Depression, Quality of life, and Anxiety in patients admitted for diagnostic Video EEG monitoring
Abstract number :
1.177
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2015
Submission ID :
2302533
Source :
www.aesnet.org
Presentation date :
12/5/2015 12:00:00 AM
Published date :
Nov 13, 2015, 12:43 PM
Authors :
Elizabeth Koontz, Paul Pritchard
Rationale: Psychiatric comorbidities have been described in patients with nonepileptic events (NEE) and patients with epilepsy. Depression, anxiety,and history of abuse have been reported as commonly occurring in patients with NEE. Many studies which have examined the characteristics of patients with NEE have been retrospective or lacked an adequate control group of patients with epilepsy. The present study examined depression, anxiety, and quality of life in patients admitted for diagnostic VEEG monitoring. One goal of the study was to determine if the rates of psychiatric comorbidities are different between patients diagnosed with NEE versus those diagnosed with epilepsy during the admission.Methods: Adults admitted for diagnostic VEEG monitoring between September 2013 and October 2014 were screened for inclusion. Exclusion criteria included: patients with a known diagnosis of epilepsy, patients with intellectual disability, or patients who were incarcerated. Information was collected regarding the length of time since the onset of events, comorbidities, and history of trauma, abuse, or head injury. Patients completed the NNDI-E, Beck Anxiety Scale, and QOLIE-31. Patients who had only interictal discharges or a nondiagnostic admission were not included for analysis.Results: There were 27 patients (38%) with no events or interictal discharges only, 23 (32%) patients diagnosed with NEE, 19 (26%) patients with Epilepsy, and 3 patients (4%) with combined NEE and Epilepsy. The NEE group was predominantly female 83% (n=19) and the average age was 40 years. The epilepsy group also had more females 68% (n=13) and the average age was 37. The mean scores for each group on depression, anxiety, and quality of life scales are listed in Table 1. Mean scores were compared using t-test with p-value for significance set at <0.05. While scores on the depression scale (p = 0.675) and qualifty of life scale ( p = 0.17) were similar, patients with NEE had significantly higher score on the anxiety scale than patients with epilepsy (p = 0.009).Conclusions: In contrast to previous studies, this study was performed prospectively prior to confirmation of the diagnosis and employed a control group of patients with epilepsy. This approach was designed to avoid the potential effect of a prior diagnosis on the results of psychological measures. Patients with NEE were more likely to have moderate to severe anxiety. This outcome is consistent with a recent report that panic attack symptoms differentiate patients with NEE from those with epilepsy¹. The role of the amygdala in fearful emotions or anxiety is well established² . Previous studies have also found elevations of serum cortisol after NEEs and human stimulation studies have demonstrated that stimulation of the amygdala produces elevation of serum adrenocorticotrophic hormone. It is thus tempting to postulate that dysfunction of amygdala or related structures plays a role in the pathogenesis of NEE. 1.Hendrickson R, Popescu A, Dixit R, et al Epilepsy Behav.2014 Aug;37:210-4 2. van der Plas EA, Boes AD, Wemmie JA, et alSoc Cogn Affect Neurosci. 2010 Dec;5(4):424-31
Cormorbidity