Clinical and psychopathological definition of the interictal dysphoric disorder of epilepsy

Marco Mula, Regina Jauch, Andrea Cavanna, Laura Collimedaglia, Davide Barbagli, Verena Gaus, Rebekka Kretz, Michele Viana, Grazia Tota, Heike Israel, Uwe Reuter, Peter Martus, Roberto Cantello, Francesco Monaco, Bettina Schmitz

Research output: Contribution to journalArticle

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Abstract

Purpose: Different authors suggested the occurrence of a pleomorphic affective syndrome in patients with epilepsy named interictal dysphoric disorder (IDD). We sought to investigate whether IDD occurs only in patients with epilepsy and to validate IDD features against DSM-IV criteria. Methods: Consecutive patients with a diagnosis of epilepsy (E) or migraine (M) have been assessed using the BDI, MDQ, and the Interictal Dysphoric Disorder Inventory (IDDI), a questionnaire specifically created to evaluate IDD symptoms. Diagnosis of current and lifetime DSM-IV Axis I disorders was established using the MINI Plus version 5.0.0. Results: A total of 229 patients (E = 117; M = 112) were evaluated. Females were significantly more represented in the migraine group (E = 46.5% vs. M = 73.3% p = 0.009), but there was no difference in age, duration of the disease, or education level. Patients with epilepsy were more likely to screen positively at MDQ (E = 17% vs. M = 5.3% p = 0.006) and to have a diagnosis of bipolar disorder (E = 14.5% vs. M = 4.5% p = 0.013) as compared to migraine patients. There was no between-groups difference in IDD prevalence (E = 17%; M = 18.7%) and IDDI total scores (E = 4.1 ± 2.0 vs. M = 3.8 ± 2.0). Validation of IDD against DSM-IV categories showed current major depression being the foremost diagnostic category correlated with IDD in both epilepsy (OR = 0.32-0.12-0.88, p = 0.028) and migraine (OR = 0.10, 95% CI = 0.02-0.49, p = 0.004) samples. Current anxiety disorder correlated with IDD only in migraine patients (OR = 0.19, 95% CI = 0.05-0.77, p = 0.02). Conclusion: IDD represents a homogenous construct that can be diagnosed in a relevant proportion of patients but it is not typical only of epilepsy, occurring in other central nervous system disorders such as migraine.

Original languageEnglish
Pages (from-to)650-656
Number of pages7
JournalEpilepsia
Volume49
Issue number4
DOIs
Publication statusPublished - Apr 2008

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Epilepsy
Migraine Disorders
Diagnostic and Statistical Manual of Mental Disorders
Equipment and Supplies
Central Nervous System Diseases
Anxiety Disorders
Bipolar Disorder
Depression
Education

Keywords

  • Bipolar disorder
  • Depression
  • Epilepsy
  • Interictal dysphoric disorder
  • Migraine

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Mula, M., Jauch, R., Cavanna, A., Collimedaglia, L., Barbagli, D., Gaus, V., ... Schmitz, B. (2008). Clinical and psychopathological definition of the interictal dysphoric disorder of epilepsy. Epilepsia, 49(4), 650-656. https://doi.org/10.1111/j.1528-1167.2007.01434.x

Clinical and psychopathological definition of the interictal dysphoric disorder of epilepsy. / Mula, Marco; Jauch, Regina; Cavanna, Andrea; Collimedaglia, Laura; Barbagli, Davide; Gaus, Verena; Kretz, Rebekka; Viana, Michele; Tota, Grazia; Israel, Heike; Reuter, Uwe; Martus, Peter; Cantello, Roberto; Monaco, Francesco; Schmitz, Bettina.

In: Epilepsia, Vol. 49, No. 4, 04.2008, p. 650-656.

