Symptoms of epilepsy and organic brain dysfunctions in patients with acute, brief depression combined with other fluctuating psychiatric symptoms: a controlled study from an acute psychiatric department.
BACKGROUND
In psychiatric acute departments some patients present with brief depressive periods accompanied with fluctuating arrays of other psychiatric symptoms like psychosis, panic or mania. For the purpose of the present study we call this condition Acute Unstable Depressive Syndrome (AUDS). The aims of the present study were to compare clinical signs of organic brain dysfunctions and epilepsy in patients with AUDS and Major Depressive Episode (MDE).


METHODS
Out of 1038 consecutive patients admitted to a psychiatric acute ward, 16 patients with AUDS and 16 age- and gender-matched MDE patients were included in the study. Using standardized instruments and methods we recorded clinical data, EEG and MRI.


RESULTS
A history of epileptic seizures and pathologic EEG activity was more common in the AUDS group than in the MDE group (seizures, n = 6 vs. 0, p = 0.018; pathologic EEG activity, n = 8 vs. 1, p = 0.015). Five patients in the AUDS group were diagnosed as having epilepsy, whereas none of those with MDE had epilepsy (p = 0.043). There were no differences between the groups regarding pathological findings in neurological bedside examination and cerebral MRI investigation.


CONCLUSIONS
Compared to patients admitted with mood symptoms fulfilling DSM 4 criteria of a major depressive disorder, short-lasting atypical depressive symptoms seem to be associated with a high frequency of epileptic and pathologic EEG activity in patients admitted to psychiatric acute departments.


BACKGROUND
NCT00201474.
Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. arne.e.vaaler@ntnu.no
Arne E
AE
Vaaler
Gunnar
G
Morken
Olav M
OM
Linaker
Trond
T
Sand
Kjell A
KA
Kvistad
Geir
G
Bråthen
D000208:Acute Disease; D000328:Adult; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D001927:Brain Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D015897:Comorbidity; D035061:Control Groups; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004569:Electroencephalography / Q000706:statistics & numerical data; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D011567:Psychiatric Department, Hospital; D011569:Psychiatric Status Rating Scales; D014743:Videotape Recording