A psychosocial view of anxiety and depression in epilepsy

The aim of this study was to study anxiety and depression in patients with epilepsy and evaluate their relationships with neuroepilepsy and psychological variables. neuroepilepsy and psychological variables. Sixty patients and 60 healthy subjects were interviewed at the outpatient clinic for epilepsy, using the Beck Depression Inventory and State-Trait-Anxiety Inventory. The objective of the semistructured interview was to identify the patients' perception of the disease, self-concept, personal strategies, and perception of seizure control. There was a significant difference in anxiety and depression between the groups, as well as a strong relationship between perception of seizure control and depression and anxiety, independently assessed. Epilepsy was associated with disease (63.4%), mental problems (11.6%), feelings of shame, fear, worry, and low self-esteem (56.6%), and perception of stigma (26.6%). The strategies were: looking for social support, seeking medical treatment, withdrawal, denial, and spiritual support. There was a significant association between psychological symptoms and perception of seizure control, which reinforces the importance of subjective aspects involved in epilepsy.     

Social anxiety and its psychosocial impact on the lives of people with epilepsy

Little is known about social anxiety among people with epilepsy (PWE), although PWE are more likely to be diagnosed with social anxiety disorder than the general population. The purpose of this study was to determine which psychosocial and seizure-related variables are associated with social anxiety. It was hypothesized that social anxiety would be positively correlated with perceived seizure severity, stigma, impact of epilepsy, fear of negative evaluation, and experiential avoidance. Further, social anxiety would be negatively correlated with epilepsy knowledge and disclosure of epilepsy. Finally, if a seizure occurred in public and others were unaware of the epilepsy, participants would report greater judgment, anxiety, and rumination compared with those in a situation where others were aware of the epilepsy. A total of 101 individuals with epilepsy participated in this online study. Social anxiety was found to correlate with both psychosocial and seizure-related variables in the expected directions. Further, social anxiety predicted significant variance in stigma and disclosure beyond known predictors of stigma. Participants in both conditions (disclosed diagnosis of epilepsy versus undisclosed diagnosis of epilepsy) were equally distressed by having a seizure in public. These findings provide an initial basis for discerning how to best assess and support PWE with social anxiety.     

Determinants of quality of life in people with epilepsy in Serbia

PurposeThis study aimed at finding determinants of quality of life in people with epilepsy (PWE) living in Belgrade, Serbia.MethodIn this study, we recruited consecutive adults with epilepsy attending our outpatient department. Adult patients (age range: 18–65 years) of normal intelligence and without any progressive neurological disease or psychiatric disorder were included in the study. They completed the following questionnaires: QOLIE-31 Inventory (Serbian version), Beck's Depression Inventory-II, Beck's Anxiety Inventory, Symptom Check List-90, and Neurotoxicity Scale-II. Hierarchical multiple regression analysis was performed to assess the predictive effects of some factors on QOLIE-31 Inventory.ResultsThe mean QOLIE-31 score of 203 patients who completed the questionnaires was 70.64 ± 17.74. Sociodemographic factors (age, sex, education, and employment) did not significantly predict QOLIE-31 score. Significant determinants of quality of life were clinical characteristics – seizure severity and etiology of epilepsy – accounting for 30.9% of the variance, depressive and anxiety symptoms accounting for 42.8% of the variance, and cognitive effects of antiepileptic drugs, accounting for 1.5% above other variables.ConclusionsThe results suggest that seizure severity and etiology of epilepsy, depressive and anxiety symptoms, and cognitive adverse medication effects are main determinants of quality of life in this population of PWE.     

Relationship of epilepsy-related factors to anxiety and depression scores in epileptic children

Cognitive and behavioral impairments are found more often among epileptic children than among their peers. In this study, we evaluated the anxiety and depression in epileptic children to compare their results with that of a healthy control group and to determine the relationship of anxiety and depression scores to epilepsy-related factors. The State Trait Anxiety Inventory (STAI) and Children's Depression Inventory (CDI) were applied to 35 patients with epilepsy aged 9 to 18 years (mean age 12.9 +/- 2.52 years) and to 35 healthy children who served as the control group. Both study and control groups were divided into two age groups (9 to 11 and 12 to 18 years) to exclude the effect of puberty on anxiety and depression scores. Significant depression and suicidal ideation were determined in the study group. The mean trait anxiety score was significantly higher in the 9- to 11-year age group of epileptic patients than the corresponding control group (35.90 +/- 6.90 and 29.33 +/- 2.84, P < .05). The mean state anxiety score (33.90 +/- 3.90 and 30.40 +/- 6.02, P < .05), trait anxiety score (38.20 +/- 6.84 and 32.20 +/- 3.90, P < .05), and depression score (16.65 +/- 8.32 and 8.15 +/- 3.15, P < .05) were significantly higher in the 12- to 18-year age group of epileptic children than in the control group. Among the epilepsy-related factors, whereas epilepsy duration, seizure frequency, and polytherapy were determined to increase anxiety and depression, age of seizure onset, seizure type, and electroencephalographic findings were not related to anxiety and depression. Symptoms of anxiety and depression are common among epileptic children, especially during puberty. The State Trait Anxiety Inventory and Children's Depression Inventory may be used as a tool to provide information to clinicians.     

