Mula, M; Borghs, S; Ferro, B; Zaccara, G; Dainese, F; Ferlazzo, E; Romigi, A; Gambardella, A; Perucca, E
(2024)
Effect of drug treatment changes and seizure outcomes on depression and suicidality in adults with drug-resistant focal epilepsy.
Epilepsia, 65 (2).
pp. 473-482.
ISSN 1528-1167
https://doi.org/10.1111/epi.17856
SGUL Authors: Mula, Marco
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Abstract
OBJECTIVE: To investigate changes in depressive and suicidality status and their relationship with seizure outcomes after addition or substitution of another antiseizure medication (ASM) in adults with drug-resistant focal epilepsy. METHODS: 770 consecutively enrolled patients were assessed and followed prospectively for seizure outcome and depressive status over a 6-month period after starting treatment with a newly introduced ASM. The Neurological Disorders Depression Inventory for Epilepsy (NDDIE) was used to screen for depression and suicidality. Correlations of NDDIE results with clinical and treatment-related variables were assessed by using a stepwise logistic regression model. RESULTS: At baseline, 50.0% of patients had a positive screening test result for depression and 13.0% had a positive screening test result for suicidal ideation. A psychiatric comorbidity at baseline was associated with a 2.3 times increased risk of an initially negative NDDIE screening result becoming positive at re-assessment after 6 months. Number of ASMs taken at baseline also correlated with an increased risk of a change in depression screening test results from negative to positive during follow-up, whereas no association was identified with sociodemographic and epilepsy-related variables, including seizure outcomes. Approximately 6% of patients initially negative at screening for suicidal ideation became positive at the 6-month re-assessment. The risk of switch from a negative to a positive screening test result for suicidal ideation was increased more than two-fold in individuals who screened positive for depression at baseline, and was unrelated to type of ASM introduced, sociodemographic variables or seizure outcomes. SIGNIFICANCE: Almost 1 in 5 adults with drug resistant focal epilepsy who screen negative for depression become positive when re-assessed 6 months after a treatment change. 6.1% who screen initially negative for passive suicidal ideation become positive at re-assessment 6 months later. These changes in screening status are independent of type of ASM introduced or seizure outcomes, but correlate with psychiatric status at baseline.
Item Type: | Article | ||||||||
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Additional Information: | This is the peer reviewed version of the following article: Mula M, Borghs S, Ferro B, Zaccara G, Dainese F, Ferlazzo E, et al. Effect of drug treatment changes and seizure outcomes on depression and suicidality in adults with drug-resistant focal epilepsy. Epilepsia. 2024; 65: 473–482, which has been published in final form at https://doi.org/10.1111/epi.17856. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. | ||||||||
Keywords: | NDDI-E, antiseizure medications, depression, epilepsy, outcome, suicidality, treatment, 1103 Clinical Sciences, 1109 Neurosciences, Neurology & Neurosurgery | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Institute of Medical & Biomedical Education (IMBE) Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE ) |
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Journal or Publication Title: | Epilepsia | ||||||||
ISSN: | 1528-1167 | ||||||||
Language: | eng | ||||||||
Dates: |
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Publisher License: | Publisher's own licence | ||||||||
PubMed ID: | 38073337 | ||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/115933 | ||||||||
Publisher's version: | https://doi.org/10.1111/epi.17856 |
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