Prevalence of psychiatric comorbidities in epilepsy

2017 ◽  
Vol 41 (S1) ◽  
pp. S470-S470 ◽  
Author(s):  
N. Charfi ◽  
S. Daoud ◽  
N. Farhat ◽  
M. Maâlej Bouali ◽  
L. Zouari ◽  
...  

IntroductionEpilepsy is a chronic disease defined as a brain disorder, characterized by a predisposition to present seizures, generating cognitive, psychological, and social consequences.ObjectiveTo determine the prevalence of psychiatric comorbid disorders in patients with epilepsy (PWEs) and its associated factors.MethodsWe conducted a cross-sectional study involving 30 PWEs who were treated in the neurology department of Habib Bourguiba Hospital in Sfax, Tunisia. We used the Mini International Neuropsychiatric Interview for the diagnosis of Axis I psychiatric disorders.ResultsThe half of patients had psychiatric comorbidities: 4 had major depressive disorder (MDD), 2 had MDD with generalized anxiety disorder, 4 had MDD with social phobia, 1 had bipolar disorder type I, 1 had panic disorder, 1 had agoraphobia and 2 had generalized anxiety disorder.Twenty-five PWEs had seizure-onset below 30 years old and among them, 40% had psychiatric comorbidities. Among patients who had seizure-onset above 30 years old, none had psychiatric comorbidities. Psychiatric comorbidities were found in 71.5% of patients with seizure frequency >2 per year. Psychiatric comorbidities were more common in patients with generalized seizures compared to whom with partial seizures (53% versus 45%). It was also more common in patients treated with polytherapy compared to whom with monotherapy (64% versus 37.5%).ConclusionThe prevalence of psychiatric comorbidities is relatively high among PWEs. The most frequent diagnoses found were mood and anxiety disorders. It is very important to identify them and treat them to enhance seizure control.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2005 ◽  
Vol 27 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Ricardo Schmitt ◽  
Fernando Kratz Gazalle ◽  
Maurício Silva de Lima ◽  
Ângelo Cunha ◽  
Juliano Souza ◽  
...  

OBJECTIVE: To investigate the efficacy and acceptability of antidepressants in the treatment of generalized anxiety disorder. METHODS: All randomized controlled trials assessing the use of antidepressants in generalized anxiety disorder up to may 2002 were included. Non randomized trials and those that included patients with both generalized anxiety disorder and another Axis I co-morbidity were excluded. Relative risks, weighted mean difference and number needed to treat were estimated. People who died or dropped out were regarded as having had no improvement. RESULTS: Antidepressants (imipramine, venlafaxine and paroxetine) were found to be superior to placebo in treating generalized anxiety disorder. The calculated number needed to treat for antidepressants in generalized anxiety disorder was 5.15. Dropout rates did not differ between antidepressants and placebo. CONCLUSION: The available evidence suggests that antidepressants would probably be a reasonable treatment for generalized anxiety disorder patients in the clinical context.


2019 ◽  
Vol 7 (5) ◽  
pp. 969-981 ◽  
Author(s):  
Charlotte Krahé ◽  
Jessica Whyte ◽  
Livia Bridge ◽  
Sofia Loizou ◽  
Colette R. Hirsch

Worry and rumination, two forms of repetitive negative thinking (RNT), are prevalent in generalized anxiety disorder (GAD) and depression. Cognitive processing biases, especially the tendency to draw negative conclusions from ambiguous information (interpretation bias), may maintain worry and rumination. Yet the relationship between interpretation bias and both forms of RNT has not been explored in clinical versus nonclinical samples. In this cross-sectional study, participants with GAD ( n = 72), depression ( n = 79), or neither disorder ( n = 71) completed two tasks assessing interpretation bias, measures of worry and rumination, and reported negative thought intrusions during a behavioral task. Interpretation bias was associated with higher levels of worry, rumination, and negative thought intrusions. Both clinical groups generated significantly more negative interpretations than healthy comparison participants. These findings link interpretation bias to worry and rumination and establish the need for research investigating the causal role of interpretation bias in maintaining RNT.


