Mood and Anxiety Disorders and Suicidality in Patients with Newly Diagnosed Focal Epilepsy: An Analysis of a Complex Comorbidity

Andres M. Kanner; Anita S. Saporta; Dong H. Kim; John J. Barry; Hamada Altalib; Hope Omotola; Nathalie Jette; Terence J. O'Brien; Siddhartha Nadkarni; Melodie R. Winawer; Michael Sperling; Jacqueline A. French; Bassel Abou-Khalil; Brian Alldredge; Martina Bebin; Gregory D. Cascino; Andrew J. Cole; Mark J. Cook; Kamil Detyniecki; Orrin Devinsky; Dennis Dlugos; Edward Faught; David Ficker; Madeline Fields; Barry Gidal; Michael Gelfand; Simon Glynn; Jonathan J. Halford; Sheryl Haut; Manu Hegde; Manisha G. Holmes; Reetta Kalviainen; Joon Kang; Pavel Klein; Robert C. Knowlton; Kaarkuzhali Krishnamurthy; Ruben Kuzniecky; Patrick Kwan; Daniel H. Lowenstein; Lara Marcuse; Kimford J. Meador; Scott Mintzer; Heath R. Pardoe; Kristen Park; Patricia Penovich; Rani K. Singh; Ernest Somerville; Charles A. Szabo; Jerzy P. Szaflarski; K. Liu Lin Thio; Eugen Trinka; Jorge G. Burneo

doi:10.1212/WNL.0000000000201671

Mood and Anxiety Disorders and Suicidality in Patients with Newly Diagnosed Focal Epilepsy: An Analysis of a Complex Comorbidity

Andres M. Kanner, Anita S. Saporta, Dong H. Kim, John J. Barry, Hamada Altalib, Hope Omotola, Nathalie Jette, Terence J. O'Brien, Siddhartha Nadkarni, Melodie R. Winawer, Michael Sperling, Jacqueline A. French, Bassel Abou-Khalil, Brian Alldredge, Martina Bebin, Gregory D. Cascino, Andrew J. Cole, Mark J. Cook, Kamil Detyniecki, Orrin DevinskyDennis Dlugos, Edward Faught, David Ficker, Madeline Fields, Barry Gidal, Michael Gelfand, Simon Glynn, Jonathan J. Halford, Sheryl Haut, Manu Hegde, Manisha G. Holmes, Reetta Kalviainen, Joon Kang, Pavel Klein, Robert C. Knowlton, Kaarkuzhali Krishnamurthy, Ruben Kuzniecky, Patrick Kwan, Daniel H. Lowenstein, Lara Marcuse, Kimford J. Meador, Scott Mintzer, Heath R. Pardoe, Kristen Park, Patricia Penovich, Rani K. Singh, Ernest Somerville, Charles A. Szabo, Jerzy P. Szaflarski, K. Liu Lin Thio, Eugen Trinka, Jorge G. Burneo

Neurology

Research output: Contribution to journal › Article › peer-review

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Abstract

Background and ObjectivesMood, anxiety disorders, and suicidality are more frequent in people with epilepsy than in the general population. Yet, their prevalence and the types of mood and anxiety disorders associated with suicidality at the time of the epilepsy diagnosis are not established. We sought to answer these questions in patients with newly diagnosed focal epilepsy and to assess their association with suicidal ideation and attempts.MethodsThe data were derived from the Human Epilepsy Project study. A total of 347 consecutive adults aged 18-60 years with newly diagnosed focal epilepsy were enrolled within 4 months of starting treatment. The types of mood and anxiety disorders were identified with the Mini International Neuropsychiatric Interview, whereas suicidal ideation (lifetime, current, active, and passive) and suicidal attempts (lifetime and current) were established with the Columbia Suicidality Severity Rating Scale (CSSRS). Statistical analyses included the t test, χ2 statistics, and logistic regression analyses.ResultsA total of 151 (43.5%) patients had a psychiatric diagnosis; 134 (38.6%) met the criteria for a mood and/or anxiety disorder, and 75 (21.6%) reported suicidal ideation with or without attempts. Mood (23.6%) and anxiety (27.4%) disorders had comparable prevalence rates, whereas both disorders occurred together in 43 patients (12.4%). Major depressive disorders (MDDs) had a slightly higher prevalence than bipolar disorders (BPDs) (9.5% vs 6.9%, respectively). Explanatory variables of suicidality included MDD, BPD, panic disorders, and agoraphobia, with BPD and panic disorders being the strongest variables, particularly for active suicidal ideation and suicidal attempts.DiscussionIn patients with newly diagnosed focal epilepsy, the prevalence of mood, anxiety disorders, and suicidality is higher than in the general population and comparable to those of patients with established epilepsy. Their recognition at the time of the initial epilepsy evaluation is of the essence.

