Investigation Of Comorbidity Of Anxiety And Depression In People With Epilepsy

Objective: The most common comorbid psychiatric conditions of epilepsy are anxiety and depression.This study examines the prevalence and risk factors of generalized anxiety and depression in people with epilepsy,and explore how seizure frequency,generalized anxiety and depression interact to influence suicidal tendency.Methods: A consecutive cohort of PWE was recruited from the First Affiliated Hospital of Chongqing Medical University.Each patient completed the Neurological Disorders Depression Inventory for Epilepsy[NDDI-E],the Generalized Anxiety Disorder-7(GAD-7)and the suicidality module of Mini-International Neuropsychiatric Interview(MINI)v.5.0.0.Demographic and clinical variables were analyzed using chi-square tests or Mann–Whitney U tests.Binary logistic regression analysis was used to identify independent risk factors of comorbidity of major depression and generalized anxiety in people with epilepsy.Spearman's correlation and moderated mediation analysis were used to examine the associations among seizure frequency,depression,generalized anxiety and suicidal tendency.Results: Among a total of 335 participants,there were 19.1% with generalized anxiety,22.7% with major depression,15.2% with comorbidity of generalized anxiety major depression,and 14.3% had a moderate to high suicide risk.High seizure frequency was independent risk factor for both generalized anxiety and major depression.Seizure frequency was positively associated with depression which,in turn,was positively associated with suicidal tendency.Generalized anxiety was positively associated with depression and suicidal tendency.Depression partially mediated the relationship between seizure frequency and suicidal tendency.The indirect effect of seizure frequency on suicidal tendency through depression was positively moderated by generalized anxiety.Conclusions: PWE have a high prevalence of depression and generalized anxiety which,in turn,may elevate the rate of suicide risk for PWE.Identifying risk factors early may contribute to timely management of these comorbidity and prevention of suicidality.Reducing seizure frequency may be the basis of suicide prevention in PWE.The effect of seizure frequency on suicidal tendency can be partially explained by the mediation of depression,and the magnitude of the indirect effect of seizure frequency on suicidal tendency was contingent upon generalized anxiety.