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, using ICD coded data. Tellez-Zenteno et al. (2005) reported a lifetime prevalence of 12.8% in a Canadian general population study using structured psychiatric interviews (Composite International Diagnostic Interview (CIDI)). Edeh reported a point prevalence of 15% in a register of patients with epilepsy from general practitioners in the United Kingdom. Strine et al. (2005) reported a point prevalence of 14.4% from a health survey where anxiety was ascertained with the Kessler 6 scale. On the other hand, studies using self-reported methods report higher prevalence rates, for example, 39% in Kobau et al.'s (2006) study.
Devinsky et al. (2005) studied 360 patients with refractory epilepsy before temporal lobe surgery. Using the Beck Anxiety Inventory and the CIDI the rate of anxiety disorders was 24.7%. This study followed patients up to 24 months and the postoperative rates of anxiety and depression improved after surgery. In Manchanda et al.'s (1996) study of 300 consecutive candidates for epilepsy surgery, 10.7% fulfilled DSM-IV criteria for anxiety disorders. A small pediatric study of epilepsy from outpatient clinics found depression in 16% of patients using the Revised Childrens Manifest Scale (Ettinger et al., 1998). Another pediatric study evaluated the prevalence of anxiety in 171 patients with epilepsy compared with 93 healthy children; the rates were 33% vs. 6%, respectively (Caplan et al., 2005). Finally, the rate of anxiety disorders among patients with intractable epilepsy seems higher in those with temporal lobe epilepsy (23%) than in those with extratemporal epilepsy (18%), and surgery did not seem to lower the rates substantially in either (24% and 17%, respectively) (Wrench et al., 2004).
The prevalence of anxiety disorders in epilepsy follows the pattern seen in other psychiatric comorbidities. It is higher in selected populations of intractable epilepsy (twofold higher than in non-selected epilepsy populations). Interestingly the overall rates of depression and anxiety are not modified in patients with intractable epilepsy that underwent epilepsy surgery.
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