Social isolation,cognitive reserve,and cognition in older people with depression and anxiety

Abstract

Objectives: Poor social connections may be associated with poor cognition in older people who are not experiencing mental health problems, and the trajectory of this association may be moderated by cognitive reserve. However, it is unclear whether this relationship is the same for older people with symptoms of depression and anxiety. This paper aims to explore social relationships and cognitive function in older people with depression and anxiety.

Method: Baseline and two-year follow-up data were analysed from the Cognitive Function and Ageing Study–Wales (CFAS-Wales). We compared levels of social isolation, loneliness, social contact, cognitive function, and cognitive reserve at baseline amongst older people with and without depression or anxiety. Linear regression was used to assess the relationship between isolation and cognition at baseline and two-year follow-up in a subgroup of older people meeting pre-defined criteria for depression or anxiety. A moderation analysis tested for the moderating effect of cognitive reserve.

Results: Older people with depression or anxiety perceived themselves as more isolated and lonely than those without depression or anxiety, despite having an equivalent level of social contact with friends and family. In people with depression or anxiety, social isolation was associated with poor cognitive function at baseline, but not with cognitive change at two-year follow-up. Cognitive reserve did not moderate this association.

Conclusion: Social isolation was associated with poor cognitive function at baseline, but not two-year follow-up. This may be attributed to a reduction in mood-related symptoms at follow-up, linked to improved cognitive function.     

Determinants of disease severity in adults with epilepsy: Results from the Neurological Diseases and Depression Study

BackgroundEpilepsy severity has been recognized as a significant predictor of health-related quality of life in patients with epilepsy. However, clinical markers of epilepsy severity such as seizure frequency often fail to capture important aspects of the disease. This study investigates the factors associated with patient-reported severity of epilepsy, assessed by the Global Assessment of Severity of Epilepsy (GASE) scale in adults with epilepsy.MethodsData from a cohort of 250 patients consecutively enrolled in the Neurological Diseases and Depression Study (NEEDS) were used to assess the determinants of epilepsy severity as measured by the GASE scale. Multiple linear regression analyses were used to examine the mediation effect of clinical and sociodemographic characteristics on patients' ratings on the GASE scale.ResultsThe mean age of the study participants was 39.8 (SD = 14.9) years, of which 44.4% were male. About 66.8% of the participants reported “not at all severe” or “a little severe” epilepsy, while 0.4% reported “extremely severe” epilepsy. One-year seizure freedom, number of antiseizure medications, medication side effects, depression, anxiety, and seizure-related disability were identified as significant determinants of patients' ratings of epilepsy severity. Seizure-related disability mediated the effects of 1-year seizure freedom, number of antiseizure medications, and medication side effects on epilepsy severity.ConclusionOverall, patients with epilepsy who reported higher GASE scores were less likely to achieve 1-year seizure freedom and more likely to be on more antiseizure medications, experience more side effects from medication, endorse more depression and anxiety symptoms, and have increased self-reported seizure-related disability. The identified determinants of global, self-rated epilepsy severity can aid the design of appropriate interventions and support services for patients with severe epilepsy.     