Original language	English (US)
Pages (from-to)	E1123-E1134
Journal	Neurology
Volume	100
Issue number	11
DOIs	https://doi.org/10.1212/WNL.0000000000201671
State	Published - Mar 14 2023

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Clinical Neurology

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10.1212/WNL.0000000000201671

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Kanner, A. M., Saporta, A. S., Kim, D. H., Barry, J. J., Altalib, H., Omotola, H., Jette, N., O'Brien, T. J., Nadkarni, S., Winawer, M. R., Sperling, M., French, J. A., Abou-Khalil, B., Alldredge, B., Bebin, M., Cascino, G. D., Cole, A. J., Cook, M. J., Detyniecki, K., ... Burneo, J. G. (2023). Mood and Anxiety Disorders and Suicidality in Patients with Newly Diagnosed Focal Epilepsy: An Analysis of a Complex Comorbidity. Neurology, 100(11), E1123-E1134. https://doi.org/10.1212/WNL.0000000000201671

Kanner, AM, Saporta, AS, Kim, DH, Barry, JJ, Altalib, H, Omotola, H, Jette, N, O'Brien, TJ, Nadkarni, S, Winawer, MR, Sperling, M, French, JA, Abou-Khalil, B, Alldredge, B, Bebin, M, Cascino, GD, Cole, AJ, Cook, MJ, Detyniecki, K, Devinsky, O, Dlugos, D, Faught, E, Ficker, D, Fields, M, Gidal, B, Gelfand, M, Glynn, S, Halford, JJ, Haut, S, Hegde, M, Holmes, MG, Kalviainen, R, Kang, J, Klein, P, Knowlton, RC, Krishnamurthy, K, Kuzniecky, R, Kwan, P, Lowenstein, DH, Marcuse, L, Meador, KJ, Mintzer, S, Pardoe, HR, Park, K, Penovich, P, Singh, RK, Somerville, E, Szabo, CA, Szaflarski, JP, Lin Thio, KL, Trinka, E & Burneo, JG 2023, 'Mood and Anxiety Disorders and Suicidality in Patients with Newly Diagnosed Focal Epilepsy: An Analysis of a Complex Comorbidity', Neurology, vol. 100, no. 11, pp. E1123-E1134. https://doi.org/10.1212/WNL.0000000000201671

@article{e92bd7133d8044b4b4e0e82d9967d030,

title = "Mood and Anxiety Disorders and Suicidality in Patients with Newly Diagnosed Focal Epilepsy: An Analysis of a Complex Comorbidity",

abstract = "Background and ObjectivesMood, anxiety disorders, and suicidality are more frequent in people with epilepsy than in the general population. Yet, their prevalence and the types of mood and anxiety disorders associated with suicidality at the time of the epilepsy diagnosis are not established. We sought to answer these questions in patients with newly diagnosed focal epilepsy and to assess their association with suicidal ideation and attempts.MethodsThe data were derived from the Human Epilepsy Project study. A total of 347 consecutive adults aged 18-60 years with newly diagnosed focal epilepsy were enrolled within 4 months of starting treatment. The types of mood and anxiety disorders were identified with the Mini International Neuropsychiatric Interview, whereas suicidal ideation (lifetime, current, active, and passive) and suicidal attempts (lifetime and current) were established with the Columbia Suicidality Severity Rating Scale (CSSRS). Statistical analyses included the t test, χ2 statistics, and logistic regression analyses.ResultsA total of 151 (43.5%) patients had a psychiatric diagnosis; 134 (38.6%) met the criteria for a mood and/or anxiety disorder, and 75 (21.6%) reported suicidal ideation with or without attempts. Mood (23.6%) and anxiety (27.4%) disorders had comparable prevalence rates, whereas both disorders occurred together in 43 patients (12.4%). Major depressive disorders (MDDs) had a slightly higher prevalence than bipolar disorders (BPDs) (9.5% vs 6.9%, respectively). Explanatory variables of suicidality included MDD, BPD, panic disorders, and agoraphobia, with BPD and panic disorders being the strongest variables, particularly for active suicidal ideation and suicidal attempts.DiscussionIn patients with newly diagnosed focal epilepsy, the prevalence of mood, anxiety disorders, and suicidality is higher than in the general population and comparable to those of patients with established epilepsy. Their recognition at the time of the initial epilepsy evaluation is of the essence.",

