Epilepsinin Psikiyatrik Bozukluklar ile İlişkisi

Year 2024, Volume: 19 Issue: 2, 75 - 84

Yalçın Kahya Cicek Hocaoglu

https://doi.org/10.17517/ksutfd.1239543

Abstract

Epilepsi, tekrarlayan nöbetlerle karakterize kronik seyirli nörolojik bir hastalıktır. Her yaştan insanı etkileyen epilepsi hastalar ve aileleri için ekonomik, sosyal alanlar gibi birçok alanda yıkıcı sorunlara neden olur. Epilepsi tanımlanırken sadece nöbetler değil, aynı zamanda hastalığa eşlik eden psikiyatrik ve bilişsel bozulmayı içeren durumlar da göz önüne alınmalıdır. Çünkü epilepsi tanısı ile izlenen hastalarda psikiyatrik eş tanıların prevalansı oldukça yüksektir. Yaşamları boyunca üç hastadan birinde psikiyatrik bozukluklar görülmektedir. Duygudurum ve anksiyete bozuklukları epilepsiye en sık eşlik eden psikiyatrik tanıların başında gelmektedir. Şizofreni, obsesif kompulsif bozukluk (OKB), kişilik bozuklukları, dikkat eksikliği hiperaktivite bozukluğu (DEHB), bipolar bozukluk (BB), bilişsel bozukluklar ve madde kullanım bozukluğu da eşlik eden diğer psikiyatrik hastalıklardır. Epilepsi aynı zamanda yüksek intihar riski ve şiddet davranışları ile de ilişkilendirilmektedir. Epilepsi tedavisinde öncelik antiepileptik ilaçların monoterapi olarak kullanılmasıdır. Ayrıca, tedavide kullanılan antiepileptik ilaçların psikiyatrik ve davranışsal yan etkileri olabilir. Bu yan etkiler ilacın özelliğine ve hastanın klinik durumuna göre değişebilir. Yan etkiler gözden kaçabildiği için kesin sıklığını belirlemek de güçtür. Özellikle psikiyatrik bozukluk öyküsü olan epilepsi tanılı hastalarda antiepileptik ilaç kullanımı ve seçimi konusunda dikkatli olunmalıdır. Eş tanılı psikiyatrik bozuklukların erken saptanması hem nöbet kontrolü açısından hem de hastalığın seyri açısından önem taşımaktadır. Bu gözden geçirmede konu ile ilgili çalışmalar gözden geçirilerek alanyazına katkı sunulması amaçlanmıştır.

Keywords

Epilepsi, Psikiyatrik Bozukluklar, tanı

Supporting Institution

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Project Number

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Thanks

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Association Between Epilepsy and Psychiatric Disorders

Abstract

Epilepsy is a chronic neurological disease characterized by recurrent seizures. Epilepsy, which affects people of all ages, causes many devastating economic and social problems for patients and their families. When defining epilepsy, not only seizures but also psychiatric and cognitive impairments accompanying the disease are taken into account. Because the prevalence of psychiatric comorbidities in patients followed up with a diagnosis of epilepsy is quite high. Psychiatric disorders occur in one out of three patients during their lifetime. Mood disorders and anxiety disorders are among the most common psychiatric diagnoses accompanying epilepsy. Other psychiatric disorders are schizophrenia, obsessive-compulsive disorder (OCD), personality disorders, attention deficit hyperactivity disorder (ADHD), bipolar disorder (BD), cognitive disorders, and substance use disorder. Epilepsy is also associated with a high risk of suicide and violent behavior. The priority in the treatment of epilepsy is the use of antiepileptic drugs as monotherapy. However, antiepileptic drugs used in treatment may also have psychiatric and behavioral side effects. These side effects may vary according to the characteristics of the drug and the clinical condition of the patient. It is also difficult to determine the exact frequency as side effects can be overlooked. Particular attention should be paid to the use and selection of antiepileptic drugs in patients with epilepsy who have a history of psychiatric disorders. Early detection of comorbid psychiatric disorders is important both in terms of seizure control and in terms of the course of the disease. In this review, it is aimed to contribute to the literature by reviewing the studies on the subject.

