Troubles psychiatriques dans l’épilepsie idiopathique
Mots-clés :
épilepsie, idiopathique, psychose, anxiété, dépression, TunisiensRésumé
Background: L'épilepsie idiopathique est connue pour avoir une évolution bénigne dans la plupart des cas. Cependant, l'association avec des troubles psychiatriques pourrait aggraver l'évolution de la maladie.
Objectif: Nous avons étudié la prévalence des symptoms psychiatriques chez les patients atteints d'épilepsie idiopathique et évalué les facteurs prédictifs de survenue de ces manifestations.
Méthodes: Nous avons mené une étude prospective incluant de façon consécutive des patients diagnostiqués avec une épilepsie idiopathique. Nous avons exclu ceux avec un diagnostic psychiatrique connu ou avec des troubles psychiatriques post-ictaux. Nous avons évalué les symptômes psychiatriques via le Neurological Disorders Depression Inventory for Epilepsy, le Generalized Anxiety Disorder - 7 et le Neuropsychiatric Inventory Scale.
Résultats: Parmi 101 patients attaints d'épilepsie idiopathique, des symptoms psychiatriques ont été diagnostiqués chez 61 % d'entre eux. Une anxiété (36,6 %), des symptômes psychotiques (21 %) et une dépression (15,8 %) étaient les manifestations psychiatriques les plus fréquentes. Le sexe féminin (p = 0,000) et une durée plus longue de l'épilepsie (p = 0,046) étaient significativement associés aux troubles psychiatriques. Les patients sous carbamazépine et acide valproïque avaient une fréquence de dépression plus faible (respectivement p = 0,018 et p = 0,003).
Conclusions: Les troubles psychiatriques sont fréquents dans l'épilepsie idiopathique dominés par les manifestations psychotiques et l'anxiété. Le sexe féminin et la longue évolution de la maladie étaient les principaux facteurs prédictifs des manifestations psychiatriques et doivent être pris en compte dans la prise en charge de l'épilepsie idiopathique.
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