author = "Kanner, {Andres M.} and Saporta, {Anita S.} and Kim, {Dong H.} and Barry, {John J.} and Hamada Altalib and Hope Omotola and Nathalie Jette and O'Brien, {Terence J.} and Siddhartha Nadkarni and Winawer, {Melodie R.} and Michael Sperling and French, {Jacqueline A.} and Bassel Abou-Khalil and Brian Alldredge and Martina Bebin and Cascino, {Gregory D.} and Cole, {Andrew J.} and Cook, {Mark J.} and Kamil Detyniecki and Orrin Devinsky and Dennis Dlugos and Edward Faught and David Ficker and Madeline Fields and Barry Gidal and Michael Gelfand and Simon Glynn and Halford, {Jonathan J.} and Sheryl Haut and Manu Hegde and Holmes, {Manisha G.} and Reetta Kalviainen and Joon Kang and Pavel Klein and Knowlton, {Robert C.} and Kaarkuzhali Krishnamurthy and Ruben Kuzniecky and Patrick Kwan and Lowenstein, {Daniel H.} and Lara Marcuse and Meador, {Kimford J.} and Scott Mintzer and Pardoe, {Heath R.} and Kristen Park and Patricia Penovich and Singh, {Rani K.} and Ernest Somerville and Szabo, {Charles A.} and Szaflarski, {Jerzy P.} and {Lin Thio}, {K. Liu} and Eugen Trinka and Burneo, {Jorge G.}",

note = "Publisher Copyright: {\textcopyright} American Academy of Neurology.",

year = "2023",

month = mar,

day = "14",

doi = "10.1212/WNL.0000000000201671",

language = "English (US)",

volume = "100",

pages = "E1123--E1134",

journal = "Neurology",

issn = "0028-3878",

publisher = "Lippincott Williams and Wilkins",

number = "11",

}

TY - JOUR

T1 - Mood and Anxiety Disorders and Suicidality in Patients with Newly Diagnosed Focal Epilepsy

T2 - An Analysis of a Complex Comorbidity

AU - Kanner, Andres M.

AU - Saporta, Anita S.

AU - Kim, Dong H.

AU - Barry, John J.

AU - Altalib, Hamada

AU - Omotola, Hope

AU - Jette, Nathalie

AU - O'Brien, Terence J.

AU - Nadkarni, Siddhartha

AU - Winawer, Melodie R.

AU - Sperling, Michael

AU - French, Jacqueline A.

AU - Abou-Khalil, Bassel

AU - Alldredge, Brian

AU - Bebin, Martina

AU - Cascino, Gregory D.

AU - Cole, Andrew J.

AU - Cook, Mark J.

AU - Detyniecki, Kamil

AU - Devinsky, Orrin

AU - Dlugos, Dennis

AU - Faught, Edward

AU - Ficker, David

AU - Fields, Madeline

AU - Gidal, Barry

AU - Gelfand, Michael

AU - Glynn, Simon

AU - Halford, Jonathan J.

AU - Haut, Sheryl

AU - Hegde, Manu

AU - Holmes, Manisha G.

AU - Kalviainen, Reetta

AU - Kang, Joon

AU - Klein, Pavel

AU - Knowlton, Robert C.

AU - Krishnamurthy, Kaarkuzhali

AU - Kuzniecky, Ruben

AU - Kwan, Patrick

AU - Lowenstein, Daniel H.

AU - Marcuse, Lara

AU - Meador, Kimford J.

AU - Mintzer, Scott

AU - Pardoe, Heath R.

