Anxiety And Depression In The General Population

The general psychiatric literature provides additional insight and findings related to the discussion of depression, anxiety and the co-occurrence of the two disorders. As clinicians and researchers in epilepsy, we can utilize the knowledge gleaned from the general population about depression and anxiety in order to gain an understanding of the similarities and differences in the presentation of these disorders in epilepsy. Based on the National Comorbidity Survey-Replication in the United...

Disorder

Kronenberger Children with epilepsy have substantially more problems with behavior and difficulties with school performance than siblings or normal population controls. Problems with attention and attention deficit hyperactivity disorder (ADHD) are found consistently in the evaluation of both emotional troubles and academic delays. In this chapter there are two primary questions. Is ADHD in epilepsy the expression of a neurological disorder Is ADHD in epilepsy...

Which Type Of Epileptic Psychosis Should Be Compared With Which Primary Psychotic Disorder

With regard to the wide-ranging clinical manifestations of epileptic psychoses and primary psychotic disorders, it is important, first of all, to determine which should be compared. Table 8.1 demonstrates the incidence of subcategories of psychosis occurring in patients with epilepsy who visited the Kansai Regional Epilepsy Center from 1983 to 1999 (Kanemoto et al, 2001), definitions of which are listed in Table 8.2. Chronic epileptic psychosis (CP), acute interictal psychosis (AIP), and...

Seesaw Phenomenon In Epilepsy

With good reason, most contemporary physicians specializing in epilepsy may well wonder why this disease used to be regarded as one of the major psychoses along with mood disorders and schizophrenia. According to population-based studies (Krohn, 1961 Helgason, 1964 Gudmundsson, 1966 Zielinski, 1974 Jalava and Sillanpaa, 1996 Bredkjaer et al. 1998 Qin et al. 2005), the incidence of psychosis among patients with epilepsy ranges from 2 to 6 at most. Further, in our prospective study (Tadokoro et...

The Psychoses of Epilepsy a Neurological Disease

Seethalakshmi A close association between psychoses and epilepsy has been known since 1854 confirmed by the fact that the early mental hospitals in Europe had special wards dedicated to epilepsy. The early proponents of psychosis of epilepsy (POE) included Kraepelin (1918) who believed that the dementia resulting from epilepsy was different from dementia praecox or schizophrenia. This was further affirmed by Vorkastner (1918) and Krapf (1928) who clarified that...

Pharmacologic And Psychotherapeutic Treatments For Depression And Anxiety

According to the World Health Organization, by 2020 major depression will be the second leading cause of disability with cardiovascular disease as the leading cause (Michaud et al., 2001). In an editorial, Evans and Charney (2003) stated if an individual has a chronic condition and is depressed there was a poorer prognosis and even increased morbidity and mortality than from the medical diagnosis alone. Additively, co-occurring depression and anxiety is related to poorer prognosis, increased...

Epilepsy training models

Epilepsy teaching starts in medical school, where students learn about ictal physiology and pathology, seizure semiology, and diagnostic and treatment methods. After medical school, psychiatry residents further advance their medical neurologic knowledge about this disorder through encounters with patients during their medical internship and neurology rotation. Formal epilepsy training for psychiatrists often stops here, as they continue with the general psychiatric education. Perhaps the most...

Shared Structural And Neuropathological Abnormalities In Depression And Epilepsy

Common structural and functional abnormalities of overlapping neuroanatomic regions have been observed in primary depression and in epileptic disorders associated with comorbid depression Kanner and Balabanov, 2002 . Structural changes have been identified in the amygdala, hippocampus, and entorhinal cortex temporal lateral neocortex prefrontal, orbitofrontal, and mesial frontal cortex and to a lesser degree, the thalamic nuclei and basal ganglia. In review of the data relevant to volumetric...

Anxiety

The lifetime prevalence of anxiety disorder in the general population in large epidemiological studies ranges from 1.9 to 5.1 Weissman and Merikangas, 1986 Wittchen et al. 1994 Hunt et al. 2002 Wittchen, 2002 Wober-Bingol et al. 2004 Lieb et al. 2005 . The prevalence of anxiety disorders in people with epilepsy in general population studies using ICD and DSM-IV case ascertainment ranges from 11 to 15 . Gaitatzis et al. 2004b obtained a point prevalence of 11.1 in the National Practice Study,...

Concluding Remarks Plural Epileptic Psychoses Should Be Understood Under Plural Hypotheses

Does the psychosis of epilepsy differ from a primary psychotic disorder Historically, several answers have been presented. As we discussed in the preceding sections, variations of the answer in the negative may be summarized as follows the coexistence of the two conditions in a single individual is only accidental epilepsy increases the vulnerability to a primary psychotic disorder and the two conditions develop from a common etiological factor, but independently. Since Slaters report 40 years...

