Summary: Phobic and agoraphobic symptoms are common in people with epilepsy and lead to a poorer quality of life.
Source: Wake Forest University
About 5.1 million people in the United States have a history of epilepsy, which causes repeated seizures. According to the Epilepsy Foundation, epilepsy is the fourth most common neurological disorder.
While current research has shown an increase in anxiety and depression in people with epilepsy, little is known about this population and about agoraphobia, an anxiety disorder that involves the fear of being in a public place or in a situation that could cause panic or embarrassment.
However, a recent study by Heidi Munger Clary, MD, MPH, associate professor of neurology at Wake Forest University School of Medicine, shows that phobic and agoraphobic symptoms are common and associated with poor quality of life in people with AD. epilepsy.
The study appears online in Epilepsy Research.
“We know that agoraphobia can lead to delays in patient care due to a reluctance to go out in public, which includes appointments with health care providers,” said Munger Clary, lead researcher of the study. “So this is an area that needs more attention in clinical practice.”
In the study, researchers conducted a cross-sectional analysis of baseline clinical data from a neuropsychology registry cohort study. The researchers analyzed a diverse sample of 420 adults, ages 18 to 75, with epilepsy who underwent neuropsychological evaluation over a 14-year period at Columbia University Medical Center in New York.
“More than a third of participants reported significant phobic/agoraphobic symptoms,” Munger Clary said. “We also found that phobic/agoraphobic symptoms, as well as depression symptoms, were independently associated with poor quality of life, but not generalized anxiety symptoms.”
According to Munger Clary, since phobic/agoraphobic symptoms are not routinely assessed by clinicians, the findings may suggest the need for future studies to develop more comprehensive screening tools for psychiatric comorbidity in epilepsy.
“Symptoms of agoraphobia do not completely overlap with the generalized symptoms of anxiety or depression that are often screened for in routine practice,” Munger Clary said.
“Providers could consider more robust symptom screening methods to identify and better help these patients. This may be important for improving health equity, given other key study findings that show people with low education and non-white race/ethnicity had increased risks of significant phobic/agoraphobic symptoms.
Funding: This work was supported in part by the National Institutes of Health under grants R01 NS035140, KM1 CA156709, UL1 TR001420, and 5KL2TR001421-04.
About this epilepsy and psychology research news
Author: Myra Wright
Source: Wake Forest University
Contact: Myra Wright – Wake Forest University
Picture: Image is in public domain
See also
Original research: Free access.
“Fear of going out: poor quality of life with phobic anxiety in a large cross-sectional sample of adult epilepsy centers” by Munger Clary et al. Epilepsy Research
Summary
Fear of going out: poor quality of life with phobic anxiety in a large cross-sectional sample of adult epilepsy centers
Aim
People with epilepsy (PWE) have unmet health care needs, particularly in the context of mental health. Although current literature has established an increased incidence of anxiety and depression in PWE and their contribution to poor quality of life, little is known about the presence and impact of specific phobia and anxiety. ‘agoraphobia. Our aim was to assess factors associated with high phobic/agoraphobic symptoms in a large sample from a single tertiary epilepsy center and to assess their impact on quality of life.
Methods
In a diverse sample of 420 adults with epilepsy, the cross-sectional association of demographic, epileptic, and cognitive factors with elevated phobic symptoms was assessed using multiple logistic regression. Symptoms were measured with the validated SCL-90R self-report subscale (T score ≥ 60 considered high phobic symptom cluster). A multiple logistic regression model was used to assess the independent association of demographic and clinical variables with the presence of elevated phobic symptoms, and a multiple linear regression model was used to assess independent cross-sectional associations with specific quality of life. to epilepsy (QOLIE-89) .
Results
Low educational level (adjusted OR 3.38), non-white race/ethnicity (adjusted OR 2.34), and symptoms of generalized anxiety (adjusted OR 1.91) were independently associated with phobic symptoms/ high agoraphobes, all p < 0.005. Phobic/agoraphobic symptoms were independently associated with poor quality of life, as were symptoms of depression, older age, and non-white race/ethnicity. Generalized anxiety did not demonstrate a significant independent association with quality of life in the multivariate model.
Conclusion
In this study sample, phobic/agoraphobic symptoms were independently associated with poor quality of life. Clinicians should consider using more holistic symptom screening instruments with particular attention to susceptible populations, as these high-impact symptoms may be overlooked using screening paradigms focused on generalized anxiety.