간질 환자의 우울과 불안: 인구학적 요인 및 간질 관련 요인과의 관계
Depression and Anxiety in the Epileptic Patients: the Association With Demographic and Seizure-Related Variables
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Background: Depression and anxiety are common psychiatric symptoms in patients with epilepsy, exerting a profound negative effect on health-related quality of life. Several issues, however, pertaining to their association with psychosocial, seizure-related and medication factors, remain controversial. In the present study we have investigated the association of depression and anxiety with various demographic and seizure-related variables in patients with newly-diagnosed and chronic epilepsy. Methods: We investigated 80 patients with epilepsy (46.3% males, mean age 36.1±11.4 years, range 18~64; mean disease duration, 13.4±12.2 years). Depression and anxiety were assessed in the interictal state with the Beck Depression Inventory, 21-item version (BDI-21) and the state and trait subscales of the State-Trait Anxiety Inventory (STAI-S and STAI-T), respectively. The association of depression and anxiety with various variables was investigated using univariate analyses and multiple linear regression analyses. Results: Duration of epilepsy, the number of side effects and the number of GABAergic anti-epileptic drugs were correlated with depression, together accounting for 25.1% of the variation of the BDI-21. The STAI-S index was significantly associated with occupation status and the number of GABAergic anti-epileptic drugs accounting for 27.4% of the variation of the STAI-S. Finally, the number of side effects was correlated with trait anxiety. Conclusions: Our study shows that the duration of epilepsy, occupation status, GABAergic anti-epileptic drugs and the number of side effects are risk factors for the development of depression and/or anxiety.
Abstract
Background: Depression and anxiety are common psychiatric symptoms in patients with epilepsy, exerting a profound negative effect on health-related quality of life. Several issues, however, pertaining to their association with psychosocial, seizure-related and medication factors, remain controversial. In the present study we have investigated the association of depression and anxiety with various demographic and seizure-related variables in patients with newly-diagnosed and chronic epilepsy. Methods: We investigated 80 patients with epilepsy (46.3% males, mean age 36.1±11.4 years, range 18~64; mean disease duration, 13.4±12.2 years). Depression and anxiety were assessed in the interictal state with the Beck Depression Inventory, 21-item version (BDI-21) and the state and trait subscales of the State-Trait Anxiety Inventory (STAI-S and STAI-T), respectively. The association of depression and anxiety with various variables was investigated using univariate analyses and multiple linear regression analyses. Results: Duration of epilepsy, the number of side effects and the number of GABAergic anti-epileptic drugs were correlated with depression, together accounting for 25.1% of the variation of the BDI-21. The STAI-S index was significantly associated with occupation status and the number of GABAergic anti-epileptic drugs accounting for 27.4% of the variation of the STAI-S. Finally, the number of side effects was correlated with trait anxiety. Conclusions: Our study shows that the duration of epilepsy, occupation status, GABAergic anti-epileptic drugs and the number of side effects are risk factors for the development of depression and/or anxiety.
참고문헌 (42)
- Allan HR, "Adams and victor’s principles of neurology. 9th ed", pp.304~338 (2009), McGraw-Hill Companies
- Rimmer EM, "Clinical pharmacology and medical treatment. In: A textbook of epilepsy. 3rd ed", pp.421~ (1988), Churchill Livingstone
- Pond DA, "A survey of epilepsy in Fourteen General Practice II: Social and Psychological Aspects", Epilepsia, 1, pp.285~299 (1960)
- Currie S, "Clinical course and prognosis of temporal lobe epilepsy: A Survey of 666 patients", Brain, 94, pp.173~190 (1971)
- Mattews WS, "Suicide and epilepsy: A review of the literature", Psychosomatics, 2, pp.515~524 (1981)
- Rahul M, "Psychiatric disorder in epilepsy: clinical aspects", Epilepsy Behav, 3, pp.39~45 (2002)