Keywords

Epilepsy, Psychiatric disorders, Diagnosis

Project Number

yok

References

• Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross HJ, Elger CE, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-482.
• Stelzle D, Kaducu J, Schmidt V, Welte TM, Ngowi BJ , Matuja W, et al. Correction: Characteristics of people with epilepsy in three Eastern African countries - a pooled analysis. BMC Neurol. 2022;22(1):499.
• Gilles VC, Robert C. How to decrease the epilepsy disease burden in sub-Saharan Africa?. Epilepsy Behav. 2023;139:109052.
• Keezer MR, Sisodiya SM, Sander JW. Comorbidities of epilepsy: current concepts and future perspectives. Lancet Neurol. 2016;15(1):106-115.
• Srinivas HV, Shah U. Comorbidities of epilepsy. Neurol India. 2017;65(Supplement):S18-S24.
• Lopez MR, Schachter SC, Kanner AM. Psychiatric comorbidities go unrecognized in patients with epilepsy: "You see what you know". Epilepsy Behav. 2019;98(Pt B):302-305.
• Kedare JS, Baliga SP. Management of psychiatric sisorders in patients of epilepsy. Indian J Psychiatry. 2022;64(Suppl 2):S319-S329.
• Kanner AM. Psychiatric comorbidities in new onset epilepsy: Should they be always investigated?. Seizure. 2017;49:79-82.
• Lu E, Pyatka N, Burant CJ, Sajatovic M. Systematic literature review of psychiatric comorbidities in adults with epilepsy. J Clin Neurol. 2021;17(2):176-186.
• Rai D, Kerr MP, McManus S, Jordanova V, Lewis G, Brugha TS. Epilepsy and psychiatric comorbidity: a nationally representative population-based study. Epilepsia. 2012;53(6):1095-1103.
• Gatta M, Raffagnato A, Mannarini S, Balottin L , Toldo I , Vecchi M, et al. Pediatric epilepsy and psychiatric comorbidity: preliminary observational data from a prospective study. Minerva Pediatr. 2018;70(6):501-512.
• Colmers PLW, Maguire J. Network dysfunction in comorbid psychiatric illnesses and epilepsy. Epilepsy Curr. 2020;20(4):205-210.
• Munger Clary HM, Snively BM, Hamberger MJ. Anxiety is common and independently associated with clinical features of epilepsy. Epilepsy Behav. 2018; 85:64-71.
• Hingray C, McGonigal A, Kotwas I, Micoulaud-Franchi JA. The relationship between epilepsy and anxiety disorders. Curr Psychiatry Rep. 2019;21(6):40.
• Van Hees S, Siewe Fodjo JN, Wijtvliet V, Van den Bergh R , Faria de Moura Villela E, da Silva CF, et al. Access to healthcare and prevalence of anxiety and depression in persons with epilepsy during the COVID-19 pandemic: A multicountry online survey. Epilepsy Behav. 2020;112:107350.
• Salpekar J. Mood disorders in epilepsy. Focus (Am Psychiatr Publ). 2016; 14(4):465-472.
• Mula M, Marotta AE, Monaco F. Epilepsy and bipolar disorders. Expert Rev Neurother. 2010;10(1):13-23.
• Mazza M, Di Nicola M, Della Marca G, Janiri L, Bria P, Mazza S. Bipolar disorder and epilepsy: a bidirectional relation? Neurobiological underpinnings, current hypotheses, and future research directions. Neuroscientist. 2007;13(4):392-404.
• Mula M, Schmitz B, Jauch R, Cavanna A, Cantello R, Monaco F, et al. On the prevalence of bipolar disorder in epilepsy. Epilepsy Behav. 2008;13(4):658-661.
• Fiest KM, Dykeman J, Patten SB, Wiebe S, Kaplan GG, Maxwell CJ, et al. Depression in epilepsy: a systematic review and meta-analysis. Neurology. 2013;80(6):590-599.
• Kim M, Kim YS, Kim DH, Yang TW, Kwon OY. Major depressive disorder in epilepsy clinics: A meta-analysis. Epilepsy Behav. 2018;84:56-69.
• Qin SK, Yang ZX, Guan ZW, Zhang JH, Ping X, Lu Y, et al. Exploring the association between epilepsy and depression: A systematic review and meta-analysis. PLoS One. 2022;17(12):e0278907.
