[Comorbidity of anxiety and depressive disorders in patients with epilepsy].

Cognitive and emotional impairments in childhood absence epilepsy

Background. Cognitive impairments in epilepsy develop under the influence of a complex interplay of interrelated factors, including age at disease onset, seizure frequency and duration, as well as the use of antiseizure medications. Their objective assessment is complicated by the heterogeneity of methodological approaches and the diversity of neuropsychological instruments employed an issue that is particularly relevant in pediatric populations. Aim. To determine the nature and severity of cognitive and emotional-behavioral impairments in children and adolescents with childhood absence epilepsy (CAE) using age-appropriate psychodiagnostic instruments. Materials and methods. A retrospective analysis of follow-up data from 70 patients with CAE was conducted. The cohort included children with active absence seizures, patients undergoing routine clinical follow-up, and individuals in sustained medication-induced remission. The study also included 34 healthy volunteers. The following psychodiagnostic methods were used: the Digit Span test, the Stroop test, and M.A. Panfilova’s “Cactus” graphic method in the 4–12 age subgroup; the Trail Making Test, the Achenbach System of Empirically Based Assessment, and the “Well-being, Activity, Mood” questionnaire in the 12–18 age subgroup. Results. The identified cognitive impairments in children and adolescents with CAE across both age subgroups predominantly involved memory, attention, and executive thinking processes. In the emotional and personality domains, reduced levels of subjective well-being and activity were observed, along with difficulties in social adaptation and the presence of somatic complaints. Conclusion. The presence of neuropsychological impairments in patients both during the active phase of the disease and during clinical remission indicates that CAE may be accompanied by disturbances in cognitive and emotional-volitional functioning, which may significantly reduce patients’ quality of life.

Comparative evaluation of neuropsychiatric and psychometric parameters in patients with functional movement disorder

Background: The primary objective of this study was to compare demographic, clinical, and comprehensive psychometric scale profiles between patients diagnosed with functional movement disorder (FMD) presenting with isolated motor phenomenology versus those with multiple clinical phenotypes. Materials and Methods: A total of 93 consecutive patients diagnosed with FMD based on clinical criteria were included in the study. According to clinical examination findings, patients were divided into two main categories: the Isolated Movement Disorder Group (n = 63) and the Multiple Movement Disorder Group (n = 30). Patients undergoing active psychotropic medication therapy were excluded. All participants were administered the Standardized Mini-Mental State Examination (SMMSE), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Buss-Perry Aggression Questionnaire (BPAQ), Barratt Impulsivity Scale-11 (BIS-11), and Body Image Satisfaction Scale (BISS). Results: No statistically significant differences were found between the isolated and multiple groups regarding age, age at onset, disease duration, SMMSE, BDI, BPAQ, BIS-11, and BISS scores (p > 0.05). Conversely, BAI scores were statistically significantly higher in the multiple motor phenotype group (19.77 ± 12.97 vs. 12.71 ± 8.43; p = 0.0096, adjusted p = 0.0288, Cohen's d = 0.69). Multivariable logistic regression confirmed that anxiety was independently associated with the multiple FMD phenotype (aOR = 1.071, 95% CI: 1.015-1.130, p = 0.012). In the gender-based subgroup analysis of the isolated group, BPAQ scores were significantly higher in female patients (48.14 ± 21.28 vs. 36.15 ± 16.79; p = 0.0152, Cohen's d = 0.62). Conclusion: The complexity of the motor phenotype in FMD is independently associated with elevated anxiety levels. Comprehensive screening for anxiety is recommended in patients presenting with multiple motor phenomenology.

