scholarly journals Invasive Electrophysiology for Circuit Discovery and Study of Comorbid Psychiatric Disorders in Patients With Epilepsy: Challenges, Opportunities, and Novel Technologies

2021 ◽  
Vol 15 ◽  
Author(s):  
Irena Balzekas ◽  
Vladimir Sladky ◽  
Petr Nejedly ◽  
Benjamin H. Brinkmann ◽  
Daniel Crepeau ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Careful Consideration ◽  
Psychiatric Comorbidities ◽  
Novel Technologies ◽  
Comorbid Psychiatric Disorders ◽  
Behavioral Tracking ◽  
Drug Resistant Epilepsy ◽  
Monitoring Technologies ◽  
Patients With Epilepsy

Intracranial electroencephalographic (iEEG) recordings from patients with epilepsy provide distinct opportunities and novel data for the study of co-occurring psychiatric disorders. Comorbid psychiatric disorders are very common in drug-resistant epilepsy and their added complexity warrants careful consideration. In this review, we first discuss psychiatric comorbidities and symptoms in patients with epilepsy. We describe how epilepsy can potentially impact patient presentation and how these factors can be addressed in the experimental designs of studies focused on the electrophysiologic correlates of mood. Second, we review emerging technologies to integrate long-term iEEG recording with dense behavioral tracking in naturalistic environments. Third, we explore questions on how best to address the intersection between epilepsy and psychiatric comorbidities. Advances in ambulatory iEEG and long-term behavioral monitoring technologies will be instrumental in studying the intersection of seizures, epilepsy, psychiatric comorbidities, and their underlying circuitry.

Psychiatric Comorbidities in Patients with Epilepsy: A Cross-sectional Study

2017 ◽  
Vol 2 (1) ◽  
pp. 24-28
Author(s):  
Saurabh Jaiswal ◽  
Santosh Kumar
Keyword(s):  
Psychiatric Disorders ◽  
Psychotic Disorders ◽  
Uttar Pradesh ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Psychiatric Comorbidities ◽  
Comorbid Psychiatric Disorders ◽  
Diagnostic And Statistical Manual ◽  
Patients With Epilepsy

ABSTRACT Introduction People with epilepsy are more likely than the general population to have comorbid psychiatric disorders that include anxiety, depression, and interictal and chronic psychoses. Even though psychiatric comorbidity is common in epilepsy, it is underrecognized and undertreated, both in specialty epilepsy centers and also in community-based services. A thorough assessment of this was sought in this study among the patients of Rohilkhand region of Uttar Pradesh (India). Materials and methods A total of 100 patients with epilepsy who visited the psychiatry outpatient clinic were recruited for this study. They were assessed in detail for the presence of comorbid psychiatric disorders on Axis 1 with the help of Structured Clinical Interview for Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders. Results Overall, it was found that a comorbidity of psychiatric disorders was present in 45% of patients with epilepsy. The frequency of cooccurrence of different types of psychiatric disorders was as follows: Mood disorders 21%, anxiety disorders 14%, and psychotic disorders 28%. Conclusion Psychiatric comorbidities were found to be a common problem in patients with epilepsy. The results of this study are in line with many different research works both in India and abroad. A proper address of this issue is important for management, better outcome, and policy making in patients with epilepsy. How to cite this article Jaiswal S, Kumar S, Sharma CS, Kuchhal A, Jaiswal A. Psychiatric Comorbidities in Patients with Epilepsy: A Cross-sectional Study. Int J Adv Integ Med Sci 2017;2(1):24-28.

scholarly journals 0967 Clinical Characteristics of Children With Sleep Problems and Comorbid Psychiatric Disorders

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A367-A367
Author(s):  
E McIntyre ◽  
S K Oles ◽  
K Walsh ◽  
A Bandyopadhyay
Keyword(s):  
Psychiatric Disorders ◽  
Clinical Characteristics ◽  
Sleep Problems ◽  
Retrospective Chart Review ◽  
P Value ◽  
Psychiatric Comorbidities ◽  
Children With Adhd ◽  
Comorbid Psychiatric Disorders ◽  
Presenting Symptoms ◽  
Icd 10