• Shen S, Dong Z, Zhang Q, Xiao J, Zhou D, Li J. The overlapping relationship among depression, anxiety, and somatic symptom disorder and its impact on the quality of life of people with epilepsy. Ther Adv Neurol Disord. 2022;15:17562864221138147.
• Liu Z, Yin R, Fan Z, Fan H, Wu H, et al. Gender differences in associated and predictive factors of anxiety and depression in people with epilepsy. Front Psychiatry. 2020;11:670.
• Gaitatzis A, Trimble MR, Sander JW. The psychiatric comorbidity of epilepsy. Acta Neurol Scand. 2004;110(4):207-220.
• Swinkels WA, Kuyk J, van Dyck R, Spinhoven P. Psychiatric comorbidity in epilepsy. Epilepsy Behav. 2005;7(1):37-50.
• Blumer D. Evidence supporting the temporal lobe epilepsy personality syndrome. Neurology 1999;53(5 Suppl 2): S9-S12
• Demirci S, Demirci K , Yürekli VA. Epilepsi’de kişilik. SDÜ Sağlık Bilimleri Enstitüsü Dergisi. 2014;5(1):32-35.
• Cascella NG, Schretlen DJ, Sawa A. Schizophrenia and epilepsy: is there a shared susceptibility?. Neurosci Res. 2009;63(4):227-235.
• Clarke MC, Tanskanen A, Huttunen MO, Clancy M, Cotter DR, Cannon M. Evidence for shared susceptibility to epilepsy and psychosis: a population-based family study. Biol Psychiatry. 2012;71(9):836-839.
• Sachdev P. Schizophrenia-like psychosis and epilepsy: the status of the association. Am J Psychiatry. 1998; 155(3):325-336.
• Lax Pericall MT, Taylor E. Psychosis and epilepsy in young people. Epilepsy Behav. 2010;18(4):450-454.
• Clancy MJ, Clarke MC, Connor DJ, Cannon M, Cotter DR. The prevalence of psychosis in epilepsy; a systematic review and meta-analysis. BMC Psychiatry. 2014;14:75.
• Abraham N, Buvanaswari P, Rathakrishnan R, Tran BX, Thu GV, Nguyen LH, et al. A Meta-Analysis of the Rates of Suicide Ideation, Attempts and Deaths in People with Epilepsy. Int J Environ Res Public Health. 2019;16(8):1451.
• Kim SJ, Kim HJ, Jeon JY, Kim HW, Lee SA. Clinical factors associated with suicide risk independent of depression in persons with epilepsy. Seizure. 2020;80:86-91.
• Falcone T, Dagar A, Castilla-Puentes RC, Anand A, Brethenoux C, Valleta LG, et al. Digital conversations about suicide among teenagers and adults with epilepsy: A big-data, machine learning analysis. Epilepsia. 2020;61(5):951-958.
• Marsh L, Krauss GL. Aggression and violence in patients with epilepsy. Epilepsy Behav. 2000;1(3):160-168.
• Izci F, Fındıklı E, Camkurt MA, Tuncel D, Şahin M. Impact of aggression, depression, and anxiety levels on quality of life in epilepsy patients. Neuropsychiatr Dis Treat. 2016;12:2595-2603.
• Tassinari CA, Tassi L, Calandra-Buonaura G, Stanzani-Maserati M, Fini N, Pizza F, et al. Biting behavior, aggression, and seizures. Epilepsia. 2005; 46(5):654-663.
• Pizzi AM, Chapin JS, Tesar GE, Busch RM. Comparison of personality traits in patients with frontal and temporal lobe epilepsies. Epilepsy Behav. 2009;15(2):225-229.
• Helmstaedter C, Witt JA. Multifactorial etiology of interictal behavior in frontal and temporal lobe epilepsy. Epilepsia. 2012;53(10):1765-1773.
• Helmstaedter C, Witt JA. Epilepsy and cognition - A bidirectional relationship?. Seizure. 2017;49:83-89.
• Choi H, Pack A, Elkind MS, Longstreth WT Jr, Ton TG, Onchiri F. Predictors of incident epilepsy in older adults: The Cardiovascular Health Study. Neurology. 2017; 88(9):870-877.
• Subota A, Pham T, Jetté N, Sauro K, Lorenzetti D, Holroyd-Leduc J. The association between dementia and epilepsy: A systematic review and meta-analysis. Epilepsia. 2017; 58(6):962-972.