2020 ◽  
Vol 68 (7) ◽  
pp. 1228-1234 ◽  
Author(s):  
Alvaro Monterrosa-Castro ◽  
Velia Redondo-Mendoza ◽  
María Mercado-Lara

Healthcare providers commonly experience symptoms of anxiety during public health crises and pandemics. The objective of the study was to identify the frequency of symptoms of generalized anxiety disorder (GAD) in general practitioners and to estimate the association with particular psychosocial and demographic factors. This is a cross-sectional study, where a total of 531 general practitioners completed an online form that contained sociodemographic variables, questions about fear and perceptions concerning medical work during the COVID-19 pandemic, 7-Item Generalized Anxiety Disorder Scale (GAD-7), questionnaire on psychosomatic problems and Fear of COVID-19 Scale. The presence of symptoms of GAD was defined by a GAD-7 score of 10 or more points. Voluntary and anonymous participation, acceptance of terms, and informed consent were requested. A p value of <0.05 was considered statistically significant. Symptoms of GAD were identified in 4 out of 10 Colombian general practitioners; the following psychosocial and demographic factors were associated with a greater presence of these symptoms: female gender, social discrimination, anguish, job disappointment, nightmares, stress and other symptoms of fear regarding the pandemic. Conversely, feeling protected by the state or employer, being satisfied with their job as a physician, and trusting government measures and information were associated with a lower presence of symptoms of GAD. These findings highlight the importance of timely psychotherapeutic and psychopharmacological interventions in these individuals. The authors suggest mental health providers should be deployed during times of crisis to decrease the risk of developing mental illness.


Author(s):  
Susan Mineka ◽  
Deepika Anand ◽  
Jennifer A. Sumner

The comorbidity of anxiety and mood disorders has been of great interest to psychopathology researchers for the past 25 years. One topic––the comorbidity of generalized anxiety disorder (GAD) and major depressive disorder (MDD)––has received considerable attention, in part because it has raised fundamental nosological issues regarding whether GAD should continue to be categorized as an anxiety disorder or whether it should be recategorized as a mood disorder. We review the logic for reclassifying GAD with the mood disorders as well as what we believe to be even more compelling reasons for why it should be retained as an anxiety disorder. In doing so, we review three different kinds of comorbidity—cross-sectional, cumulative (lifetime), and sequential. We also discuss overlaps and distinctions in what is known about the etiology of GAD and MDD and how their somewhat different cognitive and affective profiles bear on these issues of classification. Finally, we briefly discuss what some of the treatment implications may be for individuals with comorbid GAD and MDD.


2020 ◽  
pp. 019459982095927
Author(s):  
Matthew L. Carlson ◽  
David P. Larson ◽  
Erin K. O’Brien ◽  
Christine M. Lohse ◽  
Matthew L. Kircher ◽  
...  

Objective To ascertain the prevalence of and associations with distress and professional burnout among academic otolaryngology attending physicians. Study Design Cross-sectional survey. Setting Twelve US academic otolaryngology programs. Methods A questionnaire was administered that encompassed sociodemographic and professional features, the Expanded Physician Well-being Index for distress, the 2-item Maslach Burnout Inventory for professional burnout, the Patient Health Questionnaire–2 screen for major depressive disorder, and the Generalized Anxiety Disorder–2 screen for generalized anxiety disorder. Results The survey response rate was 56% and included 186 attending physicians. The average respondent age was 47 years; 72% were men; 93% were married or partnered; and 86% had children. Distress was present in 40%, professional burnout in 26%, positive depression screening in 8%, and positive anxiety screening in 11%. In a univariable setting, age, hours worked in a typical week, nights on call in a typical week, and years of practice were significantly associated with distress, although in a multivariable setting, only hours worked in a typical week remained significantly associated with a positive Expanded Physician Well-being Index screen (odds ratio for each 10-hour increase, 2.61; 95% CI, 1.73-3.93; P < .001). In a univariable setting, hours worked in a typical week was significantly associated with a positive Maslach Burnout Inventory screen. Conclusion Distress or professional burnout occurs in more than a quarter of academic otolaryngology attending physicians, whereas the prevalence of depression or anxiety is approximately 10%. The number of hours worked per week had the strongest association with distress and burnout. These findings may be used to develop and implement programs to promote physician well-being and mitigate professional burnout.


