TY - JOUR
T1 - Mood and Anxiety Disorders and Suicidality in Patients with Newly Diagnosed Focal Epilepsy
T2 - An Analysis of a Complex Comorbidity
AU - Kanner, Andres M.
AU - Saporta, Anita S.
AU - Kim, Dong H.
AU - Barry, John J.
AU - Altalib, Hamada
AU - Omotola, Hope
AU - Jette, Nathalie
AU - O'Brien, Terence J.
AU - Nadkarni, Siddhartha
AU - Winawer, Melodie R.
AU - Sperling, Michael
AU - French, Jacqueline A.
AU - Abou-Khalil, Bassel
AU - Alldredge, Brian
AU - Bebin, Martina
AU - Cascino, Gregory D.
AU - Cole, Andrew J.
AU - Cook, Mark J.
AU - Detyniecki, Kamil
AU - Devinsky, Orrin
AU - Dlugos, Dennis
AU - Faught, Edward
AU - Ficker, David
AU - Fields, Madeline
AU - Gidal, Barry
AU - Gelfand, Michael
AU - Glynn, Simon
AU - Halford, Jonathan J.
AU - Haut, Sheryl
AU - Hegde, Manu
AU - Holmes, Manisha G.
AU - Kalviainen, Reetta
AU - Kang, Joon
AU - Klein, Pavel
AU - Knowlton, Robert C.
AU - Krishnamurthy, Kaarkuzhali
AU - Kuzniecky, Ruben
AU - Kwan, Patrick
AU - Lowenstein, Daniel H.
AU - Marcuse, Lara
AU - Meador, Kimford J.
AU - Mintzer, Scott
AU - Pardoe, Heath R.
AU - Park, Kristen
AU - Penovich, Patricia
AU - Singh, Rani K.
AU - Somerville, Ernest
AU - Szabo, Charles A.
AU - Szaflarski, Jerzy P.
AU - Lin Thio, K. Liu
AU - Trinka, Eugen
AU - Burneo, Jorge G.
N1 - Publisher Copyright:
© American Academy of Neurology.
PY - 2023/3/14
Y1 - 2023/3/14
N2 - 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 the t test, χ2 statistics, 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.
AB - 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 the t test, χ2 statistics, 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.
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U2 - 10.1212/WNL.0000000000201671
DO - 10.1212/WNL.0000000000201671
M3 - Article
C2 - 36539302
AN - SCOPUS:85150225564
SN - 0028-3878
VL - 100
SP - E1123-E1134
JO - Neurology
JF - Neurology
IS - 11
ER -