Epilepsy

Adult Epilepsy: Effect of Treatment on Anxiety

Improvement in Anxiety Symptoms in Medically Treated Adult Epilepsy Patients (N = 5290)

2009 – 2017

Anxiety symptoms were assessed using the Generalized Anxiety Disorder questionnaire (GAD-7),¹ a patient-completed, validated screening measure for symptoms of anxiety. The mean GAD-7 score improved from 5.0 at the initial visit to 4.3 at the last follow-up visit in patients treated with antiepileptic medications only (P < 0.0001). N = adult epilepsy patients with at least 6 months of follow-up. Mean duration of follow-up was 38.4 months. The standard box plots reflect the median and the 25th and 75th quartiles.

Clinical Context: In the medical group, 19% of patients had moderate to severe anxiety symptoms at their initial visit, as defined by GAD-7 score ≥ 10. Anxiety symptoms resolved (GAD-7 score < 5) by the last follow-up in 27.2% of this symptomatic group. In another 30.1% of patients, the severity of anxiety was significantly lessened (GAD-7 scores = 5-10), while the rest remained unchanged. Anxiety worsened from mild to moderate/severe in 20.7% and developed de novo in 18.6% during follow-up.

Improvement in Anxiety Symptoms in Surgically Treated Adult Epilepsy Patients (N = 447)

2009 – 2017

Anxiety symptoms also improved in adult patients treated with surgery. The mean GAD-7 score improved from 6.5 at the initial visit to 4.9 at last follow-up (P < 0.001). N = adult epilepsy patients with at least 6 months of follow-up. Mean duration of follow-up was 44.9 months. The standard box plots reflect the median and the 25th and 75th quartiles.

Clinical Context: In the surgical group, 28.2% of patients had moderate to severe anxiety symptoms before surgery, as defined by GAD-7 score ≥ 10. After surgery, anxiety symptoms resolved (GAD-7 score < 5) by the last follow-up in 34.9% of this symptomatic group. In 26.2%, the severity of anxiety was significantly lessened (GAD-7 scores = 5-10). Of note, anxiety worsened from mild to moderate/severe in 17.6% and developed de novo in 21.1% during follow-up.

References
  1. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-1097.