The Relationship Between Pre-treatment Seizures and Mental Health in People with Newly Diagnosed Focal Epilepsy
Alexandra Danciutiu1, Jacob Pellinen1, Jacqueline French2, Andres Kanner3, John Barry4, Siddhartha Nadkarni5, Sarah Jackson5, Melodie Winawer6
1University of Colorado, 2NYU Comprehensive Epilepsy Ctr, 3University of Miami, Miller School of Medicine, Department of Neurology, 4Stanford Univ School of Medicine, 5NYU School of Medicine, 6Columbia Univ
Objective:
To assess the relationship between pre-treatment seizures, baseline characteristics, and psychiatric comorbidities in people with newly diagnosed focal epilepsy.
Background:
Anxiety disorders, mood disorders, and suicidal ideation are more prevalent in people with epilepsy compared to the general population. However, the associations between pre-treatment seizures, demographic factors, and psychiatric comorbidities at the time of epilepsy diagnosis are not fully understood.
Design/Methods:
This secondary analysis of Human Epilepsy Project (HEP) data included participants aged 18–60 with newly diagnosed focal epilepsy from 34 global sites. Demographic data, seizure histories, and enrollment neuropsychiatric assessments were used to model associations between participant characteristics and the presence of anxiety, depression, and suicidality near the time of diagnosis using logistic regression. Analyses were adjusted for age, sex, seizure burden, and employment status.
Results:
Of 347 participants with data, 85 (24%) had an anxiety disorder, 65 (19%) had a mood disorder, and 75 (22%) had suicidal ideation. Compared to the U.S. population, prevalence was 1.26 times higher for anxiety disorders, 3.8 times higher for mood disorders, and 5.5 times higher for suicidal ideation. Employment was significantly associated with higher odds of anxiety disorders (OR 2.39, 95% CI 1.31–4.37), mood disorders (OR 2.43, 95% CI 1.27–4.65), and suicidal ideation (OR 2.30, 95% CI 1.23–4.29). No significant associations were found with age, sex, or pre-diagnostic seizure burden.
Conclusions:
This study demonstrates an association between employment status and the prevalence of anxiety disorders, mood disorders, and suicidal ideation in people with newly diagnosed focal epilepsy. In contrast, age, sex, and pretreatment seizure burden were not associated with these comorbidities. While these results highlight employment as a potential factor related to mental health outcomes, they do not establish causation, and the underlying mechanisms remain unclear. Multiple variables may contribute to this association, and further research is needed to better understand these relationships and inform interventions.
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