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The relationship between social phobia and cognitive impairment in idiopathic generalized epilepsy patients: a cross-sectional study

Year 2024, Volume: 10 Issue: 2, 226 - 233, 04.03.2024
https://doi.org/10.18621/eurj.1421296

Abstract

Objectives: Epilepsy, a neurological disorder affecting approximately 65 million people worldwide, frequently presents with various comorbidities, including cognitive impairment. The factors contributing to cognitive impairment are complex and multifaceted. This study aimed to investigate the influence of social phobia on cognitive function in patients with idiopathic generalized tonic-clonic epilepsy.

Methods: This prospective study recruited 87 adult idiopathic generalized tonic-clonic epilepsy patients diagnosed according to the International League Against Epilepsy 2017 classification. Differential diagnosis involved electroencephalography, magnetic resonance imaging, and neurological examinations. All participants were assessed for cognitive impairment, social phobia, depression, and anxiety using the Montreal Cognitive Assessment, Liebowitz Social Anxiety Scale, Beck Depression Inventory, and Beck Anxiety Inventory, respectively.

Results: A significant majority (73.6%) of participants reported social phobia. Compared to those without social phobia, the Montreal Cognitive Assessment total score was significantly lower in the social phobia group (P=0.002). Additionally, epilepsy duration was significantly longer in the social phobia group (P=0.03). Montreal Cognitive Assessment scores showed a negative correlation with Liebowitz Social Anxiety Scale-avoidance, Liebowitz Social Anxiety Scale-total, and age (P=0.003, P=0.005, and P<0.001, respectively).

Conclusions: This study suggests that individuals with idiopathic generalized tonic-clonic epilepsy experiencing social phobia may exhibit lower cognitive function compared to those without. This indicates that comorbid social phobia might negatively impact cognitive abilities in idiopathic generalized tonic-clonic epilepsy patients.

