Epilepsi Hastalarında Bilişsel İşlevlerin Anksiyete ve Depresyon ile Olan İlişkisi

Yıl 2024, Cilt: 19 Sayı: 1, 103 - 108, 28.03.2024

Muhammet Yusuf Uslusoy , Deniz Tuncel , Hamza Şahin , Ayşegül Erdoğan

https://doi.org/10.17517/ksutfd.1231346

Öz

Amaç: Bu çalışmada epilepsi hastalarında bilişsel işlevlerin anksiyete ve depresyon ile olan ilişkisinin araştırılması amaçlandı.
Gereç ve Yöntemler: Çalışmaya, Mart 2021-Aralık 2021 tarihleri arasında nöroloji polikliniğine başvuran 43 epilepsi hastası ve 59 sağlıklı gönüllü olmak üzere toplam 102 kişi dahil edildi. Her iki gruba Beck Depresyon Ölçeği (BDÖ), Beck Anksiyete Ölçeği (BAÖ) ve Montreal Bilişsel Değerlendirme Ölçeği (MoCA) uygulandı.
Bulgular: Çalışmamızda hasta grubunda orta-şiddetli depresyon oranı %44.2; anksiyete oranı %53.4 olarak tespit edildi. Buna ek olarak epilepsi hastalarında MoCA puanlarının anlamlı olarak kontrol grubundan daha düşük olduğu da izlendi (p<0.001). Korelasyon analizinde ise hastaların BDÖ ile MoCA puanları arasında negatif yönde, zayıf ve anlamlı bir ilişki saptandı (p= 0.012). Bununla birlikte hastaların BAÖ ile MoCA puanları arasında anlamlı korelasyon izlenmedi (p= 0.097).
Sonuç: Bu çalışmaya göre bilişsel işlev bozukluğu, psikiyatrik komorbiditeler ve epilepsi arasında karmaşık bir ilişki olduğu söylenebilir.

Anahtar Kelimeler

Montreal Bilişsel Değerlendirme Ölçeği, anti-epileptik ilaç, nöbet, eğitim düzeyi, Montreal Cognitive Assessment Scale, anti-epileptic drug, seizure, education level

The Relationship of Cognitive Functions with Anxiety and Depression in Epilepsy Patients

Öz

Objectives: In this study, it was aimed to investigate the relationship between cognitive functions and anxiety and depression in epilepsy patients.
Materials-methods: A total of 102 people (43 epilepsy patients and 59 healthy volunteers), who applied to the neurology outpatient clinic between March 2021 and December 2021, were included in the study. Beck Depression Scale (BDS), Beck Anxiety Scale (BAS), and Montreal Cognitive Assessment Scale (MoCA) were performed on both groups.
Results: In our study, the rate of moderate to severe depression in the patient group was 44.2%; anxiety rate was found 53.4%. In addition, it was observed that the MoCA scores of epilepsy patients were significantly lower than the control group (p<0.001). In the correlation analysis, a negative, weak and significant relationship was found between the BDI and the MoCA total score (p= 0.012). However, no significant relationship was observed between the BAI and the MoCA total score (p= 0.097).
Conclusions: According to this study, it can be said that there is a complex relationship between cognitive dysfunction, psychiatric comorbidities, and epilepsy.

Anahtar Kelimeler

Montreal Cognitive Assessment Scale, anti-epileptic drug, seizure, education level

Kaynakça

• Beghi E, Beghi M. Epilepsy, antiepileptic drugs and dementia. Curr Opin Neurol. 2020;33(2):191-7.
• Wang L, Chen S, Liu C, Lin W, Huang H. Factors for cognitive impairment in adult epileptic patients. Brain Behav. 2020;10(1):e01475.
• Błaszczyk B, Czuczwar SJ. Epilepsy coexisting with depression. Pharmacol Rep. 2016;68(5):1084-92.
• Hingray C, McGonigal A, Kotwas I, Micoulaud-Franchi JA. The Relationship Between Epilepsy and Anxiety Disorders. Curr Psychiatry Rep. 2019;21(6):40.
• Munger Clary HM. Anxiety and epilepsy: what neurologists and epileptologists should know. Curr Neurol Neurosci Rep. 2014;14(5):445.
• Tedrus GM, Negreiros LM, Ballarim RS, Marques TA, Fonseca LC. Correlations Between Cognitive Aspects and Quantitative EEG in Adults With Epilepsy. Clin EEG Neurosci. 2019;50(5):348-53.
• Helmstaedter C, Witt JA. Epilepsy and cognition - A bidirectional relationship? Seizure. 2017;49:83-9.
• Ogundare T, Adebowale TO, Borba CPC, Henderson DC. Correlates of depression and quality of life among patients with epilepsy in Nigeria. Epilepsy Res. 2020;164:106344.
• Ulusoy M, hisli sahin N, Erkmen H. Turkish Version of the Beck Anxiety Inventory: Psychometric Properties. Journal of Cognitive Psychotherapy: An International Quarterly. 1998;12.
• Hisli N. Beck Depresyon Envanterinin Üniversite Öğrencileri Için Geçerliği, Güvenirliği. Türk Psikoloji Dergisi. 1989;7(23):3-13.
• 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):103-9.
• Husari KS, Dubey D. Autoimmune Epilepsy. Neurotherapeutics. 2019;16(3):685-702. doi: 10.1007/s13311-019-00750-3.
• Bosak M, Dudek D, Siwek M. Depresja u chorych z padaczka [Depression in patients with epilepsy]. Psychiatr Pol. 2012;46(5):891-902.
• Kwon OY, Park SP. Frequency of affective symptoms and their psychosocial impact in Korean people with epilepsy: a survey at two tertiary care hospitals. Epilepsy Behav. 2013;26(1):51-6.
• Montaño-Lozada JM, López N, Espejo-Zapata LM, Soto-Añari M, Ramos-Henderson M, Caldichoury-Obando N, et al. Cognitive changes in patients with epilepsy identified through the MoCA test during neurology outpatient consultation. Epilepsy Behav. 2021;122:108158.
• Baxendale S. Neuropsychological assessment in epilepsy. Pract Neurol. 2018;18(1):43-8.
• 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):412-9.
• Piazzini A, Canevini MP, Turner K, Chifari R, Canger R. Elderly people and epilepsy: cognitive function. Epilepsia. 2006;47 Suppl 5:82-4.
• Piazzini A, Turner K, Chifari R, Morabito A, Canger R, Canevini MP. Attention and psychomotor speed decline in patients with temporal lobe epilepsy: a longitudinal study. Epilepsy Res. 2006;72(2-3):89-96.
• Taylor J, Baker GA. Newly diagnosed epilepsy: cognitive outcome at 5 years. Epilepsy Behav. 2010;18(4):397-403.