Research output: Contribution to journalArticle

Mula, M, Jauch, R, Cavanna, A, Collimedaglia, L, Barbagli, D, Gaus, V, Kretz, R, Viana, M, Tota, G, Israel, H, Reuter, U, Martus, P, Cantello, R, Monaco, F & Schmitz, B 2008, 'Clinical and psychopathological definition of the interictal dysphoric disorder of epilepsy', Epilepsia, vol. 49, no. 4, pp. 650-656. https://doi.org/10.1111/j.1528-1167.2007.01434.x
Mula M, Jauch R, Cavanna A, Collimedaglia L, Barbagli D, Gaus V et al. Clinical and psychopathological definition of the interictal dysphoric disorder of epilepsy. Epilepsia. 2008 Apr;49(4):650-656. https://doi.org/10.1111/j.1528-1167.2007.01434.x
Mula, Marco ; Jauch, Regina ; Cavanna, Andrea ; Collimedaglia, Laura ; Barbagli, Davide ; Gaus, Verena ; Kretz, Rebekka ; Viana, Michele ; Tota, Grazia ; Israel, Heike ; Reuter, Uwe ; Martus, Peter ; Cantello, Roberto ; Monaco, Francesco ; Schmitz, Bettina. / Clinical and psychopathological definition of the interictal dysphoric disorder of epilepsy. In: Epilepsia. 2008 ; Vol. 49, No. 4. pp. 650-656.
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abstract = "Purpose: Different authors suggested the occurrence of a pleomorphic affective syndrome in patients with epilepsy named interictal dysphoric disorder (IDD). We sought to investigate whether IDD occurs only in patients with epilepsy and to validate IDD features against DSM-IV criteria. Methods: Consecutive patients with a diagnosis of epilepsy (E) or migraine (M) have been assessed using the BDI, MDQ, and the Interictal Dysphoric Disorder Inventory (IDDI), a questionnaire specifically created to evaluate IDD symptoms. Diagnosis of current and lifetime DSM-IV Axis I disorders was established using the MINI Plus version 5.0.0. Results: A total of 229 patients (E = 117; M = 112) were evaluated. Females were significantly more represented in the migraine group (E = 46.5{\%} vs. M = 73.3{\%} p = 0.009), but there was no difference in age, duration of the disease, or education level. Patients with epilepsy were more likely to screen positively at MDQ (E = 17{\%} vs. M = 5.3{\%} p = 0.006) and to have a diagnosis of bipolar disorder (E = 14.5{\%} vs. M = 4.5{\%} p = 0.013) as compared to migraine patients. There was no between-groups difference in IDD prevalence (E = 17{\%}; M = 18.7{\%}) and IDDI total scores (E = 4.1 ± 2.0 vs. M = 3.8 ± 2.0). Validation of IDD against DSM-IV categories showed current major depression being the foremost diagnostic category correlated with IDD in both epilepsy (OR = 0.32-0.12-0.88, p = 0.028) and migraine (OR = 0.10, 95{\%} CI = 0.02-0.49, p = 0.004) samples. Current anxiety disorder correlated with IDD only in migraine patients (OR = 0.19, 95{\%} CI = 0.05-0.77, p = 0.02). Conclusion: IDD represents a homogenous construct that can be diagnosed in a relevant proportion of patients but it is not typical only of epilepsy, occurring in other central nervous system disorders such as migraine.",
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AU - Jauch, Regina

AU - Cavanna, Andrea

AU - Collimedaglia, Laura

AU - Barbagli, Davide

AU - Gaus, Verena

AU - Kretz, Rebekka

AU - Viana, Michele

AU - Tota, Grazia

AU - Israel, Heike

AU - Reuter, Uwe

AU - Martus, Peter

AU - Cantello, Roberto

AU - Monaco, Francesco

AU - Schmitz, Bettina

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N2 - Purpose: Different authors suggested the occurrence of a pleomorphic affective syndrome in patients with epilepsy named interictal dysphoric disorder (IDD). We sought to investigate whether IDD occurs only in patients with epilepsy and to validate IDD features against DSM-IV criteria. Methods: Consecutive patients with a diagnosis of epilepsy (E) or migraine (M) have been assessed using the BDI, MDQ, and the Interictal Dysphoric Disorder Inventory (IDDI), a questionnaire specifically created to evaluate IDD symptoms. Diagnosis of current and lifetime DSM-IV Axis I disorders was established using the MINI Plus version 5.0.0. Results: A total of 229 patients (E = 117; M = 112) were evaluated. Females were significantly more represented in the migraine group (E = 46.5% vs. M = 73.3% p = 0.009), but there was no difference in age, duration of the disease, or education level. Patients with epilepsy were more likely to screen positively at MDQ (E = 17% vs. M = 5.3% p = 0.006) and to have a diagnosis of bipolar disorder (E = 14.5% vs. M = 4.5% p = 0.013) as compared to migraine patients. There was no between-groups difference in IDD prevalence (E = 17%; M = 18.7%) and IDDI total scores (E = 4.1 ± 2.0 vs. M = 3.8 ± 2.0). Validation of IDD against DSM-IV categories showed current major depression being the foremost diagnostic category correlated with IDD in both epilepsy (OR = 0.32-0.12-0.88, p = 0.028) and migraine (OR = 0.10, 95% CI = 0.02-0.49, p = 0.004) samples. Current anxiety disorder correlated with IDD only in migraine patients (OR = 0.19, 95% CI = 0.05-0.77, p = 0.02). Conclusion: IDD represents a homogenous construct that can be diagnosed in a relevant proportion of patients but it is not typical only of epilepsy, occurring in other central nervous system disorders such as migraine.

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KW - Depression

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