THE STRUCTURE OF THE NON-PSYCHOTIC MENTAL (PSYCHIATRIC) DISORDERS IN PATIENTS WITH EPILEPSY WITH DIFFERENT VARIANTS OF THE DISEASE
Abstract
Mental disorders persistent identified in patients with epilepsy as significant personal and affective disorders, especially depressive and anxiety spectrum observed in the interictal period of the disease.
Purpose. Study the frequency of nonpsychotic mental disorders in patients with epilepsy; highlight the clinical features of non-psychotic affective disorders and to analyze the relationship of different variants affective disorders with symptoms of pharmacological resistance.
Material and methods. The study involved 160 patients with epilepsy: 80 patients with drug-resistant epilepsy (DRE), 80 patients with controlled epilepsy using a battery of psychometric scales.
Results. The variety of depressive and anxious psychiatric condition detected in 59.4% of patients with epilepsy, in 86.3% of patients with DRE, in 32.5% – with controlled epilepsy. Clinical and psychopathological analysis of non-psychotic mental disorders showed that in patients with DRE have statistically more frequent affective disorders, also a great “brutality”, “structural complexity” and the depth of depressive and anxiety disorders than in patients controlled epilepsy. We established that patients with affective symptoms have earlier onset and a longer course of disease.
Conclusion. The therapeutic resistance of patients with epilepsy accompanied by the presence of various non-psychotic affective mental disorders represented, mainly, depressive and anxiety psychopathological conditions. In terms of clinical and psychopathological a characteristics they are close to an endogenous affective mental disorders and, essentially, represent their “organic model.”
About the Authors
N. A. Sivakova
St. Petersburg V.M. Bekhterev Psychoneurological Research Institute
Russian Federation
Russian Federation
PhD, Researcher of the Department of treatment of patients with organic mental disorders and epilepsy,
ul. Bekhtereva, 3, St. Petersburg, 192019
A. P. Kotsubinskyi
St. Petersburg V.M. Bekhterev Psychoneurological Research Institute
Russian Federation
Russian Federation
PhD, ScD, Professor, Principal Researcher, Head of biopsychosocial rehabilitation of the mentally ill,
ul. Bekhtereva, 3, St. Petersburg, 192019
L. V. Lipatova
St. Petersburg V.M. Bekhterev Psychoneurological Research Institute
Russian Federation
Russian Federation
PhD, ScD, Principal Researcher, Head of the Department of treatment of patients with organic mental disorders and epilepsy,
ul. Bekhtereva, 3, St. Petersburg, 192019
References
1. Avedisova A.S. New problems psychopharmacotherapy [Novye problemy psikhofarmakoterapii (in Russian)]. Moscow. 2005; 170 s.
2. Belousov Yu.B., Belousov D. Yu., Chikina E.S., Mednikov O. I. Kachestvennaya klinicheskaya praktika. 2004; 4 (special issue): 89 s.
3. Boldyrev A. I. epilepsy in adults [Epilepsiya u vzroslykh (in Russian)]. Moscow. 1971; 368 s.
4. Brodi M. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2005; 10: 62-68.
5. Vasserman L. I. Sovremennaya psikhiatriya. 1998; 1 (5): 38-41.
6. Vasserman L. I., Mikhailov V.A., Romitsyna E. E., Flerova I. L. Psychological mechanisms of adaptation to the disease and quality of life of patients with epilepsy. Quality of life in psychoneurology: Abstracts of the International Conference [Psikhologicheskie mekhanizmy adaptatsii k bolezni i kachestvo zhizni bol’nykh epilepsiei. Kachestvo zhizni v psikhonevrologii: tezisy dokladov mezhdunarodnoi konferentsii (in Russian)]. Sankt-Peterburg, 4-6 dekabrya 2000 g.; 38-40.
7. Vasserman L. I. The structure and mechanisms of disorders of mental functions and personality in patients with focal epilepsy. MD diss. [Struktura i mekhanizmy narushenii psikhicheskikh funktsii i lichnosti u bol’nykh fokal’noi epilepsiei: avtoref. dis. …dokt. med. nauk (in Russian)]. Leningrad. 1989; 48 s.