References

  • 1. Beghi E. The Epidemiology of Epilepsy. Neuroepidemiology. 2020;54(2):185-191. doi: 10.1159/000503831.
  • 2. Vetri L, Roccella M, Parisi L, et al. Epilepsy: A Multifaced Spectrum Disorder. Behav Sci (Basel). 2023;13(2):97. doi: 10.3390/bs13020097.
  • 3. Mirza SS, Ikram MA, Bos D, Mihaescu R, Hofman A, Tiemeier H. Mild cognitive impairment and risk of depression and anxiety: A population-based study. Alzheimers Dement. 2017;13(2):130-139. doi: 10.1016/j.jalz.2016.06.2361.
  • 4. Kutlu A, Gökçe G, Büyükburgaz Ü, Selekler M, Komşuoğlu S. Self-Esteem, Social Phobia and Depression Status in Patients with Epilepsy. Noro Psikiyatr Ars. 2013;50(4):320-324. doi: 10.4274/Npa.y6374.
  • 5. Han SH, Kim KT, Ryu HU, et al. Factors associated with social anxiety in South Korean adults with epilepsy. Epilepsy Behav. 2019;101:106569. doi: 10.1016/j.yebeh.2019.106569.
  • 6. Millan MJ, Agid Y, Brüne M, et al. Cognitive dysfunction in psychiatric disorders: characteristics, causes and the quest for improved therapy. Nat Rev Drug Discov. 2012;11(2):141-168. doi: 10.1038/nrd3628.
  • 7. Sachs G, Anderer P, Margreiter N, Semlitsch H, Saletu B, Katschnig H. P300 event-related potentials and cognitive function in social phobia. Psychiatry Res. 2004;131(3):249-261. doi: 10.1016/j.pscychresns.2004.05.005.
  • 8. Novak A, Vizjak K, Rakusa M. Cognitive Impairment in People with Epilepsy. J Clin Med. 2022;11(1):267. doi: 10.3390/jcm11010267.
  • 9. Wang L, Chen S, Liu C, Lin W, Huang H. Factors for cognitive impairment in adult epileptic patients. Brain Behav. 2020;10(1):01475. doi: 10.1002/brb3.1475.
  • 10. Kaya Y, Aki OE, Can UA, Derle E, Kibaroğlu S, Barak A. Validation of Montreal Cognitive Assessment and Discriminant Power of Montreal Cognitive Assessment Subtests in Patients With Mild Cognitive Impairment and Alzheimer Dementia in Turkish Population. J Geriatr Psychiatry Neurol. 2014;27(2):103-109. doi: 10.1177/0891988714522701.
  • 11. Mennin DS, Fresco DM, Heimberg RG, Schneier FR, Davies SO, Liebowitz MR. Screening for social anxiety disorder in the clinical setting: using the Liebowitz Social Anxiety Scale. J Anxiety Disord. 2002;16(6):661-673. doi: 10.1016/s0887-6185(02)00134-2.
  • 12. Soykan C, Ozgüven HD, Gençöz T. Liebowitz Social Anxiety Scale: the Turkish version. Psychol Rep. 2003;93(3):1059-1069. doi: 10.2466/pr0.2003.93.3f.1059.
  • 13. Beck AT, Ward CH, Mendelson M, Mock J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-571. doi: 10.1001/archpsyc.1961.01710120031004.
  • 14. Kapci EG, Uslu R, Turkcapar H, Karaoglan A. Beck Depression Inventory II: evaluation of the psychometric properties and cut-off points in a Turkish adult population. Depress Anxiety. 2008;25(10):104-110. doi: 10.1002/da.20371.
  • 15. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-897. doi: 10.1037//0022-006x.56.6.893.
  • 16. Ulusoy M, Sahin NH, Erkmen H: Turkish version of the Beck Anxiety Inventory: Psychometric properties. Turkish version of the Beck Anxiety Inventory: Psychometric properties. J. Cogn. Psychother. 1998, 12:163.
  • 17. Voltzenlogel V, Vignal JP, Hirsch E, Manning L. The influence of seizure frequency on anterograde and remote memory in mesial temporal lobe epilepsy. Seizure. 2014;23(9):792-798. doi: 10.1016/j.seizure.2014.06.013.
  • 18. Black LC, Schefft BK, Howe SR, Szaflarski JP, Yeh HS, Privitera MD. The effect of seizures on working memory and executive functioning performance. Epilepsy Behav. 2010;17(3):412-419. doi: 10.1016/j.yebeh.2010.01.006.
