Epilepsy & Behavior最新文献

{"title":"Prevalence and correlates of alexithymia in drug-resistant epilepsies.","authors":"O Paradas, S Pradier, M Dessilas, A Viaud, L Chibani, M De-Montaudouin, A Gradel, V Michel, J Aupy","doi":"10.1016/j.yebeh.2024.110222","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110222","url":null,"abstract":"<p><strong>Introduction: </strong>Alexithymia, characterized by difficulty identifying and expressing emotions, is commonly observed in individuals with psychiatric and neurological disorders. However, its prevalence in patients with epilepsy (PWE), particularly in those with drug-resistant epilepsy (DRE), remains under-researched. This study investigates the prevalence of alexithymia in patients with DRE and explores its associated factors.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of 118 adult patients with focal DRE undergoing presurgical evaluation at Bordeaux University Hospital. Alexithymia was assessed using the Toronto Alexithymia Scale-20 (TAS-20), while psychiatric symptoms were evaluated with validated scales. Data on demographic characteristics, epilepsy duration, seizure frequency, antiepileptic drug use, and localization of the epileptogenic zone (EZ) were collected and analyzed using logistic regression models.</p><p><strong>Results: </strong>Alexithymia was identified in 40.7 % of patients. Depression and anxiety were significantly associated with alexithymia (p < 0.01), whereas no correlation was observed between alexithymia and the localization or lateralization of the EZ.</p><p><strong>Discussion: </strong>These findings suggest that alexithymia is prevalent among patients with DRE, with significant associations to depression and anxiety. The high prevalence of affective symptoms underscores the importance of early identification and intervention for alexithymia to improve outcomes in patients with DRE.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110222"},"PeriodicalIF":2.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of polytherapy and psychiatric comorbidity in epilepsy.","authors":"Mercy A Odhiambo, Gilbert K Kaingu, Maria Mumbo, Karin Kipper, Josemir W Sander, Charles R J C Newton, Symon M Kariuki","doi":"10.1016/j.yebeh.2024.110215","DOIUrl":"10.1016/j.yebeh.2024.110215","url":null,"abstract":"<p><strong>Purpose: </strong>Managing epilepsy may require using more than one anti-seizure medication (ASM). While combination therapy may help, risks, including psychiatric problems, are not fully explored in Africa. We examined the relationship between polytherapy and psychiatric comorbidities among attendees of an epilepsy community clinic.</p><p><strong>Methods: </strong>We prospectively assessed individuals attending an outpatient clinic in Kilifi, Kenya, for patterns of ASM prescribing (mono- or polytherapy) and reviewed psychiatric diagnoses. We used the Psychosis Screening Questionnaire and the Patient Health Questionnaire Version 9 to assess for psychosis and depression, and the Child Behavior Checklist to assess for emotional and behavioural problems. We conducted a cross-sectional logistic regression analysis to determine factors associated with polytherapy and examine the impact of polytherapy and specific medication on psychiatric comorbidities.</p><p><strong>Results: </strong>Of 3,016 attendees, most were on older ASM (99.7 %), with about a third (32.9 %) on polytherapy. The most commonly co-administered drugs were phenobarbital and carbamazepine (13.0 %). Children were less likely to be on multiple medications than adults, and there was no difference between the sexes. Polytherapy was associated with focal to bilateralised seizures (aOR 1.2 [95 % confidence interval:1.0-1.4]) and frequent seizures (aOR = 2.1 [1.5-2.9]). Combining drugs increased the likelihood of any psychiatric problems (aOR = 1.3 [1.0-1.8]), with polytherapy associated with depression (aOR = 2.9 [1.0-8.4]) and psychosis (aOR = 1.9 (1.0-3.6)).</p><p><strong>Conclusion: </strong>Polytherapy, especially with older drugs, is associated with psychiatric comorbidities in this population. Resorting to polytherapy needs to be carefully considered. Prioritizing research into the long-term effects of ASM on psychiatric comorbidities is crucial for improving mental health outcomes in epilepsy, particularly in low-income settings.