8. Gleizer M.A., Karlov V.A. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 1988; 88 (6): 11-14.
9. Gromov S.A., Lipatova L.V. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2001; 101 (7): 22-26.
10. Dokukina T.V., Golubeva T.S., Matveichuk I.V., Mahrov M.V., Loseva V.M., Krupenkina E.V., Marchuk S.A. Epidemiologic research on epilepsy in Minsk. PHARMACOECONOMICS. Modern pharmacoeconomics and pharmacoepidemiology. 2014; 7 (2): 33-37 (In Russian).
11. Kalinin V.V. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2004; 104 (2): 64-73.
12. Kalinin V.V. Nevrologiya, neiropsikhiatriya, psikhosomatika. 2013; 2: 78-83.
13. Kalinin V.V., Polyanskii D.A. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2003; 103 (3): 18-21.
14. Kalinin V.V., Zheleznova E.V., Zemlyanaya A.A. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2006; pril 1 (Epilepsiya): 64-70.
15. Karlov V.A. Tolerance and drug-resistant epilepsy. Epilepsy. Ed. NG Neznanov [Farmakorezistentnost’ i tolerantnost’ pri epilepsii. Epilepsiya. Pod red. N.G. Neznanova (in Russian)]. SPb. 2010; 26 (III): 730-741.
16. Kissin M. Ya. Clinical Epileptology [Klinicheskaya epileptologiya (in Russian)]. Moscow. 2011.
17. Kissin M. Ya., Anan’eva N.I., Shmeleva L.M., Ezhova R.V. Obozrenie psikhiatrii i med. psikhologii im. V.M. Bekhtereva. 2012; 2: 11-17.
18. Kotsyubinskii A.P. Autokhtonnye nepsikhoticheskie rasstroistva. SPb. 2015; 495 s.
19. Kotsyubinskii A.P. Sheinina N.S., Aristova T.A., Burkovskii G.V., Butoma B.G. Obozrenie psikhiatrii i med. psikhologii. 2011; 1: 4-8.
20. Lipatova L.V. Medical and social aspects of the risk of life-threatening complications in patients with epilepsy. PhD diss. [Medikosotsial’nye aspekty riska oslozhnenii zhizni u bol’nykh epilepsiei. Dis. …kand. med. nauk (in Russian)]. SPb. 1999; 191 s.
21. Mazina N.K., Mazin P.V., Kislitsin Y.V., Markova E.M. Pharmacoeconomic evaluation of rufinamide use for the LennoxGastaut syndrome treatment. PHARMACOECONOMICS. Modern pharmacoeconomics and pharmacoepidemiology. 2016; 9 (1): 15-22 (In Russian). DOI:10.17749/2070-4909.2016.9.1.015-022.
22. Mkrtchyan V.R., Sergeev A.M., Pochigaeva K. I., Shpak I.A. Budget impact analysis of perampanel for adjunctive treatment in epilepsy patients 12 years of age and older for partial onset seizures with or without secondary generalization and primary generalized tonic-clonic seizures in the Russian Federation. PHARMACOECONOMICS. Modern pharmacoeconomics and pharmacoepidemiology. 2016; 9 (2): 28-37 (In Russian). DOI:10.17749/2070-4909.2016.9.2.028-037.
23. Mukhin K. Yu., Petrukhin A.S. Idiopathic epilepsy [Idiopaticheskie formy epilepsii (in Russian)]. Moscow. 2000; 319 s.
24. Mukhin K. Yu., Petrukhin A.S., Stryuk G.V., Alikhanov A.A. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 1998; 98 (10): 50-52.
25. Pyadushkina E.A., Frolov M.Y. Clinical and economic evaluation of lacosamide in patients with partial epilepsy. PHARMACOECONOMICS. Modern pharmacoeconomics and pharmacoepidemiology. 2016; 9 (3): 38-47. (In Russian). DOI:10.17749/2070-4909.2016.9.3.038-047.
26. Rudenko A.M., Kotov A.S. Depressive disorders in patients with epilepsy [Depressivnye rasstroistva u bol’nykh epilepsiei (in Russian)]. Moscow. 2008.
27. Sivakova N.A. Optimize and diagnosis of patients with drug-resistant epilepsy and non-psychotic mental disorders. PhD diss. [Optimizatsiya i diagnostika lecheniya bol’nykh s farmakorezistentnoi epilepsiei i nepsikhoticheskimi psikhicheskimi rasstroistvami. Avtoref. dis. … kand. med. nauk (in Russian)]. SPb. 2015.
