Abstracts

Rationale: Neuropsychiatric disorders are comorbidity in epilepsy. However, few studies have evaluating independent risk factors for anxiety disorders in epilepsy. In this study we identify independent risk factors for anxiety disorders in temporal lobe epilepsy. Methods: Cross-sectional study of 124 patients with temporal lobe epilepsy. All patients were submitted to Structured Clinical Interview for DSM Disorders (SCID) for psychiatric evaluation. Additionally, all patients were also submitted to an additional structured interview to collect variables associated with epilepsy or neuropsychiatric disorders. We review medical records of patients like age, gender, family history of epilepsy and psychiatric disorders, duration of epilepsy, control of seizures, presence of aura, history of initial precipitant insults, abuse of substances, neuroimaging and interictal EEG features. Results: In our study, thirty patients (24% of the total of patients with temporal lobe epilepsy) had anxiety disorders. Generalized anxiety disorder was the most frequent anxiety disorder observed, encountered in 40% of patients with anxiety disorders. Phobias were present in 36% of patients, panic disorders or panic attacks were observed in of 23% of patients, posttraumatic stress disorders were observed in 13% of patients and obsessive-compulsive disorder was present in10% of patients with anxiety disorders. Using univariated analysis we observed that being a woman, having positive family history of psychiatric disorders and having a life-time history of humor disorder were significantly associated with an increased risk for affective disorders in patients with temporal lobe epilepsy. After logistic regression, positive family history of psychiatric disorders (O.R=3.47; 95% CI=1.32-9.09; p=0.01 ) and a life-time diagnosis of humor disorder (O.R=2.70; 95% CI=1.05-6.94; p=0.04) remained isolated risk factor for anxiety disorder in temporal lobe epilepsy. Sex (woman) showed a statistical trend for being a risk factor for anxiety disorder in temporal lobe epilepsy (O.R=2.88; 95% CI=0.94-8.57; p=0.06). In our study an algorithm constructed based in the binary logistic regression model was able to predict correctly the presence or absence of a lifetime anxiety disorder in 77.4% of patients with temporal lobe epilepsy. Conclusions: Our results are in line with some studies published previously. However, we identified a positive family history of psychiatric disorders, a positive history of humor disorder, and possibly sex (being a woman) as independent predictors of anxiety disorders in temporal lobe epilepsy. Further studies are necessary to better understand how these factors merge together to generate anxiety disorders in patients with temporal lobe epilepsy. This work was suported by CNPq.