Abstract Introduction Anxiety and Attention Deficit Hyperactive Disorder (ADHD) are common psychiatric comorbidities in children with sleep disorders. It is known that comorbid psychiatric disorders increase the risk of sleep problems. However, no study has compared the clinical characteristics of children presenting with sleep problems and various common psychiatric disorders. Methods Retrospective chart review of all children presenting to the sleep clinic for sleep problems between March 2016 to June 2017 was performed. Demographics, sleep intake patient questionnaires, polysomnograms and ICD-9/10 codes for comorbidities and sleep diagnoses were collected. In children with diagnoses of anxiety (ICD-9 300/ICD-10 F41) and ADHD (ICD-9 314/ICD-10 F90), demographics, presenting symptoms, Epworth sleepiness scores and prevalence of sleep comorbidities were compared. T-test (continuous) and Chi Square (categorical) were used. Unadjusted odds ratio was calculated for presenting symptoms and sleep comorbidities. P value of <0.05 was considered significant. Results 250 (F=145, 58%) children were evaluated. 71.2% children were diagnosed with anxiety and 28.8% diagnosed with ADHD. Mean age at presentation was 8.53 ± 4.2 years. Age, gender and race of children presenting with sleep problems and comorbid anxiety/ADHD were statistically similar. Children with anxiety spent less time in stage N3 sleep (25.2% ± 9.1 versus 28.6% ± 9.2) and had lower arousal indices (7.19 ± 3.8 versus 8.86 ± 5.5) compared to children with ADHD. Children with anxiety were more likely to present with chief complaint of “feeling tired or sleepy during the day” (OR:2.38, 1.32-4.37) and were more likely to have a diagnosis of hypersomnia (OR: 11.67, 3.19-42.75) versus children with ADHD. Conclusion Children with psychiatric comorbidities have distinct polysomnographic characteristics. Children with anxiety are more likely to present with daytime sleepiness and have a significantly higher prevalence of hypersomnia compared to children with ADHD. Support None

scholarly journals Adults with persistent ADHD: Gender and psychiatric comorbidities – a population-based longitudinal study

2016 ◽  
Vol 33 (S1) ◽  
pp. S136-S137 ◽  
Author(s):  
K. Yoshimasu ◽  
W.J. Barbaresi ◽  
R.C. Colligan ◽  
R.G. Voigt ◽  
J.M. Killian ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Birth Cohort ◽  
Internalizing Disorders ◽  
Externalizing Disorders ◽  
Population Based ◽  
Psychiatric Interview ◽  
Psychiatric Comorbidities ◽  
Childhood Adhd ◽  
Comorbid Psychiatric Disorders ◽  
Increased Risk

ObjectiveTo evaluate in adults the associations between persistent ADHD and comorbid psychiatric disorders and gender differences, among subjects from a population-based birth cohort.MethodSubjects were recruited from a birth cohort of all children born during 1976–1982 who remained in Rochester, MN after five years of age. Participating subjects with research-identified childhood ADHD (n = 232; mean age 27.0 years; 72% men) and non-ADHD controls (n = 335; mean age 28.6 years; 63% men) were administered a structured psychiatric interview (MINI-International Neuropsychiatric Interview) to assess current ADHD status and comorbid psychiatric disorders.ResultsAmong the 232 with research-identified childhood ADHD, 68 (49 men and 19 women) had persistent adult ADHD. Compared to subjects without childhood ADHD, adults with persistent ADHD were significantly more likely to have any (81% vs. 35%, P < 0.001) as well as each of the specific psychiatric comorbidities. The associations retained significance when stratified by gender and there were no significant gender by ADHD interactions on psychiatric disorders except for dysthymia with which ADHD was more strongly associated in women than men. Among subjects with persistent ADHD, externalizing psychiatric disorders were more common in men (73%) and internalizing disorders were more common in women (53%).ConclusionPersistent ADHD is associated with an increased risk of comorbid psychiatric disorders in both adult men and women. Clinicians treating adults with persistent ADHD need to be aware of comorbid psychiatric disorders, especially externalizing disorders for men and internalizing disorders for women.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals “Ictal” Bradyarrhythmias in Patients with Drug-Resistant Epilepsy: Results of Long-Term Heart Rhythm Monitoring

