title: The influence of comorbid depression on seizure severity.
abstract: OBJECTIVE
  To determine the relation between depressive symptoms and seizure severity among people with epilepsy.
  
  
  METHODS
  A postal questionnaire was used to survey a nationwide community sample about seizures and depression. The Seizure Severity Questionnaire (SSQ) assessed the severity and bothersomeness of seizure components. The Centers for Epidemiological Studies-Depression scale categorized levels of depression.
  
  
  RESULTS
  Respondents categorized as having current severe (SEV, n = 166), mild-moderate (MOD, n = 74), or no depression (NO, n = 443) differed significantly in SSQ scores (all p < 0.0001). People with SEV or MOD reported significantly worse problems than did those with NO depression for overall seizure recovery (mean, 5.3, 4.9, 4.5, respectively); overall severity (5.0, 4.5, 4.2); and overall seizure bother (5.3, 4.8, 4.4) (all p < 0.005). Cognitive, emotional, and physical aspects of seizure recovery also were rated worse among people with SEV than with NO depression (all p < 0.05). Symptoms of depression were significantly correlated with higher levels of all components of generalized tonic-clonic seizure severity (r = 0.33-0.48; all p < 0.0001), and partial seizures (r = 0.31-0.38; all p < 0.01).
  
  
  CONCLUSIONS
  Clinically depressed people with epilepsy reported higher levels of perceived severity and bother from seizures, as well as greater problems with overall seizure recovery than did nondepressed people experiencing similar types of seizures. The pervasive influence of depressive symptoms on reports of seizure activity suggests that people with epilepsy should be screened for depression. These data highlight the importance of detecting and treating depression among people with epilepsy.
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 950 Campbell Avenue (G7E), West Haven, CT 06516-2770, USA. joyce.cramer@yale.edu
authors.forename: Joyce A
authors.initials: JA
authors.lastname: Cramer
authors.forename: David
authors.initials: D
authors.lastname: Blum
authors.forename: Michael
authors.initials: M
authors.lastname: Reed
authors.forename: Kristina
authors.initials: K
authors.lastname: Fanning
mesh_terms: D000328:Adult; D015897:Comorbidity; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D004185:Disability Evaluation; D004827:Epilepsy / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D012803:Sick Role; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014481:United States