David Baxter PhD
Late Founder
Bipolar Symptoms Elevated in Epilepsy Patients
September 7, 2005
By Michelle Rizzo
NEW YORK (Reuters Health) - The prevalence of bipolar symptoms appears to be higher among epilepsy patients than among those with other chronic medical conditions, according to researchers.
Dr. Alan B. Edinger, of Long Island Jewish Medical Center, New York, and colleagues used the Mood Disorder Questionnaire to compare the prevalence of bipolar I and II symptoms in a community-based sample of US adults with epilepsy versus those with other chronic conditions.
Data were available for 85,358 subjects. The team compared respondents with epilepsy (n= 1236) to those with migraine (n = 8994), asthma (n = 7951), diabetes (n = 7342), or a healthy comparison group (n = 57,172) for lifetime prevalence of bipolar symptoms and past clinical diagnoses of an affective disorder. The results are published in the August issue of Neurology.
Bipolar symptoms were present in 12.2% of the epilepsy patients. These symptoms were 1.6 to 2.2 times more common in epileptic patients than in those with migraine, asthma, or diabetes, and 6.6 times more common than in the healthy comparison group (p < 0.006).
Overall, 47.9% of epilepsy subjects with a positive screen for bipolar symptoms had a formal diagnosis of bipolar disorder, nearly twice the rate seen in those with chronic diseases. The authors note that 26.3% of those with epilepsy with a positive screen had a diagnosis of unipolar depression only, and 25.8% had neither a uni- nor bipolar diagnosis.
"Our findings suggest that bipolar symptoms and perhaps formal bipolar disorder may be significantly underrecognized in patients with epilepsy and patients with other chronic disorders," Dr. Ettinger said in an interview with Reuters Health.
"Physicians need to be aware of these symptoms and survey their patients for (bipolar disorder), so that further psychiatric evaluations can be pursued and proper treatment can be instituted."
The author noted that one reason bipolar symptoms may be missed in patients with epilepsy is because some of the commonly used antiepileptic agents such as carbamazepine, valproic acid, and lamotrigine may be treating the bipolar symptoms as well.
"The elevated rate of bipolar symptoms in epilepsy may (explain) the commonly described vulnerability to mood instability in individuals with epilepsy," Dr. Ettinger said. "This may relate to the complicated mind-brain interactions that occur as a result of seizure effects on the brain, the effects of the underlying condition giving rise to seizures, and the treatments for epilepsy, among other possible causes."
Neurology 2005;65:535-540.
September 7, 2005
By Michelle Rizzo
NEW YORK (Reuters Health) - The prevalence of bipolar symptoms appears to be higher among epilepsy patients than among those with other chronic medical conditions, according to researchers.
Dr. Alan B. Edinger, of Long Island Jewish Medical Center, New York, and colleagues used the Mood Disorder Questionnaire to compare the prevalence of bipolar I and II symptoms in a community-based sample of US adults with epilepsy versus those with other chronic conditions.
Data were available for 85,358 subjects. The team compared respondents with epilepsy (n= 1236) to those with migraine (n = 8994), asthma (n = 7951), diabetes (n = 7342), or a healthy comparison group (n = 57,172) for lifetime prevalence of bipolar symptoms and past clinical diagnoses of an affective disorder. The results are published in the August issue of Neurology.
Bipolar symptoms were present in 12.2% of the epilepsy patients. These symptoms were 1.6 to 2.2 times more common in epileptic patients than in those with migraine, asthma, or diabetes, and 6.6 times more common than in the healthy comparison group (p < 0.006).
Overall, 47.9% of epilepsy subjects with a positive screen for bipolar symptoms had a formal diagnosis of bipolar disorder, nearly twice the rate seen in those with chronic diseases. The authors note that 26.3% of those with epilepsy with a positive screen had a diagnosis of unipolar depression only, and 25.8% had neither a uni- nor bipolar diagnosis.
"Our findings suggest that bipolar symptoms and perhaps formal bipolar disorder may be significantly underrecognized in patients with epilepsy and patients with other chronic disorders," Dr. Ettinger said in an interview with Reuters Health.
"Physicians need to be aware of these symptoms and survey their patients for (bipolar disorder), so that further psychiatric evaluations can be pursued and proper treatment can be instituted."
The author noted that one reason bipolar symptoms may be missed in patients with epilepsy is because some of the commonly used antiepileptic agents such as carbamazepine, valproic acid, and lamotrigine may be treating the bipolar symptoms as well.
"The elevated rate of bipolar symptoms in epilepsy may (explain) the commonly described vulnerability to mood instability in individuals with epilepsy," Dr. Ettinger said. "This may relate to the complicated mind-brain interactions that occur as a result of seizure effects on the brain, the effects of the underlying condition giving rise to seizures, and the treatments for epilepsy, among other possible causes."
Neurology 2005;65:535-540.
