disorders. This pilot study aimed to assess the feasibility and efficacy of a psychological online intervention for depression (Deprexis) in PWEs who have symptoms of depression. Methods: Participants with self-reported epilepsy and subjective complaints of depressive symptoms were randomized to an intervention condition (Deprexis) or to a waiting list control (WLC) condition. After 9 weeks, participants were invited to complete an online reassessment. Results: Relative to the waiting list group, program users experienced a significant symptom decline on the Beck Depression Inventory -I (BDI-I, primary outcome) with a moderate effect size in the complete observations analysis and a small effect size in the intention-to-treat analysis. Furthermore, there was a significant improvement with a moderate effect size on the "energy/fatigue" subscale of the Quality of Life In Epilepsy Inventory -31 (QOLIE-31). Significance: The results of this trial suggest that POIs may be a feasible and beneficial tool for PWEs who have comorbid depressive symptoms. KEY WORDS: Depression, Epilepsy, Internet intervention, iCBT, Deprexis.Depressive disorders are the most frequent comorbid psychological conditions in persons with epilepsy (PWEs), with lifetime prevalence rates of 30-35%. 1Patients with uncontrolled seizures are diagnosed with major depression twice as often as patients with controlled seizures.2 Depressive symptoms, as well as seizure worry, have a major impact on the quality of life of affected individuals, 3 irrespective of the type of recent epileptic seizures. 4A recent systematic review suggests that psychological interventions, such as cognitive behavioral therapy (CBT), are effective if they are particularly focused on the reduction of depressive symptoms rather than on the reduction of seizure frequency.5 Given physician-related treatment barriers related to fears of lowering seizure threshold and adverse drug interactions between antidepressants and antiepileptic drugs (such as, reciprocal inhibitory or excitatory effects on PWEs are often interested in exploring novel approaches, but unfortunately, research on the applicability and efficacy of such approaches for depression in PWEs is rare, 9 in contrast to the well-grounded evidence on psychological online interventions (POIs) for depression in general. A metaanalysis that included seven randomized controlled trials (RCTs) of self-guided psychological interventions for depression (one self-help book and six Internet-based s...

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Depression in epilepsy is associated with lack of seizure control

Cited by 42 publications

References 11 publications

Screening symptoms of depression and suicidal ideation in people with epilepsy using the Beck depression inventory

Screening symptoms of depression and suicidal ideation in people with epilepsy using the Beck depression inventory

Mechanisms of sudden unexpected death in epilepsy: the pathway to prevention

Efficacy of a psychological online intervention for depression in people with epilepsy: A randomized controlled trial

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