TY - JOUR
T1 - Ictal fear is associated with anxiety symptoms and interictal dysphoric disorder in drug-resistant mesial temporal lobe epilepsy
AU - Melo, Hiago Murilo
AU - Guarnieri, Ricardo
AU - Vascouto, Helena Dresch
AU - Formolo, Douglas Afonso
AU - de Carvalho, Cristiane Ribeiro
AU - Campos, Wuilker Knoner
AU - Sousa, Daniel Santos
AU - Dionisio, Sasha
AU - Wolf, Peter
AU - Lin, Katia
AU - Walz, Roger
N1 - Funding Information:
This work was supported by PRONEX Program (Programa de Núcleos de Excelência - NENASC Project) of FAPESC - CNPq -MS, Santa Catarina Brazil (process 56802/2010). KL and R.W. are Researchers Fellows from CNPq (Brazilian Council for Scientific and Technologic Development, Brazil). Professor Peter Wolf was a special visitor professor of UFSC (PVE Fellowship–CNPq 307861/2013-9). HMM, HDV and DAF are supported by CAPES/DS scholarship.
Funding Information:
This work was supported by PRONEX Program (Programa de N?cleos de Excel?ncia - NENASC Project) of FAPESC-CNPq-MS, Santa Catarina Brazil (process 56802/2010). KL and R.W. are Researchers Fellows from CNPq (Brazilian Council for Scientific and Technologic Development, Brazil). Professor Peter Wolf was a special visitor professor of UFSC (PVE Fellowship?CNPq 307861/2013-9). HMM, HDV and DAF are supported by CAPES/DS scholarship. We confirm that we gave read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. The research protocol was approved by the Ethics Committee for Human Research of Universidade Federal de Santa Catarina (365-FR304969). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The authors have no conflict of interest, source of funding or financial ties to disclose and no current or past relationship with companies or manufacturers who could benefit from the results of the present study.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/2
Y1 - 2021/2
N2 - Interictal dysphoric disorder (IDD) is a poorly understood psychiatric disorder of epilepsy patients. Interictal dysphoric disorder is characterized by depressive, somatoform, and affective symptoms observed in up to 5.9% of drug-resistant mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). This study aimed to evaluate the association between ictal fear (IF) and the psychiatric symptoms and diagnosis in MTLE-HS patients. We included 116 (54.3% male) consecutive adult patients (36 ± 11 years) with MTLE-HS. Anxiety and depression symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS) and the psychiatric diagnosis were according to Fourth Edition of the Diagnosis and Statistical Manual of Mental Disorders (DSM-IV). The independent association between the occurrence of IF aura and the psychiatric diagnosis was determined by binary regression. When compared to those with other auras or without aura, patients reporting IF have higher HADS anxiety, but not HADS depression, scores. Ictal fear was independently associated with the diagnosis of interictal dysphoric disorder (OR, IC 95% = 7.6, 1.3–43.2, p = 0.02), but not with the diagnosis of anxiety (OR, CI 95% = 0.72, 0.08–6.0, p = 0.73), depression (OR, CI 95% = 0.94, 0.19–4.8, p = 0.94) or psychotic disorders (p = 0.99). Only patients with drug-resistant MTLE-HS were included and the small number of cases with DD diagnosis in the sample. In MTLE-HS patients, the occurrence of IF is associated with higher levels of anxiety symptoms and IDD. The results provide insights about fear-related neural network connections with anxiety symptoms and the IDD in MTLE-HS.
AB - Interictal dysphoric disorder (IDD) is a poorly understood psychiatric disorder of epilepsy patients. Interictal dysphoric disorder is characterized by depressive, somatoform, and affective symptoms observed in up to 5.9% of drug-resistant mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). This study aimed to evaluate the association between ictal fear (IF) and the psychiatric symptoms and diagnosis in MTLE-HS patients. We included 116 (54.3% male) consecutive adult patients (36 ± 11 years) with MTLE-HS. Anxiety and depression symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS) and the psychiatric diagnosis were according to Fourth Edition of the Diagnosis and Statistical Manual of Mental Disorders (DSM-IV). The independent association between the occurrence of IF aura and the psychiatric diagnosis was determined by binary regression. When compared to those with other auras or without aura, patients reporting IF have higher HADS anxiety, but not HADS depression, scores. Ictal fear was independently associated with the diagnosis of interictal dysphoric disorder (OR, IC 95% = 7.6, 1.3–43.2, p = 0.02), but not with the diagnosis of anxiety (OR, CI 95% = 0.72, 0.08–6.0, p = 0.73), depression (OR, CI 95% = 0.94, 0.19–4.8, p = 0.94) or psychotic disorders (p = 0.99). Only patients with drug-resistant MTLE-HS were included and the small number of cases with DD diagnosis in the sample. In MTLE-HS patients, the occurrence of IF is associated with higher levels of anxiety symptoms and IDD. The results provide insights about fear-related neural network connections with anxiety symptoms and the IDD in MTLE-HS.
KW - Anxiety
KW - Depression
KW - Ictal fear
KW - Interictal dysphoric disorder
KW - Temporal lobe epilepsy
UR - http://www.scopus.com/inward/record.url?scp=85097888214&partnerID=8YFLogxK
U2 - 10.1016/j.yebeh.2020.107548
DO - 10.1016/j.yebeh.2020.107548
M3 - Journal article
C2 - 33348195
AN - SCOPUS:85097888214
SN - 1525-5050
VL - 115
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
M1 - 107548
ER -