Volume 19, Issue 1 (3-2025)
Qom Univ Med Sci J 2025, 19(1): 244-254 |
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Ethics code: IR.USWR.REC.1400.072
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Sayadnasiri M, Deilami M, Boshkare F, Torabian M, Torabian H. The Prevalence of Seizures and Epilepsy and the Related Factors in Patients With Psychiatric Disorders Admitted to a Psychiatric Hospital in Tehran, Iran. Qom Univ Med Sci J 2025; 19 (1) : 2994.1
URL: http://journal.muq.ac.ir/article-1-3866-en.html
URL: http://journal.muq.ac.ir/article-1-3866-en.html
1- Department of Psychiatry, School of Behavioral Sciences and Mental Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Clinical Research Development Center, Rofeideh Rehabilitation Hospital, University of Social Welfare and Rehabilitation Sciences,Tehran, Iran.
3- Department of Counseling, Faculty of Human Science, Islamic Azad university, Tehran, Iran.
4- Department of Pediatric Nursing, School of Nursing, Qom University of Medical Sciences, Qom, Iran.
2- Clinical Research Development Center, Rofeideh Rehabilitation Hospital, University of Social Welfare and Rehabilitation Sciences,Tehran, Iran.
3- Department of Counseling, Faculty of Human Science, Islamic Azad university, Tehran, Iran.
4- Department of Pediatric Nursing, School of Nursing, Qom University of Medical Sciences, Qom, Iran.
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Introduction
Epilepsy and seizure are neurological disorders that occur in the form of convulsive attacks. An epileptic seizure is caused by excessive or synchronous neuronal activity. The relationship between psychiatric disorders and epilepsy highlights the necessity of investigating psychiatric disease risk factors in epileptic individuals. The factors such as aging and mental illnesses can affect the rate of seizures in different age groups. Therefore, considering the need for more information in this field in Iran, the present study aims to investigate the incidence of seizures and epilepsy in patients with psychiatric disorders admitted to Razi Psychiatric Hospital in Tehran, Iran.
Methods
This is a descriptive cross-sectional study. Participants were 300 patients of different ages hospitalized in Razi Psychiatric Hospital in Tehran in 2022, assigned to two groups of <60 and >60 years. Patients were diagnosed by clinical and physical examinations, EEG findings, and MRI. The inclusion criteria were the diagnosis of seizure, epilepsy, and psychiatric disorders by at least one psychiatrist based on clinical criteria. The exclusion criteria were no psychiatric disorder, no hospitalization, and lack of clinical symptoms or MRI findings that can confirm seizure/ diagnosis. The information recorded in the files included age, sex, marital status, education, occupation, type of epilepsy/seizure, etiology of epilepsy/seizure, EEG and MRI findings, and were analyzed by Spearman’s correlation test and multiple logistic regression analysis.
Results
It was found that 21% and 59% of hospitalized psychiatric patients aged >60 years had seizures and epilepsy, respectively, while 13% and 46% of patients <60 years had seizures and epilepsy. The rate of seizures (r=0.86, P<0.001) and epilepsy (r=0.66, P<0.05) had a significant relationship with aging. Based on the regression analy-sis results, the factors of illiteracy (OR= 1.55), male gender (OR=1.28) and having depression (OR=3.33) had a significant relationship with the rate of seizures.
Conclusion
Among the hospitalized psychiatric patients, there was a significantly higher prevalence of seizures and epilepsy in people over 60 years of age. According to the findings, although the prevalence of seizures and epilepsy in psychiatric patients cannot be determined, but the findings indicate that epilepsy is associated with some factors. The study found a higher prevalence of epilepsy in males compared to females. More studies in this field with a larger sample size are recommended.
Ethical Considerations
Compliance with ethical guidelines
The study was approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (Code: IR.USWR.REC.1400.072).
Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.
Authors contributions
All authors contributed equally to the conception and design of the study, data collection and analysis, interpretation of the results, and drafting of the manuscript. Each author approved the final version of the manuscript for submission.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors would like to thank all participants, as well as the Razi Psy-chiatric Hospital Clinical Research Development Center of Rofeideh Rehabilitation Hospital, for their cooperation.
Epilepsy and seizure are neurological disorders that occur in the form of convulsive attacks. An epileptic seizure is caused by excessive or synchronous neuronal activity. The relationship between psychiatric disorders and epilepsy highlights the necessity of investigating psychiatric disease risk factors in epileptic individuals. The factors such as aging and mental illnesses can affect the rate of seizures in different age groups. Therefore, considering the need for more information in this field in Iran, the present study aims to investigate the incidence of seizures and epilepsy in patients with psychiatric disorders admitted to Razi Psychiatric Hospital in Tehran, Iran.
Methods
This is a descriptive cross-sectional study. Participants were 300 patients of different ages hospitalized in Razi Psychiatric Hospital in Tehran in 2022, assigned to two groups of <60 and >60 years. Patients were diagnosed by clinical and physical examinations, EEG findings, and MRI. The inclusion criteria were the diagnosis of seizure, epilepsy, and psychiatric disorders by at least one psychiatrist based on clinical criteria. The exclusion criteria were no psychiatric disorder, no hospitalization, and lack of clinical symptoms or MRI findings that can confirm seizure/ diagnosis. The information recorded in the files included age, sex, marital status, education, occupation, type of epilepsy/seizure, etiology of epilepsy/seizure, EEG and MRI findings, and were analyzed by Spearman’s correlation test and multiple logistic regression analysis.