Modelling risk factors for depressive symptoms in seizure disorders

Background: Depression is a common mental health comorbidity among individuals with seizure disorders. The emergence of depression results from the complex interplay of clinical, psychological and social factors. Objectives: To identify clusters of risk factors associated with depressive symptoms in adults with seizure disorders. This study uses exploratory factor analysis (EFA) to model a range of variables and investigate their interactions and influence on depressive symptoms. Design: Cross-sectional observational study. Methods: A retrospective examination of medical records identified 121 patients with seizures and moderate depressive symptoms. Demographic, clinical and psychosocial data were extracted and modelled using EFA. Factor structure was determined by adhering to standard fit criteria: CFI ⩾0.90, TFI ⩾0.90, RMSEA ⩽0.08 and latent factor loadings ⩾0.4. Results: The mean age of the cohort was 31.3 ± 10.0 years (range of 18–64), comprising 68 males (56.2%) and 53 married individuals (43.8%). Qataris constituted the largest nationality at 48 (39.7%), and the most prevalent diagnosis was right temporal lobe epilepsy (28.9%). Moderate depressive symptoms were the most common PHQ-9 classification (42.1%), with an average score of 14. EFA yielded a three-factor solution (χ2 = 71.9, df = 52, RMSEA = 0.06, CFI = 0.96, TFI = 0.92) with the first latent factor incorporating age and social variables, the second encompassing medications and cognitive abilities, and a final factor encapsulating seizure-related items. Conclusion: Exploratory factor analysis elucidates the intricate relationships between variables that impact depressive symptoms in individuals with seizure disorders. It highlights how clusters of variables emerge, providing insight into how depressive symptoms develop in this population. These findings offer new potential avenues for the management and treatment of depression in people experiencing these debilitating events.

Anxiety, Depression, and Health-Related Quality of Life in Family Caregivers of Patients with Epilepsy

Epilepsy is a chronic neurological disorder that imposes substantial physical, psychological, and social burdens not only on patients but also on their family caregivers. Although psychiatric comorbidities and impaired quality of life have been extensively investigated in patients with epilepsy, the psychological well-being and health-related quality of life of their caregivers remain insufficiently studied. This study aimed to evaluate anxiety, depression, and health-related quality of life among family caregivers of patients with epilepsy and to identify patient-related factors associated with these outcomes. The study included three groups: patients with epilepsy, their caregivers, and healthy controls. Differences in scale scores between two groups were analyzed using the independent-samples t -test, whereas comparisons among three or more groups were performed using one-way analysis of variance (ANOVA). Associations between categorical variables were evaluated using Pearson's chi-square test or the likelihood ratio test, depending on the distribution of the data. Pearson's correlation coefficient was calculated for continuous variables. A p -value of <0.05 was considered statistically significant. Caregivers of patients with epilepsy had significantly higher anxiety and depression scores than healthy controls. These findings indicate an increased prevalence of anxiety and depressive symptoms among caregivers. Furthermore, evaluation of quality of life using the Short Form-36 (SF-36) questionnaire demonstrated significant impairment across all quality-of-life domains in the caregiver group. The findings suggest that being a caregiver of a patient with epilepsy is, by itself, an important factor adversely affecting emotional well-being and quality of life. Changes in caregivers' mood status and quality of life were not associated with the patients' sex, seizure type, or seizure frequency.

Depressive symptoms in a sample of Egyptian patients with schizophrenia on antipsychotic medications

Depressive symptoms are frequently observed among individuals with schizophrenia and are linked to unfavorable clinical outcomes, including functional impairment and a higher likelihood of relapse. However, they are frequently underrecognized in routine clinical practice. To determine the severity of depressive symptomatology and suicidal ideation in patients diagnosed with schizophrenia and to examine their association with the type of antipsychotic medication used. This cross-sectional study included 92 patients with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Depressive symptoms were evaluated using the Hamilton Depression Rating Scale (HAM-D), and suicidal ideation was evaluated using Beck’s Scale for Suicide Ideation. Patients were categorized into two groups based on antipsychotic treatment used: typical and atypical. The mean HAM-D score was 6.9 ± 4.3, with 87% of patients exhibiting minimal to mild depressive symptoms. Suicidal ideation was present in 3.3% of patients. Patients receiving typical antipsychotics had significantly higher depression scores compared to those receiving atypical antipsychotics (median = 8 vs. 5, p = 0.002). Patients on atypical antipsychotics had a higher number of previous hospitalizations (p = 0.026). No significant associations were found between depressive symptoms and most sociodemographic variables, except for gender. Depressive symptoms are common in patients with schizophrenia, even when predominantly mild. Patients receiving typical antipsychotics demonstrated higher HAM-D scores than those receiving atypical antipsychotics; however, the cross-sectional design precludes conclusions regarding temporal or causal relationships. The low prevalence of suicidal ideation limits conclusions regarding suicidality. Routine screening for depressive symptoms should be integrated into clinical care.

coexistence of anxiety sensitivity and psychiatric comorbidities in patients with chronic tinnitus