28. Yatsuk S. L. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 1988; 88 (6): 42-45.
29. Angst J., Woggon B., Schoepf J. The treatment of depression with l-5-hydroxytryptophan versus imipramine. Arch. für Psychiatrie und Nervenkrankheiten. 1977; 224 (2): 175-186.
30. Ettinger A., Reed M., Cramer J. Depression and comorbidity in community-based patients with epilepsy or asthma. Neurology. 2004; 63: 1008-1014.
31. Friedlander A.H., Cummings L. Temporal lobe epilepsy: its association with psychiatric impairment and appropriate dental management. Oral Surg. Oral Med. Oral Pathol. 1989; 68 (3): 288-292.
32. Kalinin V.V. Suicidality and antiepileptic drugs. Is there a link? Drug Saf. 2007; 30 (2): 123-42.
33. Kalinin V.V., Polyanskiy D.A. Focus laterality and interictal psychiatric disorder in temporal lobe epilepsy. Seizure. 2009; 18 (3): 176-79.
34. Kalvianen R., Salmenpera T., Partanen K. et al. Recurrent seizures may cause hippocampal damage in temporal lobe epilepsy. Neurology. 1998; 50: 1377-82.
35. Kanemoto K. Postictal psychoses, revised. In: The neuropsychiatry of epilepsy. M. Trimble, B. Schmitz (eds). Cambridge, 2002; 117-31.
36. Kobau R.G.F., Thurman D. J. Prevalence of self-reported epilepsy or seizure disorder and its associations with self-reported depression and anxiety: results from the 2004 Health Styles Survey. Epilepsia. 2006; 47: 1915-1921.
37. Kwan P., Brodie M. J. Early identification of refractory epilepsy. New Engl. J. Med. 2000; 342: 314-319.
38. Leach M. J., Randall A.D., Stefani A. et al. Lamotrigine. Mechanisms of action. In: Antiepileptic Drugs. 5th ed. R.H. Levy, R.H. Mattson, B. Meldrun, E. Perucca (eds). Philadelphia. 2002; 363-69.
39. Lehrner J., Kalchmayr R., Serles W. et al. Health-related quality of life (HRQOL), activity of daily living (ADL) and depressive mood disorder in temporal lobe epilepsy patients. Seizure. 1999; 8 (2): 88-92.
40. Mohammadi M.R., Ghanizadeh A., Davidian H. et al. Prevalence of epilepsy and comorbidity of psychiatric disorders in Iran. Seizure. 2006; 15: 476-482.
41. Mohanraj R., Brodie M. J. Pharmacological outcome in early diagnosed epilepsy. Epilepsy Behavior. 2005; 6: 382-387.
42. Moore P.M., Baker G.A. The neuropsychological and emotional consequences of living with intractable temporal lobe epilepsy: implications for clinical management. Seizure. 2002; 11 (4): 224-230.
43. Perini G. I. Tosin C., Carraro C. et al. Interictal mood and personality disorders in temporal lobe epilepsy and juvenile myoclonic epilepsy. J. Neurol. Neurosurg. Psychiatry. 1996; 61 (6): 601-605.
44. Perrine K., Kiolbasa T. Cognitive deficits in epilepsy and contribution to psychopathology. Neurology. 1999; 53 (2): 39-48.
45. Quiske A., Helmstaedter C., Lux S. et al. Depression in patients with temporal lobe epilepsy is related to mesial temporal sclerosis. Epilepsy Res. 2000; 39: 121-5.
46. Robertson M.M. Trimble M.R., Townsend H.R.A. Phenomenology of depression in epilepsy. Epilepsia. 1987; 28: 364-372.
For citation:
Sivakova N.A., Kotsubinskyi A.P., Lipatova L.V. THE STRUCTURE OF THE NON-PSYCHOTIC MENTAL (PSYCHIATRIC) DISORDERS IN PATIENTS WITH EPILEPSY WITH DIFFERENT VARIANTS OF THE DISEASE. Epilepsy and paroxysmal conditions. 2016;8(4):13-22. (In Russ.) https://doi.org/10.17749/2077-8333.2016.8.4.013-022
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