- Gilliam F, "Psychiatric comorbidity, health, and function in epilepsy", Epilepsy Behav, 4(4), pp.26~30 (2003)
- Seethalakshmi R, "Depression in epilepsy: phenomenology, diagnosis and management", Epileptic Disord, 9, pp.1~10 (2007)
- Hahn HM, "A standardization study of Beck Depression Inventory in Korea", J Korean Neuropsychiatr Assoc, 25, pp.487~502 (1986)
- Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
- Kim JT, "A standardization study of State-Trait Anxiety Inventory in Korea", New Med J, 21, pp.1223~1229 (1978)
- Spielberger CD, "STAI Manual for the State-Trait Anxiety Inventory" (1970), Consulting Psychologists Press
- Mendez MF, "Depression in epilepsy Significance and phenomenology", Arch Neurol, 43, pp.766~770 (1986)
- Hawton K, "Association between epilepsy and attempted suicide", J Neurol Neurorsurg Psychiatry, 43, pp.168~170 (1980)
- Beyenburg S, "Anxiety in patients with epilepsy: systematic review and suggestions for clinical management", Epilepsy Behav, 7, pp.161~171 (2005)
- Jacoby A, "The clinical course of epilepsy and its psychosocial correlates: finding from a U.K. community study", Epilepsia, 37, pp.148~161 (1996)
- Robertson MM, "Depressive symptomatology in a general hospital sample of outpatient with temporal lobe epilepsy: a controlled study", Epilepsia, 35, pp.771~777 (1994)
- Zielinski JJ, "Social prognosis in epilepsy", Epilepsia, 13, pp.133~140 (1972)
- Devinsky O, "A guide to understanding and living with epilepsy" (1994), FA Davis
- Fisher RS, "Epilepsy from the patient’s perspective: review of results of a community-based survey", Epilepsy Behav, 1(1), pp.9~14 (2000)
- Thorbecke R, "The range of needs and services in vocational rehabilitation. In: Epilepsy: a comprehensive textbook", pp.2211~2225 (1997), Lippincott-Raven
- Bishop ML, "Employment Concerns of People with Epilepsy and the Question of Disclosure: Report of a Survey of the Epilepsy Foundation", Epilepsy Behav, 2, pp.490~495 (2001)
- Altshuler LL, "Depression, anxiety and temporal lobe epilepsy: laterality of focus and symptoms", Arch Neurol, 47, pp.284~288 (1990)
- Indaco A, "Interictal depression in epilepsy", Epilepsy Res, 12, pp.45~50 (1992)
- Dodrill CB, "An objective method for the assessment of psychological and social problems among epileptics", Epilepsia, 21, pp.123~135 (1980)
- Jacoby A, "The clinical course of epilepsy and its psychosocial correlate: findings from a UK community study", Epilepsia, 37, pp.148~161 (1996)
- Quiske A, "Depression in patients with temporal lobe epilepsy is related to mesial temporal sclerosis", Epilepsy Res, 39, pp.121~125 (2000)
- Marsh L, "Psychiatric complications in patients with epilepsy", Epilepsy Res, 49, pp.11~33 (2002)
- Goldstein MA, "Epilepsy and anxiety", Epilepsy Behav, 1, pp.228~234 (2000)
- Vazquez B, "Epilepsy and anxiety", Epilepsy Behav, 4(4), pp.20~25 (2003)
- Kanner AM, "The use of sertraline in patients with epilepsy: Is it safe?", Epilepsy Behav, 1, pp.100~105 (2000)
- Taylor DC, "Mental state and temporal lobe epilepsy, a correlative account of 100 patients treated surgically", Epilepsia, 13, pp.727~765 (1972)
- Koch-Weser M, "Prevalence of psychologic disorders after surgical treatment of seizures", Arch Neurol, 45, pp.1308~1311 (1988)
- Hermann BP, "Depression, locus of control, and the effects of epilepsy surgery", Epilepsia, 30, pp.332~338 (1989)
- Czapinˊski P, "Mechanisms of action of antiepileptic drugs", Curr Top Med Chem, 5, pp.3~14 (2005)
- Trimble MR, "Forced normalization and the role of anticonvulsants. In: Forced normalization and alternative psychosis of epilepsy", pp.169~178 (1998), Biomedical Publishing Ltd
- Smith D, "Outcomes of add-on treatment with lamotrigine in partial epilepsy", Epilepsia, 34, pp.312~322 (1993)
- Meador KJ, "Differential cognitive and behavioral effects of carbamazepine and lamotrigine", Neurology, 56, pp.1177~1182 (2001)
- Gilliam FG, "Systematic screening allows reduction of adverse antiepileptic drug effects: a randomized trial", Neurology, 62, pp.23~27 (2004)
- Gilliam F, "Optimizing health outcomes in active epilepsy", Neurology, 58(5), pp.9~20 (2002)
- Perucca P, "Epilepsy treatment as a predeterminant of psychosocial ill health", Epilepsy Behav, 15(1), pp.46~50 (2009)
- Robertson MM, "Depressive illness in patients with epilepsy", Epilepsia, 24(2), pp.190~196 (1983)