• Sen A, Capelli V, Husain M. Cognition and dementia in older patients with epilepsy. Brain. 2018;141(6):1592-1608.
• Reilly C, Atkinson P, Das KB, Chin RF, Aylett SE, Burch V, Gillberg C, et al. Neurobehavioral comorbidities in children with active epilepsy: a population-based study. Pediatrics. 2014;133(6):e1586-e1593.
• Williams AE, Giust JM, Kronenberger WG, Dunn DW. Epilepsy and attention-deficit hyperactivity disorder: links, risks, and challenges. Neuropsychiatr Dis Treat. 2016;12:287-296.
• Cohen R, Senecky Y, Shuper A, Inbar D, Chodick G, Shalev V, et al. Prevalence of epilepsy and attention-deficit hyperactivity (ADHD) disorder: a population-based study. J Child Neurol. 2013;28(1):120-123.
• Hermann B, Jones J, Dabbs K, Allen CA, Sheth R, Fine J, et al. The frequency, complications and aetiology of ADHD in new onset paediatric epilepsy. Brain. 2007;130(Pt 12):3135-3148.
• Salpekar J. Links between epilepsy and ADHD: Time to Focus and Act. Epilepsy Curr. 2018;18(3):160-161.
• Kalilani L, Friesen D, Murray P. Treatment patterns in patients with a new diagnosis of epilepsy and psychiatric comorbidities. Epilepsy Behav. 2019;99:106405.
• Maguire MJ, Marson AG, Nevitt SJ. Antidepressants for people with epilepsy and depression. Cochrane Database Syst Rev. 2021;4(4):CD010682.
• Habibi M, Hart F, Bainbridge J. The impact of psychoactive drugs on seizures and antiepileptic drugs. Curr Neurol Neurosci Rep. 2016;16(8):71.
• Johannessen SI, Landmark CJ. Antiepileptic drug interactions - principles and clinical implications. Curr Neuropharmacol. 2010;8(3):254-267.
• Karaca A, Durna Z. Epilepsi hastasına psikososyal destek. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2018;7(1):218 - 225.
• Johnson RL, Wilson CG. A review of vagus nerve stimulation as a therapeutic intervention. J Inflamm Res. 2018;11:203-213.
• Järvenpää S, Peltola J, Rainesalo S, Leinonen E, Lehtimäki K, Järventausta K. Reversible psychiatric adverse effects related to deep brain stimulation of the anterior thalamus in patients with refractory epilepsy. Epilepsy Behav. 2018;88:373-379.
• Vanya M, Arva-Nagy N, Szili K, Szok D, Bártfai G. Effect of maternal epilepsy and antiepileptic therapy in women during pregnancy.. Ideggyogy Sz. 2015; 68(3-4):105-112.
• Klein A. The postpartum period in women with epilepsy. Neurol Clin. 2012; 30(3):867-875.
• H Bjørk M, Veiby G, A Engelsen B, Gilhus NE. Depression and anxiety during pregnancy and the postpartum period in women with epilepsy: A review of frequency, risks and recommendations for treatment. Seizure. 2015;28:39-45.
• Sivathamboo N, Hitchcock A, Graham J, Sivathamboo S, Chen Z, O'Brien TJ, et al. The use of antidepressant drugs in pregnant women with epilepsy: A study from the Australian Pregnancy Register. Epilepsia. 2018;59(9):1696-1704.
• Bjørk MH, Veiby G, Reiter SC, Berle JØ, Daltveit AK, Spigset O, et al. Depression and anxiety in women with epilepsy during pregnancy and after delivery: a prospective population-based cohort study on frequency, risk factors, medication, and prognosis. Epilepsia. 2015;56(1):28-39.
• Takubo Y, Nemoto T, Watanabe M. Pregnancy and childbirth in women with wpilepsy. Brain Nerve. 2023;75(4):303-306.
• Schmitz B. Effects of antiepileptic drugs on mood and behavior. Epilepsia. 2006;47 Suppl 2:28-33.
• Chen B, Choi H, Hirsch LJ, Katz A, Legge A, Buchsbaum R, et al. Psychiatric and behavioral side effects of antiepileptic drugs in adults with epilepsy. Epilepsy Behav. 2017; 76:24-31.
