Impulsivity in persons with epilepsy: Association with seizure severity and suicide risk
- Authors
- Lee, S.-A.; Choi, E.J.; Jeon, J.-Y.; Han, S.-H.; Kim, H.-W.; Lee, G.-H.; Ryu, H.U.; Im, K.; Yang, H.-R.
- Issue Date
- Jan-2022
- Publisher
- Elsevier B.V.
- Keywords
- Aggression; Antiepileptic drug; Depression; Epilepsy; Polytherapy; Suicidality; Trait impulsivity
- Citation
- Epilepsy Research, v.179
- Journal Title
- Epilepsy Research
- Volume
- 179
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/61797
- DOI
- 10.1016/j.eplepsyres.2021.106825
- ISSN
- 0920-1211
1872-6844
- Abstract
- Purpose: Clinical research regarding impulsivity in patients with epilepsy is limited. The present study investigated the associations between impulsivity and seizure-related factors or suicidality in patients with epilepsy, independent of depression and anxiety. Methods: The multicenter study included 146 subjects (63% men). We utilized the Barratt Impulsiveness Scale-11 (BIS-11), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and suicidality module of the Mini International Neuropsychiatric Interview (MINI). Stepwise regression analyses and an analysis of covariance with interaction terms were performed. Results: The mean BIS-11 score was 59.3 (SD = 10.7). Psychiatric pathologies, including suicidality, were reported in relatively large proportions of patients, including PHQ-9 score ≥ 10 in 29 (19.9%) patients, GAD-7 score ≥ 7 in 35 (24.0%) patients, and MINI suicidality score ≥ 6 in 15 (10.3%) patients. Stepwise linear regression revealed that BIS-11 score was positively associated with the PHQ-9 scores (p < 0.001), antiseizure medication polytherapy (p < 0.001), use of lamotrigine (p = 0.009), and recurrence of generalized or focal to bilateral tonic clonic seizures (p = 0.010). The coefficient of determination for the model was 0.397. Generalized or focal to bilateral tonic clonic seizure recurrence tended to be positively associated with total BIS-11 scores in men but not in women. In subscale analyses, somewhat different variables were associated with different BIS-11subscales. A trend for a positive association between BIS-11 score and suicidality was found (p = 0.066). Conclusions: This study identified a positive association between clinical seizure severity and impulsivity, and found that this association tended to be sex-specific, occurring only in males. Impulsivity could potentially be weakly associated with suicidality in patients with epilepsy. © 2021 Elsevier B.V.
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