Kardiologiia ◽  
2021 ◽  
Vol 60 (12) ◽  
pp. 90-96
Author(s):  
S. E. Serdyuk ◽  
K. V. Davtyan ◽  
S. G. Burd ◽  
E. S. Mishina ◽  
O. M. Drapkina ◽  
...  
Keyword(s):  
Heart Rhythm ◽  
Epileptic Seizures ◽  
Channel Blockers ◽  
Drug Resistant ◽  
Disorder Of Consciousness ◽  
Functional Changes ◽  
Long Duration ◽  
Drug Resistant Epilepsy ◽  
Patients With Epilepsy

Aim      To determine the type and incidence of ictal bradyarrhythmias in patients with drug-resistant types of epilepsy by long-term electrocardiogram (ECG) monitoring.Material and methods  Subcutaneous ECG monitors programed for recording pauses >3 sec and episodes of bradycardia ≤45 bpm were implanted in 193 patients with persistent epileptic seizures without organic pathology of the myocardium. Recording was activated by the patient/family at the onset of epileptic seizure. The follow-up period was 36 months with visits to the clinic every three months.Results For 36 months of monitoring, 6494 ECG fragments were recorded. Ictal bradycardia was observed in 6.7 % of patients, including ictal asystole in 2.6 % of patients. Episodes of bradycardia and asystole during epileptic seizures were transient and developed significantly more frequently in men, patients with long duration of the disease, bilateral tonic-clonic or focal seizures with disorder of consciousness, during sleep, on the background of treatment with several antiepileptic agents, mostly from the group of potassium channel blockers.Conclusion      Bradyarrhythmias accompanying epileptic seizures are transient and reproducible from seizure to seizure. They reflect functional changes in the myocardium and do not determine the life prediction for patients with epilepsy without organic pathology of the heart.

scholarly journals Attention Deficit Hyperactivity Disorder and Psychiatric Comorbidities

2020 ◽  
Vol 9 (1) ◽  
pp. 27-34
Author(s):  
Mengühan Araz Altay ◽  
Işık Görker ◽  
Begüm Demirci Şipka ◽  
Leyla Bozatlı ◽  
Tuğçe Ataş
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Psychiatric Disorders ◽  
Attention Deficit ◽  
Primary Care Physicians ◽  
Psychiatric Comorbidity ◽  
Psychiatric Comorbidities ◽  
Comorbid Psychiatric Disorders ◽  
Hyperactivity Disorder ◽  
Oppositional Defiant ◽  
And Gender

Aim: This study aims to obtain current information on the clinical features of attention deficit hyperactivity disorder cases, comorbid psychiatric disorders and psychiatric drug use. Methods: All patients between the ages of 6 and 18 years who were admitted to our outpatient clinic and diagnosed with attention deficit hyperactivity disorder were included in the study. The files of the patients were examined and their demographic characteristics, symptoms, psychiatric diagnoses and drug profiles were recorded. The pattern of the psychiatric disorders accompanied by attention deficit hyperactivity disorder cases and the differences according to age and gender were analyzed. The differences were determined in patients with psychiatric comorbidity compared to those without. Result: The mean age of the 777 patients included in the study was 11.1±2.94 and 76.6% were boys. 60.9% of attention deficit hyperactivity disorder patients had comorbid psychiatric disorders. The most common psychiatric comorbidities were specific learning disability (23.6%), oppositional defiant disorder (12.9%) and conduct disorder (12.1%). There was no difference between the genders in terms of the incidence of psychiatric comorbidities. The rate of psychiatric comorbidity was significantly higher in adolescents than in children. A psychotropic medication was used in 86.4% of the cases and psychotropic polypharmacy was present in 31.5%. The rate of polypharmacy was significantly higher in the group with psychiatric comorbidity. Conclusion: Attention deficit hyperactivity disorder is frequently accompanied by other psychiatric disorders and the psychiatric comorbidity leads to a more complicated clinical profile. Approximately one-third of attention deficit hyperactivity disorder patients have psychiatric polypharmacy and these patients should be carefully monitored. Primary care physicians who are frequently confronted with attention deficit hyperactivity disorder cases should be careful about psychiatric comorbidities. Keywords: Child psychiatry, attention deficit hyperactivity disorder, mental disorders, Family practice