Illicit and abused drugs

In a US national household survey on drug abuse NHSDA performed in 1994, 10 of people older than 12 years reported non-medical use of prescription drugs, 38 had used an illicit drug, and 85 had drunk an alcoholic beverage in their lifetime Rouse, 1996 . Little systematic information exists in this regard in patients with epilepsy Devinsky, 2003 . One of the current debates pertains to the therapeutic use of marijuana in patients with seizures. A survey performed in a tertiary center in Canada...

Introduction

Epilepsy is the third most common neurological disorder in adults after Alzheimer's disease and stroke. In North America, the overall prevalence of epilepsy in adults is about 5 10 per 1,000 Theodore et al., 2006 . In pediatrics, epilepsy is the most common neurologic disorder, affecting up to 1 of children under the age of16 Shinnar and Pellock, 2002 . Over the past 20 years, population-based longitudinal epidemio-logical research studies have convincingly demonstrated that epilepsy has a...

The interictal dysphoric disorder

Parietal Lobe

Kraepelin 1923 and then Bleuler 1949 , were the first authors to describe in epilepsy a pleomorphic pattern of symptoms, including affective symptoms with prominent irritability intermixed with euphoric mood, fear, anxiety as well as anergia, pain and insomnia. Gastaut et al. 1955 confirmed Kraepelin s and Bleulers observations, leading Blumer to coin the term interictal dysphoric disorder IDD to refer to this type of depressive disorder in epilepsy Blumer, 2000 . Blumers description of the IDD...

References

P. , Arzimangolou , A. , Reijs , R., Mil , S. V 2006 . Optimizing therapy of seizures in children and adolescents with ADHD , Neurology 67 , S49 S51 , Anhoury S. Brown R. J. Krishnamoorthy E. S. Trimble M. R. 2000 . Psychiatric outcome after temporal lobectomy a predictive study . Epilepsia 41 1608 1615 . Annual report of the American Epilepsy Society accessed May 22, 2007 , http www.aesnet. org Members documents . Beyenburg S. Mitchell A. Schmidt D. Elger C. Reuber M. 2005 ....

What Training Is Available For Neurologists Or Epileptologists In Evaluation And Treatment Of Psychiatric Disorders

Medical school students generally have basic science and clinical exposures in both neurology and psychiatry. A psychiatry clerkship is mandated at most medical schools, while the neurology clerkship is more variable, ranging from no mandatory exposure to 2 4 weeks of neurology, and sometimes including combined time in neurology and psychiatry or neurosurgery. The core curriculum for these clerkships certainly includes some multidisciplinary education, but the level of sophistication of the...

The Problem Of Depression Diagnosis In Epilepsy

To conclude, a definite diagnosis of depression in patients with epilepsy can be difficult because a number of symptoms, which are recognized as diagnostic criteria for a depressive episode by the ICD-10 and DSM-IV, may occur in epilepsy secondary to seizure activity or AED treatment e.g., loss of energy, insomnia or hypersomnia, increase or decrease in appetite, loss of libido, psychomotor agitation or retardation, diminished ability to think or concentrate . Because these symptoms may be...

Neuroanatomic Imaging Studies In Depression And Anxiety

In structural magnetic resonance imaging MRI studies of depression, it is reported that there is decreased brain volume in the frontal cortex, hippocampus, striatum, and limbic areas like the subgenual cingulate cortex Bremner et al, 2000 Bremner, 2002 Bremner et al, 2002 Anand and Shekhar, 2003 . Typically, total brain volume is not significantly decreased. Functional studies in depression, including functional MRI fMRI , single-photon emission-computed tomography SPECT , and positron emission...

Common Pathogenic Mechanisms In Depression Anxiety And Epilepsy

There are common pathogenic mechanisms shared by depression, anxiety, and epilepsy. Serotonin 5HT , NE, dopamine, GABA, and glutamate are likely involved in the expression of all three disorders Jobe et al., 1999 , Ressler and Nemeroff 2000 . In depression and anxiety, changes in the noradrenergic and serotoner-gic systems are implicated as playing a significant role in the expression of these disorders. There appears to be increased noradrenergic activity, contrasting with decreased activity...

Shared Functional Neuroimaging Abnormalities In Depression And Epilepsy

Hippocampus Tra Mri

Utilizing various imaging techniques, functional abnormalities in both epilepsy and depression have been identified in common subcortical structures, as well as similar regions of the frontal and temporal lobes. Frontal lobe involvement in primary depression has been demonstrated with functional neuroimaging and neuropsychological studies Baxter et al., 1989 . Frontal lobe associated executive dysfunction has been consistently shown in studies on depressive illness. Abnormalities on...

Psychotherapeutic Interventions

There are a number of psychotherapeutic treatments that have been demonstrated to be efficacious for anxiety and depression. Psychotherapy appears to be more effective than placebo, and it is often comparable to pharmacotherapy Michels, 1997 . Empirical studies of cognitive-behavioral therapy CBT have increased over the past 15 years with a growing body of evidence indicating their utility and efficacy in the management of depression and anxiety. CBT has been recommended as a first line...