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110215"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of familiarity and knowledge about epilepsy on associated cultural stereotypes in French society.","authors":"Sophie Hennion, Valentyn Fournier, Philippe Derambure, Gérald Delelis, Loris Schiaratura","doi":"10.1016/j.yebeh.2024.110216","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110216","url":null,"abstract":"<p><p>People with epilepsy face stigma that impacts numerous aspects of their daily lives. Although the stigma surrounding people with epilepsy has been extensively documented, the mechanisms underlying it-such as cultural stereotypes-remain to be explored. Cultural stereotypes are widely shared beliefs within a cultural context about attributes typically associated with members of a particular group. This study, conducted within French society, has two primary objectives: 1) to define the content of cultural stereotypes associated with people suffering from epilepsy and 2) to examine how familiarity and knowledge about epilepsy influence these stereotypes. To explore these stereotypes, a free association task was conducted across three cultural groups (n = 96): (1) the general population, with low familiarity and knowledge about epilepsy (n = 39); (2) healthcare professionals without epilepsy specialization, who have more familiarity and knowledge than the general population (n = 38); and (3) healthcare professionals specialized in epilepsy, who have the highest familiarity and knowledge of the three groups (n = 29). All participants held higher education qualifications to ensure a more homogeneous socio-cultural background across groups. Using the software program \"IraMuTeQ\", we analyzed the diversity of terms each group associated with \"people with epilepsy.\" Additionally, we examined the valence and typicality of cultural stereotypes in each group. The results reveal that, regardless of familiarity and knowledge levels, cultural stereotypes linked to epilepsy are generally negative. Across the entire sample, the most prototypical associations with people with epilepsy included \"madness,\" \"possession,\" \"tongue,\" and \"intellectual deficiency.\" The general population shares some cultural stereotypes with non-specialized healthcare professionals (e.g., \"photosensitivity\"), while non-specialized professionals share other associations with specialized healthcare professionals (e.g., \"intellectual deficiency\" and \"mental illness\"). However, no overlap was found between the cultural stereotypes of the general population and those of healthcare professionals specialized in epilepsy. Stereotypes related to epilepsy appear to be less typical among healthcare professionals compared to the general population. This distinction between cultural stereotypes and personal beliefs is further discussed below. Considering cultural stereotypes may allow for more tailored and effective interventions to reduce epilepsy-related stigma by addressing specific socio-cultural groups. Further research within a cross-cultural approach is recommended to deepen these findings.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110216"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Animal welfare assessment after controlled cortical impact in CD-1 mice - A model of posttraumatic epilepsy.","authors":"Ricardo Schmidt, Björn Welzel, Wolfgang Löscher","doi":"10.1016/j.yebeh.2024.110214","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110214","url":null,"abstract":"<p><p>The ethical use of laboratory animals requires that the benefits of an experimental study are carefully weighed against potential harm to the animals. In traumatic brain injury (TBI) research, ethical concerns are especially relevant to severe TBI, after which animals may experience suffering, depending on the implementation of refinement measures such as (1) postsurgical analgesia during the initial period following TBI and (2) humane endpoints. However, despite the frequent use of rodent models such as fluid percussion injury (FPI) and controlled cortical impact (CCI) in rats or mice, there is only one recent study that applied assessment of welfare to a severe TBI model, the FPI model in rats. In the present pilot study in a CCI mouse model of posttraumatic epilepsy, we assessed animal welfare by a brain injury-specific severity