A study published in the journal Epilepsia – a journal of the International League Against Epilepsy – suggests that almost 1 in 5 people with epilepsy may also have symptoms of attention deficit hyperactivity disorder. Led by Dr. Allan B. Ettinger, director of the Epilepsy Center at Neurological Surgery, PC and professor of Clinical Neurology at the Albert Einstein College of Medicine – both in New York City – the study is the first to show such an association.
“Little was previously known about the prevalence of attention deficit hyperactivity disorder (ADHD) symptoms in adults with epilepsy, and the results were quite striking,” says Dr. Ettinger. “To my knowledge, this is the first time ADHD symptoms in adults with epilepsy have been described in the scientific literature. Yet, the presence of these symptoms may have severe implications for patients’ quality of life, mood, anxiety, and functioning in both their social and work lives.”
To reach their findings, the team sent a postal survey to a national sample of adults with active epilepsy, of whom 1,361 responded. The survey included questions from the Adult ADHD Self-Report Scale version 6 (ASRS-6), Physicians Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Assessment 7 (GAD-7). In addition, patients were asked about seizure frequency and the number of antiepileptic drugs taken during the past 3 months, as well as periods of anxiety and depression. The Quality of Life and Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Sheehan Disability Scale (SDS) were used to measure patient outcomes, while statistical analyses were used to assess the association between ADHD symptoms and quality of life.
‘We have to broaden our view of what epilepsy entails’
The researchers say 251 of the 1,361 respondents (18.4%) were identified as experiencing symptoms of ADHD – almost 1 in 5. What is more, patients with ADHD symptoms were eight times more likely to have symptoms of anxiety and nine times more likely to have depression. Dr. Ettinger says physicians who treat epilepsy often put symptoms of anxiety, depression, reduced quality of life and psychosocial outcomes down to seizures, antiepileptic medication and other conditions of the central nervous system. However, he says the team’s findings show ADHD could be a contributor:
“This study reinforces the fact that we have to broaden our view of what epilepsy entails. Our patients may also have psychiatric comorbidities, and screening for and treating these may make a great difference to patients in their family, school and work lives.”
Dr. Ettinger points out, however, that it is unclear as to whether the occurrence of ADHD in patients with epilepsy is the same as the occurrence of ADHD among the general population. If so, there may be treatment options available. “As a next step, we need to validate measures to screen for ADHD specifically in epilepsy and clarify the nature of ADHD symptoms in adults with epilepsy,” he notes. “This will lay the foundation for future trials of treatments that offer the promise of rendering major improvements in the quality of life of adult epilepsy patients.”
This article first appeared on MNT, 19 January 2015.