Mood and Anxiety Disorders and Suicidality in Patients with Newly Diagnosed Focal Epilepsy: An Analysis of a Complex Comorbidity

Andres M. Kanner, Anita S. Saporta, Dong H. Kim, John J. Barry, Hamada Altalib, Hope Omotola, Nathalie Jette, Terence J. O'Brien, Siddhartha Nadkarni, Melodie R. Winawer, Michael Sperling, Jacqueline A. French, Bassel Abou-Khalil, Brian Alldredge, Martina Bebin, Gregory D. Cascino, Andrew J. Cole, Mark J. Cook, Kamil Detyniecki, Orrin DevinskyDennis Dlugos, Edward Faught, David Ficker, Madeline Fields, Barry Gidal, Michael Gelfand, Simon Glynn, Jonathan J. Halford, Sheryl Haut, Manu Hegde, Manisha G. Holmes, Reetta Kalviainen, Joon Kang, Pavel Klein, Robert C. Knowlton, Kaarkuzhali Krishnamurthy, Ruben Kuzniecky, Patrick Kwan, Daniel H. Lowenstein, Lara Marcuse, Kimford J. Meador, Scott Mintzer, Heath R. Pardoe, Kristen Park, Patricia Penovich, Rani K. Singh, Ernest Somerville, Charles A. Szabo, Jerzy P. Szaflarski, K. Liu Lin Thio, Eugen Trinka, Jorge G. Burneo

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Background and ObjectivesMood, anxiety disorders, and suicidality are more frequent in people with epilepsy than in the general population. Yet, their prevalence and the types of mood and anxiety disorders associated with suicidality at the time of the epilepsy diagnosis are not established. We sought to answer these questions in patients with newly diagnosed focal epilepsy and to assess their association with suicidal ideation and attempts.MethodsThe data were derived from the Human Epilepsy Project study. A total of 347 consecutive adults aged 18-60 years with newly diagnosed focal epilepsy were enrolled within 4 months of starting treatment. The types of mood and anxiety disorders were identified with the Mini International Neuropsychiatric Interview, whereas suicidal ideation (lifetime, current, active, and passive) and suicidal attempts (lifetime and current) were established with the Columbia Suicidality Severity Rating Scale (CSSRS). Statistical analyses included the t test, χ2 statistics, and logistic regression analyses.ResultsA total of 151 (43.5%) patients had a psychiatric diagnosis; 134 (38.6%) met the criteria for a mood and/or anxiety disorder, and 75 (21.6%) reported suicidal ideation with or without attempts. Mood (23.6%) and anxiety (27.4%) disorders had comparable prevalence rates, whereas both disorders occurred together in 43 patients (12.4%). Major depressive disorders (MDDs) had a slightly higher prevalence than bipolar disorders (BPDs) (9.5% vs 6.9%, respectively). Explanatory variables of suicidality included MDD, BPD, panic disorders, and agoraphobia, with BPD and panic disorders being the strongest variables, particularly for active suicidal ideation and suicidal attempts.DiscussionIn patients with newly diagnosed focal epilepsy, the prevalence of mood, anxiety disorders, and suicidality is higher than in the general population and comparable to those of patients with established epilepsy. Their recognition at the time of the initial epilepsy evaluation is of the essence.

Original languageEnglish
Pages (from-to)E1123-E1134
Issue number11
StatePublished - 14 Mar 2023
Externally publishedYes


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