Epilepsy or seizure disorder? The effect of cultural and socioeconomic factors on self-reported prevalence

Kröner, Barbara; Fahimi, Mansour; Gaillard, William D.; Kenyon, Anne; Thurman, David J.

doi:10.1016/j.yebeh.2016.07.013

Cited by 15 publications

(8 citation statements)

References 12 publications

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“…Epilepsy is a chronic neurological disorder affecting around 50 million individuals worldwide, with a self-reported active prevalence of 70% [20,21]. Epilepsy makes the greatest neurological contribution to disability-adjusted life years [22].…”

Section: The Burden Of Epilepsymentioning

confidence: 99%

Diagnosing and treating depression in epilepsy

Elger

Johnston

Hoppe

2017

Seizure

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At least one third of patients with active epilepsy suffer from significant impairment of their emotional well-being. A targeted examination for possible depression (irrespective of any social, financial or personal burdens) can identify patients who may benefit from medical attention and therapeutic support. Reliable screening instruments such as the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) are suitable for the timely identification of patients needing help. Neurologists should be capable of managing mild to moderate comorbid depression but referral to mental health specialists is mandatory in severe and difficult-to-treat depression, or if the patient is acutely suicidal. In terms of the therapeutic approach, it is essential first to optimize seizure control and minimize unwanted antiepileptic drug-related side effects. Psychotherapy for depression in epilepsy (including online self-treatment programs) is underutilized although it has proven effective in ten well-controlled trials. In contrast, the effectiveness of antidepressant drugs for depression in epilepsy is unknown. However, if modern antidepressants are used (e.g. SSRI, SNRI, NaSSA), concerns about an aggravation of seizures and or problematic interactions with antiepileptic drugs seem unwarranted. Epilepsy-related stress ("burden of epilepsy") explains depression in many patients but acute and temporary seizure-related states of depression or suicidality have also been reported. Limbic encephalitits may cause isolated mood alteration without any recognizable psychoetiological background indicating a possible role of neuroinflammation. This review will argue that, overall, a bio-psycho-social model best captures the currently available evidence relating to the etiology and treatment of depression as a comorbidity of epilepsy.

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Section: The Burden Of Epilepsymentioning

confidence: 99%

Diagnosing and treating depression in epilepsy

Elger

Johnston

Hoppe

2017

Seizure

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“…Epilepsy encompasses a large group of complex neurological disorders characterized by the development of recurrent and usually unprovoked seizures [ 1 ]. According to recent estimates, epilepsy affects more than 50 million people worldwide [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Astroglial role in the pathophysiology of statusepilepticus: an overview

et al. 2018

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Status epilepticus is a medical emergency with elevated morbidity and mortality rates, and represents a leading cause of epilepsy-related deaths. Though status epilepticus can occur at any age, it manifests more likely in children and elderly people. Despite the common prevalence of epileptic disorders, a complete explanation for the mechanisms leading to development of self-limited or long lasting seizures (as in status epilepticus) are still lacking. Apart from neurons, research evidence suggests the involvement of immune and glial cells in epileptogenesis. Among glial cells, astrocytes represent an ideal target for the study of the pathophysiology of status epilepticus, due to their key role in homeostatic balance of the central nervous system. During status epilepticus, astroglial cells are activated by the presence of cytokines, damage associated molecular patterns and reactive oxygen species. The persistent activation of astrocytes leads to a decrease in glutamate clearance with a corresponding accumulation in the synaptic extracellular space, increasing the chance of neuronal excitotoxicity. Moreover, major alterations in astrocytic gap junction coupling, inflammation and receptor expression, facilitate the generation of seizures. Astrocytes are also involved in dysregulation of inhibitory transmission in the central nervous system and directly participate in ionic homeostatic alterations during status epilepticus. In the present review, we focus on the functional and structural changes in astrocytic activity that participate in the development and maintenance of status epilepticus, with special attention on concurrent inflammatory alterations. We also include potential astrocytic treatment targets for status epilepticus.

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“…Additionally, E-CAB members suggested that the language on study documents be expanded to "epilepsy or seizure disorder" to accommodate those who might not feel comfortable identifying their condition as "epilepsy" or who may understand their diagnosis as "seizure disorder" but are not aware of or may not remember whether the diagnosis of epilepsy was explicitly stated. This change is also supported by past research that found that 75% of respondents who had a history of epilepsy identified their condition as a seizure disorder rather than epilepsy [61]. Modifications to all recruitment documents were made based on the above suggestions.…”

Section: Blacksmentioning

confidence: 87%

Depression self-management in people with epilepsy: Adapting project UPLIFT for underserved populations

Quarells

Spruill

Escoffery

et al. 2019

Epilepsy & Behavior

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Data from the 2015 National Health Interview Survey found that the prevalence of active epilepsy has increased to three million adults. Although findings have been mixed, some research indicates that Blacks and Hispanics share a higher burden of epilepsy prevalence compared with non-Hispanic whites. Moreover, depression is a common comorbid condition among people with epilepsy (PWE), affecting up to 55% of the epilepsy population. Widespread use and increased public health impact of evidence-based self-management interventions is critical to reducing disease burden and may require adapting original interventions into more culturally relevant versions for racial and ethnic minority groups. Project UPLIFT provides access to mental health self-management skills training that is distance-delivered, does not interfere with medication management, and has been shown to be effective in reducing depressive symptoms. This paper presents the process of exploring the adaptation of Project UPLIFT for Black and Hispanic PWE and herein suggests that evidence-based interventions can be successfully adapted for new populations or cultural settings through a careful and systematic process. Additional key lessons learned include the importance of community engagement and that language matters. Ultimately, if the adapted Project UPLIFT intervention produces positive outcomes for diverse populations of PWE, it will extend the strategies available to reduce the burden of depression. Implementing evidence-based interventions such as Project UPLIFT is critical to reducing disease burden; however, their delivery may need to be tailored to the needs and culture of the populations of interest.

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Epilepsy or seizure disorder? The effect of cultural and socioeconomic factors on self-reported prevalence

Cited by 15 publications

References 12 publications

Diagnosing and treating depression in epilepsy

Diagnosing and treating depression in epilepsy

Astroglial role in the pathophysiology of statusepilepticus: an overview

Depression self-management in people with epilepsy: Adapting project UPLIFT for underserved populations

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