Suicidality and psychiatric comorbidities among adults with childhood identified ADHD: Gender differences – a population-based longitudinal study

2016 ◽  
Vol 33 (S1) ◽  
pp. S77-S77
Author(s):  
K. Yoshimasu ◽  
W.J. Barbaresi ◽  
R.C. Colligan ◽  
R.G. Voigt ◽  
J.M. Killian ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Interaction Effect ◽  
Odds Ratio ◽  
Population Based ◽  
Suicidal Risk ◽  
Psychiatric Interview ◽  
Psychiatric Comorbidities ◽  
Childhood Adhd ◽  
Comorbid Psychiatric Disorders ◽  
Competing Interest

ObjectiveTo evaluate the effect of comorbid psychiatric disorders (PD) on the association between childhood ADHD and suicidality and the effect of gender on the association between PDs and suicidality among adults with childhood ADHD.MethodSubjects were recruited from a birth cohort of all children born 1976–1982 remaining in Rochester, MN after five years of age. Participating subjects with research-identified childhood ADHD (n = 232; mean age 27.0 years; 72% men) and non-ADHD controls (n = 335; mean age 28.6 years; 63% men) were administered a structured psychiatric interview (MINI International Neuropsychiatric Interview) to assess suicidality and psychiatric comorbidities.ResultsCompared to controls, ADHD cases were significantly more likely to meet criteria for suicidality [odds ratio (OR) = 2.7, 95% CI 1.7–4.5]. Although this association was not moderated by the presence of PDs (P = 0.63 for interaction effect), the association between ADHD and suicidality was partially mediated by the presence of PDs [OR decreased from 2.7 to 2.1 (95% CI 1.2–3.5)]. Among adults with childhood ADHD, there was no significant moderating effect of gender on the association between suicidality and PD (P = 0.26 for interaction effect). However, the odds of suicidality was 6.1 (95% CI, 2.3–15.9) times higher among males with both externalizing and internalizing PDs compared to males with no disorders; among females the corresponding odds ratio was 3.4 (95% CI, 0.7–16.6).ConclusionChildhood ADHD is significantly associated with adult suicidal risk. Among those with ADHD, associations between suicidality and comorbid psychiatric disorders are more apparent in men among those with comorbid externalizing and internalizing disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Adults With Persistent ADHD: Gender and Psychiatric Comorbidities—A Population-Based Longitudinal Study

2016 ◽  
Vol 22 (6) ◽  
pp. 535-546 ◽  
Author(s):  
Kouichi Yoshimasu ◽  
William J. Barbaresi ◽  
Robert C. Colligan ◽  
Robert G. Voigt ◽  
Jill M. Killian ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Adult Adhd ◽  
Structured Interview ◽  
Population Based ◽  
Psychiatric Comorbidities ◽  
Men And Women ◽  
Childhood Adhd ◽  
Comorbid Psychiatric Disorders ◽  
Adult Men ◽  
Increased Risk

Objective: The aim of the study was to evaluate associations between ADHD and comorbid psychiatric disorders among adults from a population-based birth cohort. Method: Participants were recruited from all children born between 1976 and 1982 remaining in Rochester, Minnesota, after age 5. Participants with childhood ADHD ( n = 232; M age = 27.0 years; 72% men) and non-ADHD controls ( n = 335; M age = 28.6 years; 63% men) completed a structured interview (M.I.N.I. International Neuropsychiatric Interview) assessing current ADHD status and comorbid psychiatric disorders. Results: Among 232 with childhood ADHD, 68 (49 men, 19 women) had persistent adult ADHD. Compared with non-ADHD controls and non-persistent ADHD participants, adults with persistent ADHD were significantly more likely to have any or each of 12 psychiatric comorbidities. The associations retained significant or marginally significant when stratified by gender. Externalizing psychiatric disorders were more common in men (74%) and internalizing disorders in women (58%). Conclusion: Persistent ADHD is associated with an increased risk of comorbid psychiatric disorders in adult men and women.

scholarly journals Is EEG a Useful Examination Tool for Diagnosis of Epilepsy and Comorbid Psychiatric Disorders?

