Abstracts

Psychiatric symptoms are often unreported by patients. In fact, spouses and companions of patients with epilepsy (PWE) are often the ones recognizing and reporting the presence of symptoms of depression to the treating clinician. The agreement between PWE and their spouses (or comapnions) on the existance of psychiatric symptoms has yet to be investiogated in a systematic manner. The purpose of this study was to establish the level of disagreement between PWE and their spouse/companion with respect to the presence of common psychiatric symptoms in epilepsy and to identify the type of symptoms with best and worst agreement. 42 pairs (PWE + spouse/companion) were asked to complete a 46 item self-rating questionnaire (Common Psychiatric Symptoms in Epilepsy Item Pool developed to identify symptoms of depreesion in the previous 2 weeks (n = 14 items), anxiety (n = 7), irritability (n = 9), socialization difficulties (n = 5), paranoia (n = 3) hypomanic-like symptoms (n = 3) and physical symptoms (n = 2). The instrument had a high internal consistency (Alpha Chronbach = 0.96). Each item was rated on a 1 to 4 Likert scale (1 = never, 2 = rarely, 3 = sometimes, 4 = always). A rating of 3 or 4 was considered to reflect the existence of a symptom. We compared the frequency of disagreement between PWE and spouse/companion among each of these symptom categories. Depression: 70% (range: 56-83%), Anxiety: 74% (62-83%), Irritability: 65% (55-83%), Socialization difficulties: 73% (55-83%), Paranoia: 75% (69-90%), Hypomanic-like symptoms: 65% (60-78%).
Irritability = median disagreement in 37% of pairs, (range: 14 to 55%), depression, 28% (9 - 42%), anxiety, 26% (3 - 31%) hypomanic-like symptoms, 20% (9 - 26%), paranoia, 19% (0 0- 20%), socialization difficulties, 16% (6 - 23%).
Hypomanic-like symptom, median disagremment in 80% of pairs, (range: 75 to 86%), socialization difficulties, 63% (36 - 70%), paranoia, 59% (52 - 80%), anxiety, 39% (23 - 67%), irritability, 38% (22 - 45%), depression, 38% (14 - 63%). These findings suggest an adeqaute agreement between PWE and spouse/ companion in the recognition of psychiatric symptoms. However, patients are more likely to deny symptoms of irritability identified by spouse/companion, while spouses are less likely to recognize hypomanic-like symptoms. (Supported by Glaxo-Smith-Kline)