Abstracts

Rationale: In people with primary depressive disorders, anxiety has been shown to worsen depressive episodes. Yet, in people with epilepsy (PWE), this phenomenon has yet to be established. Given the high comorbidity of depressive and anxiety disorders in PWE, this question needs to be addressed. Our aim is to determine whether the presence of anxiety disorders worsen the severity of depressive episodes.Methods: Structured interviews with the MINI International neuropsychiatric interview were administered to 188 PWE to identify the presence of mood and anxiety disorders according to DSM-IV criteria. Patients were grouped according to the following psychiatric diagnosis: 1) Asymptomatic; 2) Subsyndromic depressive episode (SSDE); 3) Major depressive episode (MDE); 4) One anxiety disorder (1AD); 5) >1AD; 6) Current mixed MDE w/ 1AD; 7) Current mixed MDE w/ >1AD. Severity of depressive episodes were measured with three self-rating scales: Beck Depression Inventory (BDI-II), Centers for Epidemiologic Studies-Depression (CES-D), and Cornell Dysthymic Rating Scale (CDRS). We used ANOVA for comparison of the total scores of the 3 instruments among the diagnostic groups; post-hoc analyses with Bonferroni were carried out.Results: The comorbidity of MDE and Anxiety Disorders yielded significantly higher total scores in the BDI-II, CES-D and CDRS compared to the scores obtained with only MDE [BDI (p = 0.014), CES-D (p = 0.015), and CDRS (p = 0.04)], but this was identified only if more than one type of anxiety disorder was present. Conclusions: These results demonstrate that the presence of anxiety disorders can worsen the severity of comorbid depressive episodes in PWE. Therefore, it is imperative that clinicians not limit themselves to the screening of depression, but include a screen for anxiety disorders in PWE.