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Master Thesis

Épidémiologie et facteurs associés au syndrome dépressif chez les patients suivis au centre hospitalo-universitaire de Rennes pour une épilepsie

Abstract : Objectives : The occurrence of depression in people with epilepsy is almost twice as common as in the general population. Furthermore, depression is the first cause of lower quality of life among those patients. That’s why the main goal of this study was to assess the epidemiology of depression and its associated factors among the patients from the tertiary department of epileptology in Rennes. Methods/Results : The subjects were included prospectively and consecutively at the moment of their consultation or hospitalisation in the department. Personnel data about the socio-economic status and the type of epilepsy was collected. The subjects filled validated self-assessment of depression (NDDIE), anxiety (GAD-7) and quality of life (QOLIE-10). Thanks to the NDDIE, the patients were divided in : “depressed” and “not depressed” ; and the two groups were compared with univariate and multivariate models. 322 patients have been followed-up in the department between the 17th of June and the 9th of September 2016, among them 223 were included in the study. According to the NDDIE, 22.6% suffered from depression ; according to the GAD-7, 46.4% suffered from anxiety. In the “depressed” group, 82% were not under anti-depressant medication. In univariate model, depression was associated with : anxiety, suicidal ideations, lower quality of life, vague nervus stimulation treatment, anticonvulsant benzodiazepine medication or psychiatric medication, and last of all bitherapy or polytherapy antiepileptic medication compared to monotherapy. In multivariate model, depression was significantly related with anxiety (OR : 8.86 [3.00 ; 26.19] p=0.0001), suicidal ideations (OR : 7.43 [2.93 ; 18.81] p<0.0001), anticonvulsant benzodiazepine medication (OR : 3.31 [1.16 ; 9.49] p=0.0255), and lower quality of life (OR : 1.09 [1.02 ; 1.17] p=0.0087). Generalised epilepsy was a protective factor with uni and multivariate models (OR : 0.34 [0.11 ; 1.00] p=0.0492). Conclusions : In the tertiary epileptic department of Rennes, more than 20% of patients with epilepsy in our department suffered from depression during the inclusion period according to the NDDIE. Among those “depressed” subjects, less than one out of five seemed to receive a proper psychiatric care. That’s why this study highlights the importance of interdisciplinary cooperation between neurologists and psychiatrists in order to aim a better management of epileptic patients as a whole.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02145897
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Submitted on : Monday, June 3, 2019 - 2:00:37 PM
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Claire Vallée. Épidémiologie et facteurs associés au syndrome dépressif chez les patients suivis au centre hospitalo-universitaire de Rennes pour une épilepsie. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02145897⟩

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