Author(s):  
Ayfer BAYINDIR ÇEVİK ◽  
Elçin Sebahat KASAPOĞLU

Aim: The aim of the study is to evaluate the knowledge, attitudes, behaviors and anxiety of university students about the Covid-19 epidemic at the beginning of the Covid-19 pandemic. Material and Methods: The study is a cross-sectional study. The sample consists of 1243 health students. The data were collected through an online questionnaire consisting of three parts. The questionnaire included questions to assess the socio-demographic characteristics of students, their level of knowledge, awareness and behavior about the Covid-19 pandemic, and the impact of the epidemic on their psychological health. The GAD-7 scale was used to assess students' anxiety levels. Results: In this study; 79.60% of the Health Care Students (HCSs) did not attend any training on COVID-19. Their sources of information were internet/social media (97.18%) and TV (97.18%). In the COVID-19 knowledge assessment test, it was found that 65.7% of them had a high level of knowledge. Most of HCSs thought that their knowledge about COVID-19 was very good (55%). The correct answer means of the 31 questions on the COVID-19 knowledge questionnaire were 22.07±1.70. In this questionnaire, it stated that the most effective methods of protection were the use of a mask in crowded environments (99.1%). Most of the HCSs stated that outbreak was affected their mental health negatively (73.1%) and some of them named this state as "Coronaphobia" (33.2%). In this study was found that some HCSs have a generalized anxiety disorder (22.6%) and anxiety experienced due to COVID "completely affected" their lives (19.5%). The average knowledge score of the students who received applied training in the hospital at the beginning of the pandemic (22.29±1.58) and anxiety level of students (6.77±5.85) was higher than those who did not receive applied training in the hospital (5.84±5.47, p<0.05). The GAD-7 scores for those with a previous diagnosis of psychological disease were 2 times higher than those without a previous diagnosis (p<0.05)Conclusion: At the beginning of the pandemic, students who received hands-on training at the hospital had higher knowledge and awareness levels. Generalized Anxiety Disorder was observed more frequently in those with a previous psychological disorder than in other students. Keywords: Anxiety; coronavirus disease 2019 (covid-19); knowledge; health students; pandemic and mental health


2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Astri Budikayanti ◽  
Andira Larasari ◽  
Khamelia Malik ◽  
Zakiah Syeban ◽  
Luh Ari Indrawati ◽  
...  

Introduction. Generalized anxiety disorder (GAD) is one of the most common types of anxiety disorder in epilepsy population, comprising 21.9%, that would further impair patients’ quality of life. Generalized Anxiety Disorder-7 (GAD-7) is the only screening tool for GAD that has been validated in patients with epilepsy (PWE). It is a self-reporting instrument that can be completed in less than three minutes; hence, its usage is appropriate in primary healthcare and neurology outpatient clinic. This study aimed to obtain a valid and reliable Indonesian version of GAD-7, assess its accuracy, and finally evaluate the prevalence of GAD in Indonesian PWE along with its contributing factors. Methods. A cross-sectional study was conducted in Cipto Mangunkusumo General Hospital, Jakarta. The GAD-7 was translated and adapted using World Health Organization (WHO) steps. Validity, reliability, test-retest reliability, and diagnostic accuracy were evaluated. Then, epilepsy outpatients were screened for GAD using the Indonesian version of GAD-7. Results. Internal validity and reliability for Indonesian version of GAD-7 were satisfactory with validity coefficient of 0.648 to 0.800 (p<0.01) and Cronbach’s alpha value of 0.867. The best cutoff value to detect GAD in Indonesian PWE was >6 with the sensitivity, specificity, negative predictive value, and positive predictive value of 100%, 84.4%, 100%, and 55.8%, respectively. ROC analysis showed the area under the curve of 0.98 (95% CI: 0.96–0.99). The total subjects screened with the validated Indonesian version of GAD-7 were 146, and 49% were screened as having GAD. Sociodemographic and clinical characteristics had no statistically significant association with the presence of GAD. Conclusion. The Indonesian version of GAD-7 was a valuable screening tool to detect GAD in PWE. GAD was screened in a quite high proportion of PWE. Sociodemographic and clinical characteristics were not proven to play role in its development.


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