Factors affecting quality of life in adults with epilepsy in Taiwan: A cross-sectional,correlational study

PurposeThe purpose of this study was to assess eight factors considered important for quality of life in persons with epilepsy in order to determine which of these components affect quality of life in adults with epilepsy in Taiwan.MethodsA cross-sectional, correlational study using structured questionnaires assessed 260 patients with epilepsy purposively sampled from a medical center in Northern Taiwan. Health-related quality of life (HRQoL) was evaluated with the Quality of Life in Epilepsy—31 (QOLIE-31) questionnaire. Data also included personal and health-related characteristics, knowledge of epilepsy, efficacy in the self-management of epilepsy, and social support.ResultsScores for the QOLIE-31 were correlated with the following factors: (1) demographic characteristics of age, gender, and income; (2) sleep quality; (3) symptoms of anxiety and depression; (4) epilepsy-specific variables: seizure frequency; types, number, and frequency of antiepileptic drugs (AEDs); and adverse events of AEDs; and (5) social support. Stepwise regression analysis showed that seven factors were predictive for quality of life: anxiety, depression, adverse events of AEDs, social support, seizure frequency of at least once in three months, household income of NT$ 40,001–100,000, and male gender. These factors accounted for 58.2% of the variance of quality of life.SignificanceOur study assessed multiple factors in an examination of relationships and predictive factors for quality of life in adults with epilepsy in Taiwan. Knowledge of these contributing factors can assist health-care providers when evaluating patients with epilepsy to help target interventions for improving quality of life.     

Factors determining social distance toward people with depression among community pharmacists

ObjectiveThe aim of the present study was to measure stigma among community pharmacists regarding patients with depression, using social distance as a proxy measure. Furthermore, factors influencing stigmatization were identified.MethodsA survey consisting of questions regarding social distance, cognitive attitude components, stereotypical beliefs and behavioural tendencies towards pharmaceutical care for patients with depression was carried out. The survey was completed by 149 community pharmacists with a response rate of 82%. Multiple linear regression analysis was applied to the results of the survey.ResultsMost pharmacists endorsed social distance towards patients with depression. The social distance further increased the more the situation described implied “social closeness”. Age, depression care attitude, the stereotypical belief “danger to others” and the level of involvement pharmacists showed towards patients with depression were found to predict social distance. The present model explains 32.3% of the variance in social distance.ConclusionThe results showed that community pharmacists have a stigmatizing attitude towards patients with depression. The determinants found to influence these stigmatizing attitudes might be addressed when trying to reduce stigmatization of patients with depression.     

Genetic background contributes to the co-morbidity of anxiety and depression with audiogenic seizure propensity and responses to fluoxetine treatment

BackgroundAnxiety and depression are the most frequent comorbidities of different types of convulsive and non-convulsive epilepsies. Increased anxiety and depression-like phenotype have been described in the genetic absence epilepsy models as well as in models of limbic epilepsy and acquired seizure models, suggesting a neurobiological connection. However, whether anxiety and/or depression are comorbid to audiogenic epilepsy remains unclear. The aim of this study was to investigate whether anxiety or depression-like behavior can be found in rat strains with different susceptibility to audiogenic seizures (AS) and whether chronic fluoxetine treatment affects this co-morbidity.MethodsBehavior in the elevated plus-maze and the forced swimming test was studied in four strains: Wistar rats non-susceptible to AS; Krushinsky–Molodkina (KM) strain, selectively bred for AS propensity from outbred Wistar rats; and a selection lines bred for maximal AS expression (strain “4”) and for a lack of AS (strain “0”) from KM × Wistar F2 hybrids. Effects of chronic antidepressant treatment on AS and behavior were also evaluated.ResultsAnxiety and depression levels were higher in KM rats (with AS) compared with Wistar rats (without AS), indicating the comorbidity with AS. However, in strains “4” and “0” with contrasting AS expression, but with a genetic background close to KM rats, anxiety and depression were not as divergent as in KMs versus Wistars. Fluoxetine treatment exerted an antidepressant effect in all rat strains irrespective of its effect on AS.ConclusionsGenetic background contributes substantively to the co-morbidity of anxiety and depression with AS propensity.     

Association of subjective anxiety, depression, and sleep disturbance with quality-of-life ratings in adults with epilepsy

Purpose :  To determine the relative contributions of subjective anxiety, depression, sleep disturbance, and seizure-related variables to quality-of-life scores in adults with epilepsy, and the interrelationships among these factors.
Methods :  Consecutive adult patients with epilepsy attending neurology outpatient clinics were recruited. Patients completed the following scales: Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Rating Scale, Medical Outcomes Study (MOS) Sleep Scale, Epworth Sleepiness Scale, and Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Univariate and multivariate linear regression models were used to identify variables associated with QOLIE-31 overall score. Path analysis model was constructed to test for interrelations between the variables.
Results :  Two hundred forty-seven patients completed the questionnaires. By multivariate analysis, in order of degree of contribution, HADS anxiety subscale score, MOS Sleep Scale Sleep Problems Index score, HADS depression subscale score, number of current antiepileptic drugs used, and seizure freedom in the past 4 weeks, significantly correlated with QOLIE-31 overall score, accounting for 65.2% of the variance. Complex interrelationships were present between these factors. A general linear model to predict QOLIE-31 overall score in the presence of these factors was constructed.
Conclusion :  Subjective anxiety, depression, and sleep disturbance exerted greater effect than short-term seizure control on quality of life scores of patients with epilepsy. These factors should be considered simultaneously when evaluating effects of treatment on quality of life.     