  • 19. Taylor J, Kolamunnage-Dona R, Marson AG, et al. Patients with epilepsy: cognitively compromised before the start of antiepileptic drug treatment? Epilepsia. 2010;51(1):48-56. doi: 10.1111/j.1528-1167.2009.02195.x.
  • 20. Piazzini A, Canevini MP, Turner K, Chifari R, Canger R. Elderly people and epilepsy: cognitive function. Epilepsia. 2006;47 Suppl 5:82-84. doi: 10.1111/j.1528-1167.2006.00884.x.
  • 21. Oyegbile TO, Dow C, Jones J. The nature and course of neuropsychological morbidity in chronic temporal lobe epilepsy. Neurology. 2004;62(10):1736-1742. doi: 10.1212/01.wnl.0000125186.04867.34.
  • 22. Hermann B, Meador KJ, Gaillard WD, Cramer JA. Cognition across the lifespan: antiepileptic drugs, epilepsy, or both? Epilepsy Behav. 2010;17(1):1-5. doi: 10.1016/j.yebeh.2009.10.019.
  • 23. Witt JA, Elger CE, Helmstaedter C. Adverse cognitive effects of antiepileptic pharmacotherapy: Each additional drug matters. Eur Neuropsychopharmacol. 2015;25(11):1954-1959. doi: 10.1016/j.euroneuro.2015.07.027.
  • 24. Eddy CM, Rickards HE, Cavanna AE. The cognitive impact of antiepileptic drugs. Ther Adv Neurol Disord. 2011;4(6):385-407. doi: 10.1177/1756285611417920.
  • 25. Brandt C, Mula M. Anxiety disorders in people with epilepsy. Epilepsy Behav. 2016;59:87-91. doi: 10.1016/j.yebeh.2016.03.020.
  • 26. Miller LA, Galioto R, Tremont G, et al. Cognitive impairment in older adults with epilepsy: Characterization and risk factor analysis. Epilepsy Behav. 2016;56:113-117. doi: 10.1016/j.yebeh.2016.01.011.
  • 27. Velissaris SL, Saling MM, Newton MR, Berkovic SF, Wilson SJ. Psychological trajectories in the year after a newly diagnosed seizure. Epilepsia. 2012;53(10):1774-1781. doi: 10.1111/j.1528-1167.2012.03658.x.
  • 28. Kobau R, Gilliam F, Thurman DJ. Prevalence of self-reported epilepsy or seizure disorder and its associations with self-reported depression and anxiety: results from the 2004 HealthStyles Survey. Epilepsia. 2006;47(11):1915-1921. doi: 10.1111/j.1528-1167.2006.00612.x.
  • 29. Stefanello S, Marín-Léon L, Fernandes PT, Li LM, Botega NJ. Depression and anxiety in a community sample with epilepsy in Brazil. Arq Neuropsiquiatr. 2011;69(2B):342-348. doi: 10.1590/s0004-282x2011000300015.
  • 30. Indaco A, Carrieri PB, Nappi C, Gentile S, Striano S. Interictal depression in epilepsy. Epilepsy Res. 1992;12(1):45-50. doi: 10.1016/0920-1211(92)90090-g.
  • 31. Feldman L, Lapin B, Busch RM, Bautista JF. Evaluating subjective cognitive impairment in the adult epilepsy clinic: Effects of depression, number of antiepileptic medications, and seizure frequency. Epilepsy Behav. 2018;81:18-24. doi: 10.1016/j.yebeh.2017.10.011.
  • 32. Grabowska-Grzyb A, Jedrzejczak J, Nagańska E, Fiszer U. Risk factors for depression in patients with epilepsy. Epilepsy Behav. 2006;8(2):411-417. doi: 10.1016/j.yebeh.2005.12.005.
  • 33. Lee SA, Cho YJ, Ryu HU, et al. Sex differences in seizure effects on social anxiety in persons with epilepsy. Epilepsy Behav. 2021;124:108318. doi: 10.1016/j.yebeh.2021.108318.
  • 34. Lu Y, Zhong R, Li M, et al. Social anxiety is associated with poor quality of life in adults with epilepsy in Northeast China: A cross-sectional study. Epilepsy Behav. 2021;117:107866. doi: 10.1016/j.yebeh.2021.107866.
Year 2024, Volume: 10 Issue: 2, 226 - 233, 04.03.2024
https://doi.org/10.18621/eurj.1421296

