Identifying depression in epilepsy in a busy clinical setting is enhanced with systematic screening

Friedman, David; Kung, Doris; Laowattana, Somchai; Kass, Joseph S.; Hrachovy, Richard A.; Levin, Harvey S.

doi:10.1016/j.seizure.2009.03.001

Cited by 90 publications

(59 citation statements)

References 36 publications

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“…6 If interictal depression or the need for social assistance was significantly associated with PCBI in any group, multiple logistic regression was used to determine whether the association retained significance when controlling for known risk and protective factors selected a priori. When evaluating depression, we controlled for age, 7-9 sex, 12 the presence of a chronic medical comorbidity, 10 occurrence of seizures over the prior year, 13 epilepsy of presumed genetic origin, 14 focal dyscognitive seizures, 7,15 a temporal lobe focus, 16 a frontal lobe focus, 16 current AED use, 10,16 and a history of epilepsy surgery. 16 When evaluating the need for social assistance, we controlled for current age, age at event onset (no collinearity was detected between age at onset and current age), sex, level of education, marital status, regular use of recreational drugs, current or past diagnosis of depression, concurrent chronic medical comorbidities, and occurrence of any events over the prior year.…”

Section: Methods Study Population the Calgary Comprehensivementioning

confidence: 99%

An investigation into the psychosocial effects of the postictal state

et al. 2016

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Objective: To determine whether postictal cognitive and behavioral impairment (PCBI) is independently associated with specific aspects of a patient's psychosocial health in those with epilepsy and nonepileptic events. Methods:We used the University of Calgary's Comprehensive Epilepsy Clinic prospective cohort database to identify patients reporting PCBI. The cohort was stratified into those diagnosed with epilepsy or nonepileptic events at first clinic visit. Univariate comparisons and stepwise multiple logistic regression with backward elimination method were used to identify factors associated with PCBI for individuals with epilepsy and those with nonepileptic events. We then determined if PCBI was independently associated with depression and the use of social assistance when controlling for known risk factors.Results: We identified 1,776 patients, of whom 1,510 (85%) had epilepsy and 235 had nonepileptic events (13%). PCBI was independently associated with depression in those with epilepsy (odds ratio [OR] 1.73; 95% confidence interval [CI] 1.06-2.83; p 5 0.03) and with the need for social assistance in those with nonepileptic events (OR 4.81; 95% CI 2.02-11.42; p , 0.001).Conclusions: PCBI appears to be significantly associated with differing psychosocial outcomes depending on the patient's initial diagnosis. Although additional research is necessary to examine causality, our results suggest that depression and employment concerns appear to be particularly important factors for patients with PCBI and epilepsy and nonepileptic attacks, respectively. The postictal state constitutes the period of time between termination of a seizure and return to the baseline level of function.1 The patient may experience no neurologic dysfunction or may alternatively have mild, moderate, or severe levels of impairment of varying duration.Confusion, fear, and agitation are the most frequently encountered symptoms during the postictal state.2 These symptoms can be extremely debilitating 3,4 and may last hours to days after a seizure.1 However, there is a relative paucity of data related to the clinical, psychological, and social consequences of postictal cognitive and behavioral impairment (PCBI) in the current literature.PCBI can persist for prolonged periods and may expose the patient to additional stigma, limit employment opportunities, and contribute to lowered self-esteem. Furthermore, employers may not wish to hire or retain people whose seizures do not simply terminate with a return to normal baseline but instead involve potentially prolonged periods of confusion and disorientation. These factors are reasonably expected to compound any preexisting disposition to adverse psychosocial outcomes.It is our observation that in contrast to patients with immediate postictal recovery, those with PCBI seem more prone to fatigue and low mood. In the absence of existing evidence, we hypothesized a priori that PCBI would cause significant distress in excess of that related to the seizure itself.

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Section: Methods Study Population the Calgary Comprehensivementioning

confidence: 99%

An investigation into the psychosocial effects of the postictal state

et al. 2016

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“…Its use in busy clinical settings in the United States has been shown to facilitate the management of depression in such patients [12]. Recently, a Brazilian version of the NDDI-E was developed and reported to be an effective tool for screening depression in Brazilian individuals with epilepsy [13].…”

Section: Introductionmentioning

confidence: 99%

Screening for major depressive episodes in Japanese patients with epilepsy: Validation and translation of the Japanese version of Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)

Tadokoro

Oshima

Fukuchi³

et al. 2012

Epilepsy & Behavior

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“…Nesse contexto, é oportuno destacar a recente validação para o português de um instrumento de triagem da depressão na epilepsia, o Inventário de Depressão em Transtornos Neurológicos para a Epilepsia (IDTN-E) 8 . Esse instrumento foi desenvolvido especificamente para a depressão na epilepsia e leva apenas 3 minutos 9,10 , podendo ser útil na triagem de depressão na qual não se tenha disponível um profissional capacitado na aplicação da HAM-D ou caso o paciente apresente dificuldades no preenchimento do BDI.…”

Section: Discussionunclassified

Inventário de Depressão de Beck (BDI) e Escala de Avaliação de Depressão de Hamilton (HAM-D) em pacientes com epilepsia

Oliveira

Filho

Kümmer

et al. 2011

J. bras. psiquiatr.

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Identifying depression in epilepsy in a busy clinical setting is enhanced with systematic screening

Abstract: Use of the NDDI-E significantly improved the ability to detect depression in epilepsy patients in a busy clinical practice.

Cited by 90 publications

References 36 publications

An investigation into the psychosocial effects of the postictal state

An investigation into the psychosocial effects of the postictal state

Screening for major depressive episodes in Japanese patients with epilepsy: Validation and translation of the Japanese version of Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)

Inventário de Depressão de Beck (BDI) e Escala de Avaliação de Depressão de Hamilton (HAM-D) em pacientes com epilepsia

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