scoresheet. Furthermore, nest building was used as a sensitive indicator of health and welfare in laboratory mice. Sham mice that underwent craniotomy but not CCI were used for comparison. Craniotomy and CCI were performed under anesthesia with isoflurane, followed by 3 days of postsurgical analgesia with the opioid l-methadone. Mannitol was used to prevent the head pain caused by increased intracranial pressure. Using the TBI-specific scoresheet to describe and monitor potential distress in animals, moderately increased scores were determined in CCI mice only over the first 2 days after surgery, indicating that animal suffering in this model is transitory. Similarly, significantly impaired nest building was observed at 1 but not 7 days after CCI. We conclude that with effective postsurgical analgesia and mannitol behavioral recovery is rapid in mice after CCI.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110214"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal epilepsy and pregnancy, delivery and neonatal outcomes: A population-based retrospective cohort study.","authors":"Noah Margolese, Ahmad Badeghiesh, Haitham Baghlaf, Samantha Jacobson, Michael H Dahan","doi":"10.1016/j.yebeh.2024.110221","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110221","url":null,"abstract":"<p><strong>Objective: </strong>To investigate associations between maternal epilepsy and pregnancy, delivery and neonatal outcomes.</p><p><strong>Methods: </strong>A population-based retrospective cohort study was conducted using the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS) database, between 2004-2014. Through logistic regression analysis, we compared associations between epilepsy and pregnancy-related outcomes while adjusting for demographic characteristics and comorbidities.</p><p><strong>Results: </strong>Of 9,096,788 pregnancies, 25,044 were in pregnant women with epilepsy (PWWE). PWWE were more likely to be younger, white or black, have a lower income and to be insured through Medicare or Medicaid. Furthermore, PWWE were more likely to have been diagnosed with obesity, chronic hypertension, gestational diabetes, thyroid disease and HIV, and to have smoked tobacco during pregnancy or used illicit drugs. Pregnancy and delivery outcomes associated with epilepsy include pregnancy-induced hypertension(adjusted OR(aOR):1.26, 95 %CI:1.21-1.32), preeclampsia(aOR:1.33, 95 %CI:1.26-1.41), eclampsia(aOR:8.34, 95 %CI:7.14-9.74), superimposed preeclampsia/eclampsia(aOR:1.29, 95 %CI:1.14-1.47), placenta previa(aOR:1.24, 95 %CI:1.06-1.44), preterm delivery(aOR:1.27, 95 %CI:1.21-1.32), abruptio placenta(aOR:1.24, 95 %CI:1.12-1.36), chorioamnionitis(aOR:1.12, 95 %CI:1.02-1.23), cesarean section(aOR:1.29, 95 %CI:1.25-1.33), hysterectomy(aOR:1.79, 95 %CI:1.31-2.45), postpartum hemorrhage(aOR:1.12, 95 %CI:1.05-1.21), wound complications(aOR:1.38, 95 %CI:1.17-1.63), maternal death(aOR:3.42, 95 %CI:1.79-6.53), transfusion(aOR:1.67, 95 %CI:1.53-1.83), maternal infection(aOR:1.18, 95 % CI:1.09-1.28, p < 0.001), deep vein thrombosis(aOR:2.11, 95 %CI:1.43-3.10), pulmonary embolism(aOR:2.98, 95 %CI:1.87-4.76), venous thromboembolism(aOR:2.25, 95 %CI:1.65-3.08) and disseminated intravascular coagulation(aOR:1.48, 95 %CI:1.19-1.83). Epilepsy-linked neonatal complications include small for gestational age(aOR:1.52, 95 %CI:1.43-1.62), intrauterine fetal demise(aOR:1.20, 95 %CI:1.02-1.41) and congenital anomalies(aOR:2.76, 95 %CI:2.47-3.07).</p><p><strong>Conclusions: </strong>PWWE have significantly higher risk of nearly every pregnancy, delivery and neonatal complication investigated, including maternal death and intrauterine fetal demise. PWWE should be considered high risk patients and be carefully followed during pregnancy.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110221"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the lived experiences of people living with epilepsy: Oral history assessment in the Shai Osudoku and Ningo Prampram districts, Ghana.","authors":"Sabina Asiamah, Phyllis Dako Gyeke, Emmanuel Kwame Darkwa, Sloan Mahone, John Williams, Albert Akpalu, Charles R Newton, Cynthia Sottie, Patrick Adjei","doi":"10.1016/j.yebeh.2024.110211","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110211","url":null,"abstract":"<p><strong>Introduction: </strong>Epilepsy is a prevalent neurological condition globally, especially in Sub-Saharan Africa. In Ghana, it is one of the top five causes of premature death and disability, impacting children's neurological development and learning outcomes. Although 25% of epilepsy cases are preventable, many go undiagnosed and untreated. People with epilepsy face social stigma and rejection, hindering their ability to seek healthcare, employment, and social interactions, which worsens their self-esteem and social integration.