J Clin Neurol.  2014 Jul;10(3):175-188. 10.3988/jcn.2014.10.3.175.

Depression and Anxiety in People with Epilepsy

• Kwon OY
• Park SP

• KMID: 2179443
• DOI: http://doi.org/10.3988/jcn.2014.10.3.175

Abstract

Many recent epidemiological studies have found the prevalence of depression and anxiety to be higher in people with epilepsy (PWE) than in people without epilepsy. Furthermore, people with depression or anxiety have been more likely to suffer from epilepsy than those without depression or anxiety. Almost one-third of PWE suffer from depression and anxiety, which is similar to the prevalence of drug-refractory epilepsy. Various brain areas, including the frontal, temporal, and limbic regions, are associated with the biological pathogenesis of depression in PWE. It has been suggested that structural abnormalities, monoamine pathways, cerebral glucose metabolism, the hypothalamic-pituitary-adrenal axis, and interleukin-1b are associated with the pathogenesis of depression in PWE. The amygdala and the hippocampus are important anatomical structures related to anxiety, and gamma-aminobutyric acid and serotonin are associated with its pathogenesis. Depression and anxiety may lead to suicidal ideation or attempts and feelings of stigmatization. These experiences are also likely to increase the adverse effects associated with antiepileptic drugs and have been related to poor responses to pharmacological and surgical treatments. Ultimately, the quality of life is likely to be worse in PWE with depression and anxiety than in PWE without these disorders, which makes the early detection and appropriate management of depression and anxiety in PWE indispensable. Simple screening instruments may be helpful for in this regard, particularly in busy epilepsy clinics. Although both medical and psychobehavioral therapies may ameliorate these conditions, randomized controlled trials are needed to confirm that.

Keyword

epilepsy; depression; anxiety

MeSH Terms

Amygdala
Anticonvulsants
Anxiety*
Axis, Cervical Vertebra
Brain
Depression*
Epilepsy*
gamma-Aminobutyric Acid
Glucose
Hippocampus
Mass Screening
Metabolism
Prevalence
Quality of Life
Serotonin
Stereotyping
Suicidal Ideation
Anticonvulsants
Glucose
Serotonin
gamma-Aminobutyric Acid

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