Abstract

References

  • 1. Beghi E. The Epidemiology of Epilepsy. Neuroepidemiology. 2020;54(2):185-191. doi: 10.1159/000503831.
  • 2. Vetri L, Roccella M, Parisi L, et al. Epilepsy: A Multifaced Spectrum Disorder. Behav Sci (Basel). 2023;13(2):97. doi: 10.3390/bs13020097.
  • 3. Mirza SS, Ikram MA, Bos D, Mihaescu R, Hofman A, Tiemeier H. Mild cognitive impairment and risk of depression and anxiety: A population-based study. Alzheimers Dement. 2017;13(2):130-139. doi: 10.1016/j.jalz.2016.06.2361.
  • 4. Kutlu A, Gökçe G, Büyükburgaz Ü, Selekler M, Komşuoğlu S. Self-Esteem, Social Phobia and Depression Status in Patients with Epilepsy. Noro Psikiyatr Ars. 2013;50(4):320-324. doi: 10.4274/Npa.y6374.
  • 5. Han SH, Kim KT, Ryu HU, et al. Factors associated with social anxiety in South Korean adults with epilepsy. Epilepsy Behav. 2019;101:106569. doi: 10.1016/j.yebeh.2019.106569.
  • 6. Millan MJ, Agid Y, Brüne M, et al. Cognitive dysfunction in psychiatric disorders: characteristics, causes and the quest for improved therapy. Nat Rev Drug Discov. 2012;11(2):141-168. doi: 10.1038/nrd3628.
  • 7. Sachs G, Anderer P, Margreiter N, Semlitsch H, Saletu B, Katschnig H. P300 event-related potentials and cognitive function in social phobia. Psychiatry Res. 2004;131(3):249-261. doi: 10.1016/j.pscychresns.2004.05.005.
  • 8. Novak A, Vizjak K, Rakusa M. Cognitive Impairment in People with Epilepsy. J Clin Med. 2022;11(1):267. doi: 10.3390/jcm11010267.
  • 9. Wang L, Chen S, Liu C, Lin W, Huang H. Factors for cognitive impairment in adult epileptic patients. Brain Behav. 2020;10(1):01475. doi: 10.1002/brb3.1475.
  • 10. Kaya Y, Aki OE, Can UA, Derle E, Kibaroğlu S, Barak A. Validation of Montreal Cognitive Assessment and Discriminant Power of Montreal Cognitive Assessment Subtests in Patients With Mild Cognitive Impairment and Alzheimer Dementia in Turkish Population. J Geriatr Psychiatry Neurol. 2014;27(2):103-109. doi: 10.1177/0891988714522701.
  • 11. Mennin DS, Fresco DM, Heimberg RG, Schneier FR, Davies SO, Liebowitz MR. Screening for social anxiety disorder in the clinical setting: using the Liebowitz Social Anxiety Scale. J Anxiety Disord. 2002;16(6):661-673. doi: 10.1016/s0887-6185(02)00134-2.
  • 12. Soykan C, Ozgüven HD, Gençöz T. Liebowitz Social Anxiety Scale: the Turkish version. Psychol Rep. 2003;93(3):1059-1069. doi: 10.2466/pr0.2003.93.3f.1059.
  • 13. Beck AT, Ward CH, Mendelson M, Mock J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-571. doi: 10.1001/archpsyc.1961.01710120031004.
  • 14. Kapci EG, Uslu R, Turkcapar H, Karaoglan A. Beck Depression Inventory II: evaluation of the psychometric properties and cut-off points in a Turkish adult population. Depress Anxiety. 2008;25(10):104-110. doi: 10.1002/da.20371.
  • 15. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-897. doi: 10.1037//0022-006x.56.6.893.
  • 16. Ulusoy M, Sahin NH, Erkmen H: Turkish version of the Beck Anxiety Inventory: Psychometric properties. Turkish version of the Beck Anxiety Inventory: Psychometric properties. J. Cogn. Psychother. 1998, 12:163.
  • 17. Voltzenlogel V, Vignal JP, Hirsch E, Manning L. The influence of seizure frequency on anterograde and remote memory in mesial temporal lobe epilepsy. Seizure. 2014;23(9):792-798. doi: 10.1016/j.seizure.2014.06.013.
  • 18. Black LC, Schefft BK, Howe SR, Szaflarski JP, Yeh HS, Privitera MD. The effect of seizures on working memory and executive functioning performance. Epilepsy Behav. 2010;17(3):412-419. doi: 10.1016/j.yebeh.2010.01.006.
  • 19. Taylor J, Kolamunnage-Dona R, Marson AG, et al. Patients with epilepsy: cognitively compromised before the start of antiepileptic drug treatment? Epilepsia. 2010;51(1):48-56. doi: 10.1111/j.1528-1167.2009.02195.x.