</p><p><strong>Purposes: </strong>The study aims to address the critical gaps in understanding and supporting people living with epilepsy (PLWE), through recording and analysing their experiences, and seeks to inform policy and practice, finally contributing to improve healthcare delivery, reduce stigma, and enhance support systems for PLWE.</p><p><strong>Methods: </strong>A qualitative research design was employed for the study. Oral histories (OHs) were conducted with ten PLWE. These interviews encourage interviewees to focus on the life stories and experiences that mean the most to them and can be shared in their own words The interview questions were constructed in English and conducted in English, Twi, Ga and Dangme.</p><p><strong>Results: </strong>The residents of Shai Osudoku and Ningo Prampram hold robust religious convictions and engage in profound spiritual practices as is the case throughout Ghana. When faced with health challenges, the PLWE and their caregivers often seek assistance from faith-based spiritual healers, including pastors or religious leaders, as their initial source of support and healing. These healers provide care by offering prayers, spiritual counselling, and incorporating various religious rituals into their healing practices. It was revealed that many PLWE, caregivers and community members perceived epilepsy differently. Some perceived it as a spiritual or demonic disease. Whilst others attributed to curse and disease of witches, idols, or gods. However, the healthcare practitioners perceived epilepsy as a medical condition. Also, it was found that individuals faced challenges, such as stigma and discrimination.</p><p><strong>Conclusion: </strong>It is recommended that public education on epilepsy be intensified. Furthermore, there is the need to ensure that PLWE have access to improved healthcare to increase their quality of life.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110211"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accelerometer-measured physical activity patterns in daily life and their association with factors of sedentary behavior in people with epilepsy.","authors":"Burcin Aktar, Birgul Balci, Hatice Eraslan Boz, Sevgi Ferik Ozalan, Ibrahim Oztura, Baris Baklan","doi":"10.1016/j.yebeh.2024.110198","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110198","url":null,"abstract":"<p><strong>Objectives: </strong>Being physically active is important, but people with epilepsy (PWE) tend to have a sedentary lifestyle. There is limited evidence about physical activity patterns in PWE using objective measures. The aims of this study were: (1) to examine the physical activity patterns of PWE, (2) compare activity patterns between PWE in terms of drug-resistant epilepsy and medically controlled epilepsy with age- and sex-matched healthy controls; and (3) explore the association between physical activity patterns and body function and structure, activity and participation, and quality of life of PWE.</p><p><strong>Methods: </strong>Seventy-three PWE and 74 healthy controls were enrolled. Physical activity data were collected prospectively over a 7-day period using a SenseWear Arm Band. Body function and structure in PWE were evaluated using the Fatigue Severity Scale, 30-second Chair Stand (30CST), Biodex-Fall Risk, Generalized Anxiety Disorder, Beck Depression Inventory, Pittsburg Sleep Quality Index, and Montreal Cognitive Assessment (MoCA). Activity and participation in PWE were measured using Activities-specific Balance Confidence, Timed Up and Go Test, Six-Minute Walk Test, and Tinetti-Balance and Tinetti-Gait. The quality of life of PWE was evaluated using the Quality of Life in Epilepsy Inventory-31.</p><p><strong>Results: </strong>PWE took fewer steps per day and were sedentary for more time compared with healthy controls (7826 vs. 10,564 steps, P = 0.01; 534 min/day vs. 463 min/day, P < 0.001), especially PWE with drug-resistant epilepsy. 