Utilization of care among drug resistant epilepsy patients with symptoms of anxiety and depression

PurposeEpilepsy patients have a significantly higher rate of anxiety and depression than the general population, and psychiatric disease is particularly prevalent among drug resistant epilepsy patients. Symptoms of anxiety and depression might serve as a barrier to appropriate epilepsy care.The aim of this study was to determine if drug resistant epilepsy patients with symptoms of anxiety and/or depression receive different epilepsy management than controls.MethodWe identified 83 patients with drug resistant focal epilepsy seen at the Penn Epilepsy Center. Upon enrollment, all patients completed 3 self-report scales and a neuropsychiatric inventory and were grouped into those with symptoms of anxiety and/or depression and controls. Each patient's medical records were retrospectively reviewed for 1–2 years, and objective measures of outpatient and inpatient epilepsy management were assessed.ResultsAt baseline, 53% (n = 43) of patients screened positive for symptoms of anxiety and/or depression. The remaining 47% (n = 38) served as controls. Patients with anxiety and/or depression symptoms had more missed outpatient visits per year compared to controls (median 0.84 vs. 0.48, p = 0.02). Patients with symptoms of both anxiety and depression were more likely to undergo an inpatient admission or procedure (56% vs. 24%, p = 0.02).ConclusionFor most measures of epilepsy management, symptoms of anxiety and/or depression do not alter epilepsy care; however, drug resistant epilepsy patients with anxiety and/or depression symptoms may be more likely to miss outpatient appointments, and those with the highest burden of psychiatric symptoms may be admitted more frequently for inpatient services compared to controls.     

Prevalence of self-reported epilepsy or seizure disorder and its associations with self-reported depression and anxiety: results from the 2004 HealthStyles Survey

PURPOSE: To examine the prevalence of self-reported epilepsy or seizure disorder and its association with self-reported recent depression and anxiety in a large sample of the U.S. adult population. METHODS: We analyzed data from adults aged 18 years or older (n = 4,345) who participated in the 2004 HealthStyles Survey, a large mail panel survey designed to be representative of the U.S. population. RESULTS: Among U.S. adults aged 18 years or older, we estimated that 2.9% have been told by a doctor that they had epilepsy or seizure disorder, and an estimated 1.6% and 0.9% had active and inactive epilepsy, respectively. After controlling for demographic characteristics, we estimated that adults with self-reported epilepsy were twice as likely to self-report depression or anxiety in the previous year as were adults without epilepsy, and adults with active epilepsy were 3 times as likely to self-report depression and twice as likely to have anxiety in the previous year as were adults without epilepsy. CONCLUSIONS: Our findings highlight the burden of self-reported depression and anxiety among adults with self-reported epilepsy or seizure disorder, and suggest that healthcare providers should attempt to determine whether adult patients with epilepsy have any psychiatric comorbidity potentially to improve health outcomes. Questions about epilepsy and related factors should be routinely included on population-based surveys so that we can better understand the epilepsy distribution in the U.S. population and identify the unmet health and psychosocial needs of people with epilepsy.     

Depression,anxiety and quality of life in parents of children with epilepsy

0bjectives – To assess the impact of childhood epilepsy on parental quality of life (QOL) and psychological health, and to investigate possible correlations between parental QOL and background variables as well as parental anxiety and depression. Subjects and methods – Parents having an epileptic child (n = 263) and parents having a healthy child (n = 270) were enrolled. Groups were in balance for background variables. Short‐Form Health Survey (SF‐36) Questionnaire, Zung Depression Scale (ZDS) and Zung Anxiety Scale (ZAS) were applied to all parents. Patients were divided into the first visit group (newly diagnosed epilepsy) and follow‐up visit group. Results – The parents of children with epilepsy had significantly lower QOL scores in SF‐36 for all subscales and higher levels of depression and anxiety by using ZDS and ZAS. The factors correlated with parental QOL were seizure control, visit status, anxiety, depression, employment, cost of epilepsy, status epilepticus, drug side effect and age of parents. Conclusions – Childhood epilepsy has a severe impact on parental QOL and psychological health, and recognition of possible correlations between parental QOL and background variables will be helpful to improve parental QOL.     

