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RISS 인기검색어
- 검색키워드
- 저자 : Martha Sajatovic (검색결과 3 건)
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Erdong Chen,Martha Sajatovic,Hongyan Liu,Ashley Bukach,Curtis Tatsuoka,Elisabeth Welter,Samantha S. Schmidt,Yvan A. Bamps,Shelley C. Stoll,Tanya M. Spruill,Daniel Friedman,Charles E. Begley,Ross Shego 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.2
Background and Purpose Epilepsy is a chronic neurological disease that represents a tremendousburden on both patients and society in general. Studies have addressed how demographicvariables, socioeconomic variables, and psychological comorbidity are related to thequality of life (QOL) of people with epilepsy (PWE). However, there has been less focus on howthese factors may differ between patients who exhibit varying degrees of seizure control. Thisstudy utilized data from the Managing Epilepsy Well (MEW) Network of the Centers for DiseaseControl and Prevention with the aim of elucidating differences in demographic variables,depression, and QOL between adult PWE. Methods Demographic variables, depression, and QOL were compared between PWE whoexperience clinically relevant differences in seizure occurrence. Results Gender, ethnicity, race, education, income, and relationship status did not differ significantlybetween the seizure-frequency categories (p>0.05). People with worse seizure controlwere significantly younger (p=0.039), more depressed (as assessed using the Patient HealthQuestionnaire) (p=0.036), and had lower QOL (as determined using the 10-item Quality of Lifein Epilepsy for Adults scale) (p<0.001). Conclusions The present results underscore the importance of early screening, detection, andtreatment of depression, since these factors relate to both seizure occurrence and QOL in PWE.
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Systematic Literature Review of Psychiatric Comorbidities in Adults with Epilepsy
Elaine Lu,Nataliya Pyatka,Christopher J Burant,Martha Sajatovic 대한신경과학회 2021 Journal of Clinical Neurology Vol.17 No.2
Background and Purpose Mental illness is disproportionately common in people with epilepsy (PWE). This systematic literature review identified original research articles that reported the prevalence of psychiatric comorbidities based upon clinical assessments in a sample of PWE and assessed the clinical features of the populations found in studies included in our review of mental health comorbidity. Methods The included articles were written in English and published from 2008 to 2018, and focused on adults aged ≥18 years who had psychiatric diagnoses determined in clinical assessments, such as those found in medical records, clinician psychiatric evaluations, structured diagnostic interviews, and mental health screening questionnaires specific for a psychiatric disorder. The primary outcome was the prevalence of psychiatric comorbidities as a percentage of the total sample of PWE. Additional data included the overall sample size, mean age, epilepsy type, study design, and method of diagnosis. A modified Newcastle Ottawa Scale was used to assess the quality of the studies. All 23 articles that were consistent with the inclusion criteria were related to observational studies. Results Mood disorders and anxiety disorders were the most common psychiatric comorbidities, with prevalence rates of 35.0% and 25.6%, respectively. Major depressive disorder was the most common mood disorder, with a prevalence of 24.2%. Post-traumatic stress disorder (PTSD) had the highest reported prevalence among anxiety disorders, at 14.2%, followed by general anxiety disorder at 11.1%. Other comorbidities included psychosis (5.7%), obsessivecompulsive disorder (3.8%), schizophrenia (1.7%), bipolar disorder (6.2%), and substance abuse (7.9%). The pooled prevalence of suicidality, as reported for two studies, was 9.3%. Temporal lobe epilepsy (TLE) was associated with higher levels of psychiatric comorbidity. Two (8.7%) of the 23 studies compared psychiatric comorbidities in TLE with that of extratemporal lobe epilepsy (ETLE), and one of these two studies found that depression was more common in TLE (53.8%) than in ETLE (25%). Regarding seizure types, partial seizures were associated with a higher prevalence of depression vs generalized seizures. Conclusions This systematic literature review of recent original research found a relatively high prevalence of mental health comorbidities in PWE. Mood and anxiety disorders are the most common comorbidities, while psychotic spectrum conditions such as schizophrenia and bipolar disorder are much rarer. The prevalence of comorbidity may vary with the epilepsy type and treatment responsiveness. These findings suggest that screening tools for depression and anxiety should be included as part of the training for epilepsy care, while resources for other relatively common conditions such as PTSD and substance abuse disorders should be readily available to neurology specialists who treat PWE.
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Correlates of Stigma in People with Epilepsy
Carol Blixen,Daisy Ogede,Farren Briggs,Michelle E. Aebi,Christopher Burant,Betsy Wilson,Javier Ponce Terashima,Martha Sajatovic 대한신경과학회 2020 Journal of Clinical Neurology Vol.16 No.3
Background and Purpose Epilepsy is often associated with substantial stigma. This study evaluated clinical correlates of stigma in a sample of people living with epilepsy (PLWE) considered high risk due to frequent seizures or other negative health events. Methods Data were derived from an epilepsy self-management clinical trial. Standardized measures assessed socio-demographics, epilepsy stigma, epilepsy severity, self-efficacy, selfmanagement competency, health literacy, depressive symptoms severity, functional status, social support and quality of life. Results There were 120 individuals, mean age of 41.73 (SD=17.08), 81 men (66.9%), and 79 (65.3%) African-American. Individual factors correlated with worse stigma w ere indicative of more severe or poorly controlled seizures (frequent seizures, worse seizure severity scores, more antiepileptic drugs), mental health comorbidity (worse depression severity, other comorbidities) and factors related to individual functioning and perceived competency in managing their health (health literacy, health functioning, self-efficacy, quality of life). Multivariable linear regression found that worse quality of life, and having a mental condition were associated with more stigma (β=6.4 and 6.8, respectively), while higher self-efficacy, health literacy and social support were associated with less stigma (β=-0.06, -2.1, and -0.3, respectively). These five variables explained 50% of stigma variation. Conclusions Stigma burden can be substantial among PLWE and may vary depending on contextual factors such as mental health comorbidity. Care approaches that screen for psychiatric comorbidities, address low health literacy, institute promising self-management programs, and employ effective health communication strategies about epilepsy misconceptions, may reduce epilepsy related burden.
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