30CST, MoCA, and Biodex-Fall Risk were associated with sedentary behavior, with Biodex-Fall Risk explaining 7.2 % of the variance.</p><p><strong>Conclusions: </strong>PWE demonstrated lower physical activity levels compared with healthy individuals, especially those with drug-resistant epilepsy. Our study highlights the need to tailor strategies including postural stability exercises for the enhancement of physical activity levels in PWE.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110198"},"PeriodicalIF":2.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of temporal changes in cognitive effects induced by antiseizure medications in epilepsy patients.","authors":"Ömer Karadaş, Javid Shafiyev, Akçay Övünç Karadaş, Uğur Burak Şimşek, Betül Özenç, Özlem Aksoy Özmenek","doi":"10.1016/j.yebeh.2024.110199","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110199","url":null,"abstract":"<p><strong>Objective: </strong>Numerous studies have been conducted investigating the effects of antiseizure medications (ASMs) on cognitive functions, and the cognitive side effects of some ASMs have been demonstrated. However, data on whether tolerance to these side effects develops over time is insufficient. The aim of this study is to evaluate the reversibility of cognitive impairments caused by ASMs in patients, utilizing event-related potentials (ERPs) and the Montreal Cognitive Assessment (MoCA) test.</p><p><strong>Materials and methods: </strong>The single-center prospective study was conducted from July 2022 to August 2023. This study enrolled participants aged 18 to 50 who had been diagnosed with epilepsy and were planning to commence treatment with an antiseizure medication (ASM). The inclusion criteria comprised individuals aged between 18 and 50 years, with a diagnosis of epilepsy, and who were intending to initiate a new ASM as monotherapy. Exclusion criteria encompassed individuals younger than 18 or older than 50 years, those diagnosed with psychogenic non-epileptic seizures, those currently on antiepileptic drugs, and those with cognitive dysfunction or dementia. Before starting treatment, patients were subjected to the MoCA test and ERP measurements by a neurologist. These tests and measurements were repeated at the second and sixth months of treatment.</p><p><strong>Result: </strong>The study included a cohort of 254 participants with a mean age of 32.6 (±14) years. At the second month after starting treatment with carbamazepine (CBZ), zonisamide (ZNS), valproic acid (VPA), and topiramate (TPM), both MoCA and ERP values showed significantly worse cognitive impairment compared to before treatment (p < 0.05). This impairment showed a significant improvement by the sixth month for CBZ, ZNS, and VPA (p < 0.05). Although there was improvement in MoCA and ERP values in patients using TPM, the changes remained statistically significant compared to baseline values (p < 0.05). In patients using levetiracetam, lamotrigine, oxcarbazepine, and lacosamide, cognitive impairment was not statistically significant at either the second or sixth month.</p><p><strong>Conclusion: </strong>This study demonstrated that the detrimental cognitive effects associated with CBZ, VPA, and ZNS could be reversible. Although some improvement was observed over time with TPM, the absence of significant recovery suggests that additional time may be required for a substantial reversal of these effects.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110199"},"PeriodicalIF":2.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum depression and mother-infant bonding in women with epilepsy: A case-control study.","authors":"Rehab Magdy, Nirmeen A Kishk, Mennat-Allah Tarek, Manal Moussa, Marwa M Zein, Mohamed Khodery, Salsabil Abo Al-Azayem","doi":"10.1016/j.yebeh.2024.110213","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110213","url":null,"abstract":"<p><strong>Background & objectives: </strong>Postpartum depression is a debilitating mental health condition that consequently can negatively impact the mother/infant unit. This study aimed to screen for postpartum depression among women with epilepsy (WWE) versus healthy women and its consequences on establishing a proper mother-infant bonding.