Prospective associations between social anxiety and depression in youth: The moderating role of maternal major depressive disorder

IntroductionAlthough social anxiety symptoms and exposure to maternal major depressive disorder (MDD) have each been conceptualized as key contributors to the development of depression symptoms in youth, these risk factors have not been integrated into a single model of risk. The current study evaluated a two-hit model of risk to determine whether the impact of social anxiety on prospective changes in youth depressive symptoms is stronger among youth exposed to maternal MDD than among those of never-depressed mothers.MethodsParticipants were youth (aged 8–14 at baseline, 50.4% girls, 80.9% Caucasian) and their biological mothers recruited from the community in the United States. Of the mothers, 129 had a history of MDD during their youth's lifetime and 117 had no lifetime history of MDD. At the initial assessment, mothers completed diagnostic interviews and youth completed self-report measures of social anxiety and depressive symptoms. Participants were reassessed every 6 months for 2 years during which youth again completed the symptom measures.ResultsResults of hierarchical linear modeling revealed that levels of social anxiety predicted prospective increases in depressive symptoms among offspring of mothers with a history of MDD, but not among those of never-depressed mothers. Depressive symptoms did not predict prospective changes in social anxiety (alone or in interaction with maternal MDD).ConclusionsThese results provide preliminary evidence for an integrated model of risk such that social anxiety symptoms may be a particularly strong risk factor for the subsequent development of depression symptoms among youth with exposure to maternal MDD.     

Factors affecting the quality of life in patients with epilepsy in Seoul, South Korea

OBJECTIVES: The level of, and factors affecting the quality of life (QOL) in patients with epilepsy may be different in Korea where social prejudice toward them is still pronounced. However, these issues have not yet been addressed properly. METHODS: We consecutively identified 154 epilepsy patients who visited the outpatient clinic at the Seoul National University Hospital. An interview was performed by two research nurses with the use of a standardized questionnaire, which included data pertaining to seizure characteristics, symptoms of depression/anxiety, social support, family life/social life satisfaction, and the activities of daily living (ADLs). The QOL was assessed with the use of QOL in Epilepsy Inventory (QOLIE-31). RESULTS: Factors affecting the QOL were: age (P<0.01), education in years (P<0.01), employment status (P<0.05), employment type (P<0.05), current economic status (P<0.05), seizure frequency (P<0.01), the number of antiepileptic drugs (P<0.01), family life/social life dissatisfaction (P<0.01, respectively), social support (P<0.01), the symptoms of anxiety and depression (P<0.01, respectively) and ADL dysfunction (P<0.01). In multiple regression analysis, the symptom of anxiety was the most important factor in explaining lower QOL in patients with epilepsy, while depression (P<0.01), social life dissatisfaction (P<0.01), ADL dysfunction (P<0.05) and seizure frequency (P<0.05) were also significant factors. CONCLUSION: Psycho-social factors outweighed the physical factors in determining QOL in Korean epilepsy patients. Recognition of these factors will lead health professionals to develop different strategies to improve the QOL of these patients.     

Perception of stigma and associated factors in people with epilepsy at Amanuel Specialized Mental Hospital,Addis Ababa,Ethiopia

Objective: Stigma is a major problem for people living with epilepsy. Perceived stigma may be more prevalent than enacted stigma and causes excessive worry for the individual even if it does not arise from a social interaction. Therefore, we assessed perceived stigma and associated factors among people with epilepsy.

Methods: An institution-based cross-sectional study was conducted from April to May, 2013, among 423 samples of people with epilepsy.

Results: One hundred sixty-nine (40.7%) of the respondents perceived as they were stigmatised by other people with 19.5% highly stigmatised by their illness. Most of the respondents (54.9%) had one or more seizure attacks per month, 61.9% were under monotherapy and 52.5% had no side effects of antiepileptic drugs. Those respondents who were from rural, low income, divorced/widowed, with frequent seizure attack and side effects of antiepileptic drugs were more likely to felt stigmatised by other people due to their illness.

Conclusions: Perceived stigma was found to be a common problem among people living with epilepsy. Therefore, the finding suggests that the need of creating awareness and addressing incorrect conceptions attached to epilepsy.     

