Focal Epilepsy Linked to Increased Risk for Mood Disorders

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Mood disorders are underdiagnosed and undertreated in patients with epilepsy.
Mood disorders are underdiagnosed and undertreated in patients with epilepsy.

Mood disorders appear to be more common in patients with epilepsy who have one or more relatives with focal epilepsy (FE) compared with generalized epilepsy (GE), according to findings published in Epilepsia.

The study investigators administered the Composite International Diagnostic Interview to a total of 192 participants from 60 families. Individuals with FE (n=50), GE (n=42), FE and GE (n=6), unclassifiable epilepsy (n=12), and relatives without epilepsy (n=82) were included in the study.

Individuals with FE had significantly higher odds for mood disorders compared with relatives without epilepsy (odds ratio [OR] 2.4; 95% CI, 1.1-5.2). Participants with GE, however, did not demonstrate higher rates of mood disorders in the same comparison analysis (OR 1.0; 95% CI, 0.4-2.2). Although the rate of mood disorders was increased in relatives without epilepsy, the increase was not considered statistically significant (standardized prevalence ratio [SPR] 1.4; P =.14).

The lifetime prevalence of mood disorders was also increased in epilepsy participants who had ≥1 relative with FE (OR 2.4; 95% CI, 1.01-5.48; P =.05). A non-significant higher prevalence of mood disorders was also found in individuals with FE (OR 1.3; 95% CI, 0.31-5.58; P =.71) or GE (OR 1.9; 95% CI, 0.50-7.53; P =.34). The prevalence of mood disorders in relatives without epilepsy was not associated with the total number of epileptic family members or the number of relatives with FE or GE.

Mood disorder diagnoses were collected from validated semi-structured interviews and retrospective recall instead of medical records. In addition, the investigators obtained little information on the features of patients' seizures and did not obtain data on the family environment, both of which may have an impact on illness burden.

In patients with epilepsy, mood disorders are underdiagnosed and undertreated, making it imperative that clinicians “evaluate their patients, particularly those with focal epilepsy, for mood disorders and initiate appropriate treatment.”

Reference

Insel BJ, Ottman R, Heiman GA. Mood disorders in familial epilepsy: A test of shared etiology [published January 10, 2018]. Epilepsia. doi:10.1111/epi.13985

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