Depression and anxiety in epilepsy: the association with demographic and seizure-related variables

We investigated 201 patients with epilepsy (51.2% males, mean age 33.2 ± 10.0 years, range 16–60) with a mean disease duration of 13.9 ± 9.5 years. Depression and anxiety were assessed in the interictal state with the Beck Depression Inventory, 21-item version (BDI-21) and the state and trait subscales of the State-Trait Anxiety Inventory (STAI-S and STAI-T), respectively. The association of mood disorders with various variables was investigated with simple and multiple linear regression analyses.High seizure frequency and symptomatic focal epilepsy (SFE) were independent determinants of depression, together accounting for 12.4% of the variation of the BDI-21. The STAI-S index was significantly associated with the type of epilepsy syndrome (SFE). Finally, high seizure frequency, SFE and female gender were independent determinants of trait anxiety accounting for 14.7% of the variation of the STAI-T.Our results confirm the prevailing view that depression and anxiety are common psychological disorders in epileptics. It is additionally concluded that female gender, high seizure frequency and a symptomatic epilepsy syndrome are independent risk factors for the development of anxiety and/or depression.Despite the fact that some patients with epilepsy lead normal lives, devoid of cognitive or emotional problems, a significant number of them experience psychiatric disturbances, including mood disorders. Amongst the latter, depression is the most extensively studied with a large number of controlled studies reporting prevalence rates ranging from 3–55% [1]. Anxiety might be even more common, occurring in 25% of epileptic subjects in a community setting (versus 9% classified as depressed) [2] whereas in secondary care and specialist centers its prevalence exceeds 50% [3,4]. Of particular clinical importance is the recent finding that depression and anxiety exert a profound negative effect on the health-related quality of life (HRQOL) in patients with epilepsy. For instance, i