2020 ◽  
Author(s):  
Hideki Azuma
Keyword(s):  
Psychiatric Disorders ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Case Series ◽  
Eeg Analysis ◽  
Comorbid Psychiatric Disorders ◽  
Language Studies ◽  
Interictal Eeg ◽  
Patients With Epilepsy ◽  
Nonlinear Eeg Analysis

Diagnosis of epilepsy usually involves interviewing the patients and the individuals who witnessed the seizure. An electroencephalogram (EEG) adds useful information for the diagnosis of epilepsy when epileptic abnormalities emerge. EEG exhibits nonlinearity and weak stationarity. Thus, nonlinear EEG analysis may be useful for clinical application. We examined only about English language studies of nonlinear EEG analysis that compared normal EEG and interictal EEG and reported the accuracy. We identified 60 studies from the public data of Andrzejak 2001 and two studies that did not use the data of Andrzejak 2001. Comorbid psychiatric disorders in patients with epilepsy were not reported in nonlinear EEG analysis except for one case series of comorbid psychotic disorders. Using a variety of feature extraction methods and classifier methods, we concluded that the studies that used the data of Andrzejak 2001 played a valuable role in EEG diagnosis of epilepsy. In the future, according to the evolution of artificial intelligence, deep learning, new nonlinear analysis methods, and the EEG association with the rating scale of the quality of life and psychiatric symptoms, we anticipate that EEG diagnosis of epilepsy, seizures, and comorbid psychiatric disorders in patients with epilepsy will be possible.

Perceived Group Climate as a Predictor of Long-Term Outcome in a Randomized Controlled Trial of Cognitive-Behavioural Group Therapy for Patients with Comorbid Psychiatric Disorders

2009 ◽  
Vol 37 (5) ◽  
pp. 497-510 ◽  
Author(s):  
Truls Ryum ◽  
Roger Hagen ◽  
Hans M. Nordahl ◽  
Patrick A. Vogel ◽  
Tore C. Stiles
Keyword(s):  
Group Therapy ◽  
Psychiatric Disorders ◽  
Outcome Measures ◽  
Anxiety Symptoms ◽  
Group Climate ◽  
Long Term Outcome ◽  
Comorbid Psychiatric Disorders ◽  
Cognitive Behavioural

Background: Research on group therapy indicates that various dimensions of the helpful relationship qualities (cohesion, climate, empathy, alliance) are associated with outcome. However, the use of a wide variety of empirical scales makes comparisons between studies as well as generalizations somewhat difficult. Although a generic, trans-theoretical measure such as the Group Climate Questionnaire-Short Form (GCQ-S; MacKenzie, 1983) is available and applicable to most treatment conditions, it has never been tested with cognitive-behavioural group therapy. Aims: To investigate perceived dimensions of group climate (engagement, avoidance and conflict) as predictors of long-term (1 year) follow-up in a manualized, structured time-limited cognitive-behavioural group therapy (CBGT) for out-patients with comorbid psychiatric disorders. Methods: Data from 27 patients were analysed using hierarchical multiple regression analyses. Outcome measures used were general symptomatic complaints (SCL-90-R), interpersonal problems (IIP-64), specific mood- and anxiety symptoms (BDI; BAI) and early maladaptive schemas (YSQ). After controlling for scores on the relevant dependent variables at both intake and treatment termination, dimensions of group climate measured close to termination were entered as predictors in separate analyses. Results: Higher ratings of engagement were associated with reduced scores on all outcome measures at follow-up, except for anxiety symptoms (BAI). Higher ratings of avoidance were associated with lower anxiety symptoms at follow up, whereas ratings of conflict were unrelated to all follow-up scores. Conclusions: The results provide partial support for the use of the GCQ-S as a predictor of long-term follow-up in CBGT, and highlights perceived engagement as the most important dimension. Clinical implications are discussed.

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