</p><p><strong>Methods: </strong>A group of WWE (n = 102) and a control group of healthy women (n = 119) were evaluated 4-6 weeks postpartum. The Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Bonding Questionnaire (PBQ) were used.</p><p><strong>Results: </strong>The median scores of EPDS did not significantly differ between WWE and the control group (P = 0.077). The median scores of infant-focused anxiety of PBQ were significantly lower in WWE than in the control group, while the median scores of risk of abuse were significantly higher in the former than in the latter group. Scores of EPDS and PBQ didn't significantly differ between groups of different seizure types, etiologies, and ASMs regimens. However, the EPDS scores were significantly higher in WWE, who experienced seizure exacerbation, than in others (P = 0.049). Also, EPDS scores were significantly correlated with PBQ scores. By linear regression analysis, the only independent predictor of EPDS score was seizure exacerbation during pregnancy.</p><p><strong>Conclusion: </strong>The current postpartum screening report revealed that WWE are not at an increased risk of postpartum depression than healthy women. However, WWE who experience seizure exacerbations during their pregnancy need to be cautiously screened for postpartum depression, which may negatively impact mother-infant bonding. Strenuous efforts should be made to improve the mental health services for those women.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110213"},"PeriodicalIF":2.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double Stigma: Reluctance to be referred to a psychiatrist among people with epilepsy and psychiatric comorbidities.","authors":"Si-Lei Fong, Aminath Shauna, Kheng-Seang Lim, Chong-Guan Ng, Xuen Yu, Siew-Tim Lai, Hui-Jan Tan, Juen-Kiem Tan, Venus Tang, Chong-Tin Tan","doi":"10.1016/j.yebeh.2024.110196","DOIUrl":"https://doi.org/10.1016/j.yebeh.2024.110196","url":null,"abstract":"<p><strong>Introduction: </strong>Psychiatric comorbidities such as depression and anxiety disorders are highly prevalent among people with epilepsy (PWE). These two co-occurring chronic illnesses could lead to double stigma and negatively impact every aspect of psychiatric and epilepsy care for PWE, especially in help-seeking behavior. We aimed to identify the socio-demographic and clinical factors contributing to reluctance to be referred to a psychiatrist among PWE.</p><p><strong>Methods: </strong>A prospective cross-sectional study was conducted at a tertiary teaching hospital in Kuala Lumpur, Malaysia. Psychological screening was done using the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and General Anxiety Disorder (GAD-7) questionnaire. Patients screened positive were offered psychiatric referrals and given an early psychiatric clinic appointment if they agreed to the referral. The reasons for those who refused the referral were noted.</p><p><strong>Results: </strong>Out of 585 patients, 91 (15.5 %) were screened positive for depression and/or anxiety. Eighteen patients were excluded from the study due to pre-existing psychiatric disorders. Of the remaining 73 patients, 23 (31.5 %) agreed to be referred to a psychiatrist. Only 17 (23.3 %) attended the psychiatrist appointment. A total of 11 (15.1 %) and one (1.4 %) patients were subsequently diagnosed with major depressive disorder and generalized anxiety disorder, respectively. Another 50 (68.5 %) patients were not referred to a psychiatrist, predominantly (n = 43, 58.9 %) due to reluctance to be referred to a psychiatrist. The reasons included avoidance of referral likely related to stigma (n = 22, 51.2 %), self-reliance, family and caregivers' disapproval of referral, and logistic difficulty. The mean scores in NDDI-E and GAD-7 in the referred group were higher than the not-referred group but not statistically significant (NDDI-E: 17.8 ± 3.6 vs. 16.5 ± 2.5, p = 0.072; GAD-7: 12.4 ± 5.70 vs. 9.8 ± 5.4, p = 0.061).</p><p><strong>Conclusion: </strong>A significant number of PWE were reluctant to receive psychiatric referrals predominantly due to self-avoidance or family and caregiver disapproval of referral likely related to stigma. An integrated epilepsy care management model is recommended.</p>","PeriodicalId":11847,"journal":{"name":"Epilepsy & Behavior","volume":"163 ","pages":"110196"},"PeriodicalIF":2.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}