Cognitive - behavioral aspects in women with epilepsy

Abstract

Introduction Women with epilepsy are particularly susceptible to anxiety (A), depression (D), acute stress response (ASR) and the development of intellectual disability (ID). It is important to know whether there is a correlation between mental disorders, ID and epilepsy at any stage of the disease, depending on the type of epileptic seizure (ES) and if General Disability (GD) will develop or not. Materials and methods A prognostic cohort study enrolled 128 women with epilepsy, aged 15-49 years. The diagnosis was set according to the International League Against Epilepsy (ILAE), while for the type of ES, the Classification of Epileptic Seizures of 1981, New Deli, was applied. The manifestations of each patient’s ES as well as the socio-demographic data were logged. To assess the presence of A and D, the Hospital Anxiety and Depression Scale (HADS –A, HADS - D) was used. The questionnaire completed by the patients included 7 separate questions for each A and D, the value being assessed according to the Linkert scale. ID, which is included in the group of mental illness by the ICD Classification - 10, was found by the doctor - psychiatrist by applying the Stanford - Binet Intelligence Scale. The Global Assessment of Disability (GAD) was applied to assess the GD. Patients answered the question: "Given the severity of your seizures, how disabled do you consider yourself." Answer: 1. I am not disabled; 2. Little disabled; 3. To a certain extent disabled; 4. Moderate disability; 5. Quite disabled; 6. Very disabled; 7. Extreme disability. Results 2. The type of ES recorded during a year of monitoring: Focal Seizure (FS) - 227: Simple Focal Seizure (SFS) – 121 Complex Focal Seizure (CFS) – 106 Secondary Generalized Seizure (SGS) – 104 Primary Generalized Seizure (PGS) – 51 83% of cases - of focal seizures were associated with D and A. 43% of cases - generalized seizures were associated with D and A. 27% of cases - did not present mental disorders. 6. According to the HADS /D and HADS /A Scales performed, in the examined group were found: 32 women with depression - 25.2%, 80 women with anxiety - 62,5% 7. According to ICD-10 diagnostic criteria: 49 women - 30.9% with acute reactions to stress were identified 8. Stanford - Binet Intelligence Scale applied by the psychiatrist demonstrated the presence of ID in 22 women - 17% Conclusions 1. The ES conditions the occurrence of the mental disorders specified in ICD-10. In women with epilepsy Anxiety occurs more frequently, followed by Depression and Acute Stress Reaction. 2. The GD is not directly proportional to the ES type, frequency and duration of the disease. Self-assessment of the severity of the ES using the GAD scale shows the patient's state of health at that moment 3. Patients with a rural residence, unmaried, with secondary and primary education are more exposed to developing GD 4. ID in women with epilepsy needs to be evaluated with the onset of the first ES in order to determine if ES is not a symptom of evolving ID. 5. Patients with epilepsy are advised to consult a psychiatrist at the beginning of the ES and during the course of the disease.