14/02/2022 - General information
People diagnosed with treatment-resistant epilepsy have high levels of depression and anxiety, as well as a poor quality of life, according to a study published in the journal Frontiers in Neurology by Hospital del Mar's Epilepsy Unit . In fact, half of these patients suffer from depression and anxiety and more than 70% claim to have a poor quality of life. This fact suggests that a global approach to these patients should be evaluated, taking into account the psychiatric aspects of their pathology to try to control their epileptic seizures.
Members of the Epilepsy Unit
Dr. Rodrigo Rocamora, first author of the study, head of the Epilepsy Unit and coordinator of the Epilepsy Research Group at the Hospital del Mar Medical Research Institute (IMIM-Hospital del Mar), highlights the importance of the study, one of the most important ever carried out in this field, taking into account the psychiatric comorbidities of people affected by treatment-resistant epilepsy. As Dr. Rocamora points out, it should be borne in mind that "Epilepsy does not only involve seizures, but there is a much more generalised alteration of the brain and its manifestations in patients. It is not just the seizures, it is a lifelong condition."
500 patients analysed
The study analysed almost 500 patients (493) admitted to Hospital del Mar with a diagnosis of drug-resistant epilepsy between 2013 and 2021, with the aim of identifying the origin of epileptic seizures or the possibility of a surgical approach. More than 71% claimed to have a poor quality of life, while half of them had diagnostic symptoms of depression and 53% has anxiety. The results were obtained by performing various tests on the people who visited the centre for this pathology. According to Dr. Rocamora, "It shows that epilepsy, beyond seizures, is a disease that affects multiple levels of life, with some of the most important being psychiatric disorders, as well as its impact on quality of life." It should be noted that only one in three sufferers had previously been diagnosed with a psychiatric disorder.
Another of the study's remarkable results is that women have higher levels of depression and anxiety, as well as a poorer quality of life than men. Furthermore, the study confirms that these symptoms occur in all types of epilepsy, not only in temporal lobe epilepsy as previously thought. Finally, it has been shown that pathological anxiety is as prevalent as depression and that, in general, these are associated. Patients who had psychogenic seizures, similar to epileptic seizures but caused by a psychiatric disorder, were also studied. They presented worse results in all three respects. However, the people who suffer most from these disorders are those who combine epilepsy with psychogenic seizures, with four out of five patients suffering from depression and anxiety.
The authors of the study indicate that the problems associated with epilepsy are often under-diagnosed in these patients and that being aware of them can help to establish a more empathetic relationship between the healthcare team and the patients. This would improve their understanding of the diagnosis as well as the challenges involved in treating the full extent of the disease.
This is vital when dealing with seizures in patients who do not respond to the usual pharmacological treatments, as stress is one of the most important triggers of an episode. In this sense, controlling stress can help to reduce seizures. For this reason, "The study raises the possibility of evaluating methods that, through stress reduction techniques, can control this type of symptom and potentially also reduce the frequency of seizures", explains Dr Rocamora. A collaborative approach with psychiatric services that explores how to manage patient stress and psychiatric comorbidities may therefore be crucial for improving patient quality of life.
Reference article
Rocamora R, Chavarría B, Pérez E, Pérez-Enríquez C, Barguilla A, Panadés-de Oliveira L, Principe A, Zucca R. Mood Disturbances, Anxiety, and Impact on Quality of Life in Patients Admitted to Epilepsy Monitoring Units. Front Neurol. 2021 Oct 28;12:761239. doi: 10.3389/fneur.2021.761239. PMID: 34777230; PMCID: PMC8584435.
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