Self-perception of seizure precipitants and their relation to anxiety level, depression, and health locus of control in epilepsy.

BACKGROUND: The aim of this study was to determine the prevalence and nature of self-perceived seizure precipitants in epilepsy patients, and evaluate whether anxiety level, depression, or health locus of control influence self-perception of seizure precipitants. METHODS: Adults aged 18 and older who had epilepsy for at least 1 year were recruited in either the inpatient epilepsy monitoring unit or the outpatient epilepsy clinic at Thomas Jefferson University in 2006. Patients anonymously filled out a questionnaire, which included data about age, sex, education, seizure control, and three questionnaires including identification of seizure precipitants, Hospital anxiety and depression (HAD) scale, and Form C of the multidimensional health locus of control (MHLC). Discriminant function analysis was used for statistical analysis. RESULTS: Two hundred patients participated, with a mean age of 40.3+/-16 years. One hundred thirty (65%) patients reported one or more seizure precipitants. Stress (49.5%), lack of sleep (35.5%), and fatigue (32.5%) were the most common seizure triggers reported. Seizure control, anxiety level, and powerful others subscale in HLC scores were significantly related to self-perception of seizure precipitants. Subjective seizure triggers (stress, lack of sleep) were related to psychological factors. CONCLUSIONS: The perception that certain triggers precipitate seizures is related to anxiety, health locus of control, and seizure control. Hence, seizures might be misattributed to irrelevant precipitants because of an underlying psychological predisposition. Alternatively, there may be a physiological relationship between seizures and the triggers. Prospective studies are required to clarify the relationship between seizure precipitants and seizure occurrence.     

The relative impact of anxiety, depression, and clinical seizure features on health-related quality of life in epilepsy

PURPOSE: To determine the independent effects of depression and anxiety on health-related quality of life (HRQOL) in epilepsy as well as the relative explanatory power of psychiatric comorbidity compared with demographic and clinical epilepsy variables (e.g., seizure frequency, severity, and chronicity). METHODS: Subjects (n = 87) with temporal lobe epilepsy completed self-report measures of depression, anxiety, HRQOL, and seizure severity. Information was derived regarding subjects' seizure frequency, duration, and treatment. HRQOL status (QOLIE-89) was examined in relation to self-reported symptoms of anxiety and depression, clinical seizure features, and demographic characteristics. RESULTS: Depression and anxiety were independently associated with reduced HRQOL. Psychiatric comorbidity explained more variance in HRQOL than did combined groups of clinical seizure or demographic variables. Although weaker in explanatory power than psychiatric comorbidity, several epilepsy factors were nonetheless significantly related to HRQOL, including seizure frequency, severity, and chronicity. CONCLUSIONS: Interictal anxiety and depression exert independent adverse effects on HRQOL. In addition, frequent, severe, and chronic seizures reduce HRQOL, but appear less powerful predictors of HRQOL than interictal psychiatric symptoms. Recognition and treatment of comorbid depression and anxiety is an important consideration in improving quality of life in epilepsy.     

The global burden and stigma of epilepsy

Epilepsy is one of the most prevalent neurological conditions and it knows no age, racial, social class, geographic, or national boundaries. The impact of epilepsy rests not only on the individual patient, but also on the family and indirectly on the community. The burden of epilepsy may be due to the physical hazards of epilepsy resulting from the unpredictability of seizures; the social exclusion as a result of negative attitudes of others toward people with epilepsy; and the stigma, as children with epilepsy may be banned from school, adults may be barred from marriage, and employment is often denied, even when seizures would not render the work unsuitable or unsafe. Furthermore, epilepsy is a disorder associated with significant psychological consequences, with increased levels of anxiety, depression, and poor self-esteem compared with people without this condition. Here we discuss some of the aspects of the global burden of epilepsy.     

癫(疒间)患者焦虑抑郁情绪研究

目的:探讨癫(疒间)患者焦虑抑郁情绪的有关因素. 方法:80例成年癫疒间患者,前期诊疗不规范,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估. 结果:癫疒间合并焦虑情绪者25%,合并抑郁情绪者45%.多因素回归分析结果显示,病程越长,发作程度越严重,男性患者更易产生焦虑情绪,而居住在农村的癫疒间患者更易产生抑郁情绪. 结论:癫疒间患者焦虑抑郁情绪明显高于正常人群,性别、病程、发作严重程度和生活居住地是影响癫疒间患者焦虑抑郁情绪的独立危险因素.