Epilepsy

Adult Epilepsy: Effect of Treatment on Anxiety

Improvement in Anxiety Symptoms in Medically Treated Adult Epilepsy Patients (N = 7415)

2009 – 2018

GAD-7 – Generalized Anxiety Disorder questionnaire

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 5.3 at the initial visit to 4.5 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 37.3 months. The standard box plots reflect the median and the 25th and 75th quartiles.

Clinical Context:

In the medical group, 21.4% 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 29.9% of this symptomatic group. In another 26% of patients, the severity of anxiety was significantly lessened (GAD-7 scores = 5–10), while the rest remained stable. However, anxiety worsened from mild to moderate/severe in 20.3% and developed de novo in 5.5% during follow-up.

Improvement in Anxiety Symptoms in Surgically Treated Adult Epilepsy Patients (N = 476)

2009 – 2018

GAD-7 – Generalized Anxiety Disorder questionnaire

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 Anxiety symptoms also improved in adult patients treated with surgery. The mean GAD-7 score at the initial visit was 6.2, higher than the mean score of 4.7 seen 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 33.4 months. The standard box plots reflect the median and the 25th and 75th quartiles.

Clinical Context:

In the surgical group, 23.1% 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 55.5% of this symptomatic group. In 28.2%, the severity of anxiety was significantly lessened (GAD-7 scores = 5-10). The rest remained stable by the last follow-up. Of note, anxiety worsened from mild to moderate/severe in 17.5% and developed de novo in 17% 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.