Psychiatric disorders in temporal lobe epilepsy: An overview from a tertiary service in Brazil

详细信息    查看全文

• 作者：Guilherme Nogueira M. de Oliveira ; Arthur Kummer ; Joã ; o Viní ; cius Salgado ; Eduardo Jardel Portela ; Sí ; lvio Roberto Sousa-Pereira ; Anthony S. David ; Antô ; nio Lú ; cio Teixeira
• 关键词：Temporal lobe epilepsy ; Mesial temporal sclerosis ; Psychiatric disorders ; Depression ; Anxiety
• 刊名：Seizure
• 出版年：2010
• 出版时间：October 2010
• 年：2010
• 卷：19
• 期：8
• 页码：479-484
• 全文大小：143 K

文摘

Purpose

To evaluate the frequency and intensity of psychiatric disorders in a group of temporal lobe epilepsy (TLE) patients from a tertiary-care center.

Methods

Clinical and sociodemographic data of 73 patients were collected and a neuropsychiatric evaluation was performed with the following instruments: Mini-Mental State Examination (MMSE), structured clinical interview (MINI-PLUS), Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D), Brief Psychiatric Rating Scale (BPRS).

Results

Patients with TLE showed a high frequency of lifetime psychiatric disorders (70 % ), the most frequent being mood disorders (49.3 % ). At assessment, 27.4 % of the patients were depressed and 9.6 % met criteria for bipolar disorder. Nevertheless, depression had not been properly diagnosed nor treated. Anxiety disorders were also frequent (42.5 % ), mainly generalized anxiety disorder (GAD) (21.9 % ). Obsessive compulsive disorder (OCD) was present in 11.0 % and psychotic disorders in 5.5 % of the sample. Patients with left mesial temporal sclerosis (LMTS) exhibited more psychopathologic features, mainly anxiety disorders (p = 0.006), and scored higher on HAM-A and HAM-D (p < 0.05 in both).

Conclusion

TLE is related to a high frequency of psychiatric disorders, such as anxiety and depression, which are usually underdiagnosed and undertreated. Damage to the left mesial temporal lobe, seen in LMTS, seems to be an important pathogenic lesion linked to a broad range of psychopathological features in TLE, mainly anxiety disorders. The present study prompts discussion on the recognition of the common psychiatric disorders in TLE, especially on the Brazilian setting.