• Chen B, Detyniecki K, Choi H, Hirsch L, Katz A, Legge A, et al. Psychiatric and behavioral side effects of anti-epileptic drugs in adolescents and children with epilepsy. Eur J Paediatr Neurol. 2017;21(3):441-449.
• Kawai M, Goji H, Kanemoto K. Aggression as psychiatric side effect of newer AEDs in patients with epilepsy: Cross-sectional study based on Buss-Perry Aggression Questionnaire. Epilepsy Behav. 2021;115:107546.
• Steinhoff BJ, Klein P, Klitgaard H, Laloyaux C, Moseley BD, Ricchetti-Masterson K, et al. Behavioral adverse events with brivaracetam, levetiracetam, perampanel, and topiramate: A systematic review. Epilepsy Behav. 2021;118:107939.
• von Wrede R, Meschede C, Brand F, Helmstaedter C. Levetiracetam, perampanel, and the issue of aggression: A self-report study. Epilepsy Behav. 2021;117:107806.
• Hasegawa N, Tohyama J. Differences in levetiracetam and perampanel treatment-related irritability in patients with epilepsy. Epilepsy Behav. 2021;116:107644.
• Kawai M, Goji H, Kanemoto K. Differences in aggression as psychiatric side effect of levetiracetam and perampanel in patients with epilepsy. Epilepsy Behav. 2022;126:108493.
• Chen B, Choi H, Hirsch LJ, Legge A, Buchsbaum R, Detyniecki K. Cross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use. Seizure. 2018;62:38-42.
• Dussaule C, Bouilleret V. Psychiatric effects of antiepileptic drugs in adults. Effets psychiatriques des médicaments antiépileptiques chez l’adulte. Geriatr Psychol Neuropsychiatr Vieil. 2018;16(2):181-188.
• Yapıcı A, Güvenç C, Ceylan ME, Kılınç E, Oğuz N. Epilepsili hastalarda psikiyatrik bozukluklar. Düşünen Adam. 2003;I 6(4):240-248.
• Rukiye Ay. Epilepsy and stigmatization: A review. J Clin Psy. 2017;20(2):129-136.
• Demirci S , Demirci K, Yürekli VA. Personality in epilepsy. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2014;5(1):32-35.
• Görgülü Ü, Fesci H. Epilepsi ile yaşam: Epilepsinin psikososyal etkileri. Göztepe Tıp Dergisi. 2011;26(1):27-32.
• İzci F. Alexithymia, temperament and character traits in patients with epilepsy. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry. 2016;8(1):64-75
• Karaca A, Durna Z. Psychosocial support in epilepsy patient. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2018;7(1):218-225.
• Neze H, Havle N, İlnem MC, Yener FE. Epilepsi tanısı ile takip edilen kişilerde psikiyatrikh ve bunun yaşam kalitesi üzerine etkisi. Yeni Symposium. 2009;(47) 3:147-154.
• Akaçalı A, Aldındağ A, Geyik S, Cansel N. Epilepsi hastalarında yaşam kalitesi, depresyon, anksiyete ve çok boyutlu algılanan sosyal destek. Nöropsikiyatri Arşivi. 2009;46: 91-97.
• Yulaf Y, Gümüştaş F. Çocuk psikiyatrisi polikliniğine başvuran çocuk ve ergenlerde epilepsi varlığında psikiyatrik sorunların cinsiyet ile ilişkisi. Anatolian Journal of Psychiatry. 2019;20(2):204-210.
• Özyurt G, Öztura İ, Alkın T, Özerdem A. Epilepsiye bağlı anksiyete bozukluğu Olgusu. Türk Psikiyatri Dergisi. 2015;26(1):71-75.
• Selek A, Arslan M, Balamtekin N. Epilepsy associated with dysphagia: A case report. The Turkish Journal of Academic Gastroenterology. 2020;19:94-97.
• Güleç ÖD, Yıldız D. Bir yıl süre ile izlenen İnteriktal psikoz tanılı bir olguda aripiprazol kullanımı Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology. 2011;21(3):253-257.
• Erdoğan S, Aslan S, Yüksel N. Levetirasetam kullanımı ile ilişkili psikotik bozukluk: İki Olgu Sunumu. Klinik Psikofarmakoloji Bülteni. 2009;19 (4):420 – 422.
• Sevim EM, Özden SY, Saner S, Türkmenoğlu M. Epilepsiye bağlı psikiyatrik bozukluklara ilişkin iki olgu sunumu. Düşünen Adam. 2001;14(1): 29-32.