Soo Jeong Kim1, Sang-Ahm Lee2, Han Uk Ryu3, Su-Hyun Han4, Gha-Hyun Lee5, Kwang-Deog Jo6, Jung Bin Kim7. 1. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 2. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: salee@amc.seoul.kr. 3. Department of Neurology, Chonbuk National University Medical School, Jeonju, Republic of Korea. 4. Department of Neurology, Chung-Ang University College of Medicine, Seoul, Republic of Korea. 5. Department of Neurology, Pusan National University School of Medicine, Pusan, Republic of Korea. 6. Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea. 7. Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
Abstract
PURPOSE: Obsessive-compulsive disorder (OCD) is a common but underrecognized psychiatric condition comorbid with epilepsy. We thus investigated clinical factors associated with obsessive-compulsive symptoms (OCS) in adults with epilepsy. METHODS: This was a cross-sectional multicenter study in Republic of Korea. Obsessive-compulsive symptoms were assessed using the Obsessive-Compulsive Inventory-Revised (OCI-R). Clinical factors that were assessed included age, sex, seizure-related variables, and the number and use of antiepileptic drugs (AEDs) prescribed. Data were analyzed by stepwise linear regression and adjusted according to anxiety and depressive symptoms as assessed by Hospital Anxiety Depression Scale (HADS). RESULTS: The study population comprised 221 adults with epilepsy (42.1% male, 39.7 ± 11.9 years of age). The mean OCI-R score was 18.0 (standard deviation, 12.7), and an OCI-R score of ≥21 was obtained for 40.3% of the study sample. On a stepwise linear regression analysis, epilepsy severity, temporal lobe seizures, the use of topiramate, and the use of lamotrigine were identified as independent factors associated with OCI-R score after adjusting for anxiety according to the HADS. All factors except topiramate usage were positively associated with OCS. The total explained variance was 37.3%. CONCLUSIONS: Obsessive-compulsive symptoms are common in persons with epilepsy and are associated with severe epilepsy, temporal lobe seizures, and the use of topiramate and lamotrigine. Specifically, the use of lamotrigine may aggravate OCS, whereas the use of topiramate may have beneficial effects on OCS.
PURPOSE:Obsessive-compulsive disorder (OCD) is a common but underrecognized psychiatric condition comorbid with epilepsy. We thus investigated clinical factors associated with obsessive-compulsive symptoms (OCS) in adults with epilepsy. METHODS: This was a cross-sectional multicenter study in Republic of Korea. Obsessive-compulsive symptoms were assessed using the Obsessive-Compulsive Inventory-Revised (OCI-R). Clinical factors that were assessed included age, sex, seizure-related variables, and the number and use of antiepileptic drugs (AEDs) prescribed. Data were analyzed by stepwise linear regression and adjusted according to anxiety and depressive symptoms as assessed by Hospital Anxiety Depression Scale (HADS). RESULTS: The study population comprised 221 adults with epilepsy (42.1% male, 39.7 ± 11.9 years of age). The mean OCI-R score was 18.0 (standard deviation, 12.7), and an OCI-R score of ≥21 was obtained for 40.3% of the study sample. On a stepwise linear regression analysis, epilepsy severity, temporal lobe seizures, the use of topiramate, and the use of lamotrigine were identified as independent factors associated with OCI-R score after adjusting for anxiety according to the HADS. All factors except topiramate usage were positively associated with OCS. The total explained variance was 37.3%. CONCLUSIONS:Obsessive-compulsive symptoms are common in persons with epilepsy and are associated with severe epilepsy, temporal lobe seizures, and the use of topiramate and lamotrigine. Specifically, the use of lamotrigine may aggravate OCS, whereas the use of topiramate may have beneficial effects on OCS.