  • 20. Piazzini A, Canevini MP, Turner K, Chifari R, Canger R. Elderly people and epilepsy: cognitive function. Epilepsia. 2006;47 Suppl 5:82-84. doi: 10.1111/j.1528-1167.2006.00884.x.
  • 21. Oyegbile TO, Dow C, Jones J. The nature and course of neuropsychological morbidity in chronic temporal lobe epilepsy. Neurology. 2004;62(10):1736-1742. doi: 10.1212/01.wnl.0000125186.04867.34.
  • 22. Hermann B, Meador KJ, Gaillard WD, Cramer JA. Cognition across the lifespan: antiepileptic drugs, epilepsy, or both? Epilepsy Behav. 2010;17(1):1-5. doi: 10.1016/j.yebeh.2009.10.019.
  • 23. Witt JA, Elger CE, Helmstaedter C. Adverse cognitive effects of antiepileptic pharmacotherapy: Each additional drug matters. Eur Neuropsychopharmacol. 2015;25(11):1954-1959. doi: 10.1016/j.euroneuro.2015.07.027.
  • 24. Eddy CM, Rickards HE, Cavanna AE. The cognitive impact of antiepileptic drugs. Ther Adv Neurol Disord. 2011;4(6):385-407. doi: 10.1177/1756285611417920.
  • 25. Brandt C, Mula M. Anxiety disorders in people with epilepsy. Epilepsy Behav. 2016;59:87-91. doi: 10.1016/j.yebeh.2016.03.020.
  • 26. Miller LA, Galioto R, Tremont G, et al. Cognitive impairment in older adults with epilepsy: Characterization and risk factor analysis. Epilepsy Behav. 2016;56:113-117. doi: 10.1016/j.yebeh.2016.01.011.
  • 27. Velissaris SL, Saling MM, Newton MR, Berkovic SF, Wilson SJ. Psychological trajectories in the year after a newly diagnosed seizure. Epilepsia. 2012;53(10):1774-1781. doi: 10.1111/j.1528-1167.2012.03658.x.
  • 28. Kobau R, Gilliam F, Thurman DJ. Prevalence of self-reported epilepsy or seizure disorder and its associations with self-reported depression and anxiety: results from the 2004 HealthStyles Survey. Epilepsia. 2006;47(11):1915-1921. doi: 10.1111/j.1528-1167.2006.00612.x.
  • 29. Stefanello S, Marín-Léon L, Fernandes PT, Li LM, Botega NJ. Depression and anxiety in a community sample with epilepsy in Brazil. Arq Neuropsiquiatr. 2011;69(2B):342-348. doi: 10.1590/s0004-282x2011000300015.
  • 30. Indaco A, Carrieri PB, Nappi C, Gentile S, Striano S. Interictal depression in epilepsy. Epilepsy Res. 1992;12(1):45-50. doi: 10.1016/0920-1211(92)90090-g.
  • 31. Feldman L, Lapin B, Busch RM, Bautista JF. Evaluating subjective cognitive impairment in the adult epilepsy clinic: Effects of depression, number of antiepileptic medications, and seizure frequency. Epilepsy Behav. 2018;81:18-24. doi: 10.1016/j.yebeh.2017.10.011.
  • 32. Grabowska-Grzyb A, Jedrzejczak J, Nagańska E, Fiszer U. Risk factors for depression in patients with epilepsy. Epilepsy Behav. 2006;8(2):411-417. doi: 10.1016/j.yebeh.2005.12.005.
  • 33. Lee SA, Cho YJ, Ryu HU, et al. Sex differences in seizure effects on social anxiety in persons with epilepsy. Epilepsy Behav. 2021;124:108318. doi: 10.1016/j.yebeh.2021.108318.
  • 34. Lu Y, Zhong R, Li M, et al. Social anxiety is associated with poor quality of life in adults with epilepsy in Northeast China: A cross-sectional study. Epilepsy Behav. 2021;117:107866. doi: 10.1016/j.yebeh.2021.107866.
There are 34 citations in total.

Details

Primary Language English
Subjects Central Nervous System
Journal Section Original Articles
Authors

İdris Kocatürk 0000-0002-3415-6906

Ali İnaltekin 0000-0003-0933-0308

Early Pub Date February 15, 2024
Publication Date March 4, 2024
Submission Date January 17, 2024
Acceptance Date February 13, 2024
Published in Issue Year 2024 Volume: 10 Issue: 2

Cite

AMA Kocatürk İ, İnaltekin A. The relationship between social phobia and cognitive impairment in idiopathic generalized epilepsy patients: a cross-sectional study. Eur Res J. March 2024;10(2):226-233. doi:10.18621/eurj.1421296

e-ISSN: 2149-3189 


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