AU - Park, Kristen

AU - Penovich, Patricia

AU - Singh, Rani K.

AU - Somerville, Ernest

AU - Szabo, Charles A.

AU - Szaflarski, Jerzy P.

AU - Lin Thio, K. Liu

AU - Trinka, Eugen

AU - Burneo, Jorge G.

PY - 2023/3/14

Y1 - 2023/3/14

N2 - Background and ObjectivesMood, anxiety disorders, and suicidality are more frequent in people with epilepsy than in the general population. Yet, their prevalence and the types of mood and anxiety disorders associated with suicidality at the time of the epilepsy diagnosis are not established. We sought to answer these questions in patients with newly diagnosed focal epilepsy and to assess their association with suicidal ideation and attempts.MethodsThe data were derived from the Human Epilepsy Project study. A total of 347 consecutive adults aged 18-60 years with newly diagnosed focal epilepsy were enrolled within 4 months of starting treatment. The types of mood and anxiety disorders were identified with the Mini International Neuropsychiatric Interview, whereas suicidal ideation (lifetime, current, active, and passive) and suicidal attempts (lifetime and current) were established with the Columbia Suicidality Severity Rating Scale (CSSRS). Statistical analyses included the t test, χ2 statistics, and logistic regression analyses.ResultsA total of 151 (43.5%) patients had a psychiatric diagnosis; 134 (38.6%) met the criteria for a mood and/or anxiety disorder, and 75 (21.6%) reported suicidal ideation with or without attempts. Mood (23.6%) and anxiety (27.4%) disorders had comparable prevalence rates, whereas both disorders occurred together in 43 patients (12.4%). Major depressive disorders (MDDs) had a slightly higher prevalence than bipolar disorders (BPDs) (9.5% vs 6.9%, respectively). Explanatory variables of suicidality included MDD, BPD, panic disorders, and agoraphobia, with BPD and panic disorders being the strongest variables, particularly for active suicidal ideation and suicidal attempts.DiscussionIn patients with newly diagnosed focal epilepsy, the prevalence of mood, anxiety disorders, and suicidality is higher than in the general population and comparable to those of patients with established epilepsy. Their recognition at the time of the initial epilepsy evaluation is of the essence.

AB - Background and ObjectivesMood, anxiety disorders, and suicidality are more frequent in people with epilepsy than in the general population. Yet, their prevalence and the types of mood and anxiety disorders associated with suicidality at the time of the epilepsy diagnosis are not established. We sought to answer these questions in patients with newly diagnosed focal epilepsy and to assess their association with suicidal ideation and attempts.MethodsThe data were derived from the Human Epilepsy Project study. A total of 347 consecutive adults aged 18-60 years with newly diagnosed focal epilepsy were enrolled within 4 months of starting treatment. The types of mood and anxiety disorders were identified with the Mini International Neuropsychiatric Interview, whereas suicidal ideation (lifetime, current, active, and passive) and suicidal attempts (lifetime and current) were established with the Columbia Suicidality Severity Rating Scale (CSSRS). Statistical analyses included the t test, χ2 statistics, and logistic regression analyses.ResultsA total of 151 (43.5%) patients had a psychiatric diagnosis; 134 (38.6%) met the criteria for a mood and/or anxiety disorder, and 75 (21.6%) reported suicidal ideation with or without attempts. Mood (23.6%) and anxiety (27.4%) disorders had comparable prevalence rates, whereas both disorders occurred together in 43 patients (12.4%). Major depressive disorders (MDDs) had a slightly higher prevalence than bipolar disorders (BPDs) (9.5% vs 6.9%, respectively). Explanatory variables of suicidality included MDD, BPD, panic disorders, and agoraphobia, with BPD and panic disorders being the strongest variables, particularly for active suicidal ideation and suicidal attempts.DiscussionIn patients with newly diagnosed focal epilepsy, the prevalence of mood, anxiety disorders, and suicidality is higher than in the general population and comparable to those of patients with established epilepsy. Their recognition at the time of the initial epilepsy evaluation is of the essence.

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Mood and Anxiety Disorders and Suicidality in Patients with Newly Diagnosed Focal Epilepsy: An Analysis of a Complex Comorbidity

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