Results
It was found that 21% and 59% of hospitalized psychiatric patients aged >60 years had seizures and epilepsy, respectively, while 13% and 46% of patients <60 years had seizures and epilepsy. The rate of seizures (r=0.86, P<0.001) and epilepsy (r=0.66, P<0.05) had a significant relationship with aging. Based on the regression analy-sis results, the factors of illiteracy (OR= 1.55), male gender (OR=1.28) and having depression (OR=3.33) had a significant relationship with the rate of seizures.
Conclusion
Among the hospitalized psychiatric patients, there was a significantly higher prevalence of seizures and epilepsy in people over 60 years of age. According to the findings, although the prevalence of seizures and epilepsy in psychiatric patients cannot be determined, but the findings indicate that epilepsy is associated with some factors. The study found a higher prevalence of epilepsy in males compared to females. More studies in this field with a larger sample size are recommended.
Ethical Considerations
Compliance with ethical guidelines
The study was approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (Code: IR.USWR.REC.1400.072).
Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.
Authors contributions
All authors contributed equally to the conception and design of the study, data collection and analysis, interpretation of the results, and drafting of the manuscript. Each author approved the final version of the manuscript for submission.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors would like to thank all participants, as well as the Razi Psy-chiatric Hospital Clinical Research Development Center of Rofeideh Rehabilitation Hospital, for their cooperation.
Type of Study: Original Article |
Subject:
داخلی اعصاب
Received: 2023/11/19 | Accepted: 2024/06/30 | Published: 2024/04/29
Received: 2023/11/19 | Accepted: 2024/06/30 | Published: 2024/04/29
References
1. Verma A, Kumar A. Clinical and etiological profile of epilepsy in elderly: A hospital-based study from rural India. Acta Neurol Belgica. 2017. 117(1):139-44. [DOI:10.1007/s13760-016-0719-x] [DOI:10.1007/s13760-016-0719-x]
2. Subota A, Pham T, Jette N, Sauro K, Lorenzetti D, Holroyd‐Leduc J. The association between dementia and epilepsy: A systematic review and meta‐analysis. Epilepsia. 2017; 58(6):962-72. [DOI:10.1111/epi.13744] [DOI:10.1111/epi.13744]
3. Najafi M, Ahmadi P, Tabrizi Z. [Comparison of clinical characteristics of epilepsy in two age groups of 20-60 and more than 60 years old among the patients referred to Isfahan city, Iran, epilepsy clinics during 2014-2015 (Persian)]. J Isfahan Med Sch. 2017; 34(411):1523-30. [Link]
4. McLaughlin DP, Pachana NA, Mcfarland K. Stigma, seizure frequency and quality of life: The impact of epilepsy in late adulthood. Seizure. 2008; 17(3):281-7. [DOI:10.1016/j.seizure.2007.09.001] [DOI:10.1016/j.seizure.2007.09.001]
5. Burley SK, Bhikadiya C, Bi C, Bittrich S, Chen L, Crichlow GV, et al. RCSB protein data bank: Powerful new tools for exploring 3D structures of biological macromolecules for basic and applied research and education in fundamental biology, biomedicine, biotechnology, bioengineering and energy sciences. Nucleic Acids Res. 2021; 49(D1):D437-51. [DOI:10.1093/nar/gkaa1038] [DOI:10.1093/nar/gkaa1038]
6. Domínguez-Aguilera MC, Muñiz-Landeros CE. Prevalence of psychiatric disorders in patients with epilepsy in a tertiary level care hospital: Detection through the MINI PLUS International Structured Interview. Med Univ. 2017; 19(74):3-6. [DOI:10.1016/j.rmu.2016.11.003] [DOI:10.1016/j.rmu.2016.11.003]
7. Dewar S, Eliashiv D, Walshaw PD, Engel J, Fried I, Moseley BD. Safety, efficacy, and life satisfaction following epilepsy surgery in patients aged 60 years and older. J Neurosurg. 2016; 124(4):945-51. [DOI:10.3171/2015.3.JNS142317] [DOI:10.3171/2015.3.JNS142317]
8. Edefonti V, Bravi F, Turner K, Beghi E, Canevini MP, Ferraroni M, et al. Health-related quality of life in adults with epilepsy: The effect of age, age at onset and duration of epilepsy in a multicentre Italian study. BMC Neurol. 2011; 11:1-3. [DOI:10.1186/1471-2377-11-33] [DOI:10.1186/1471-2377-11-33]
9. Cloyd J, Hauser W, Towne A, Ramsay R, Mattson R, Gilliam F, et al. Epidemiological and medical aspects of epilepsy in the elderly. Epilepsy Res. 2006; 68:39-48. [DOI:10.1016/j.eplepsyres.2005.07.016] [DOI:10.1016/j.eplepsyres.2005.07.016]
10. Hughes JR. Behavior, Gamma, fast, and ultrafast waves of the brain: Their relationships with epilepsy and behavior. Epilepsy Behav. 2008; 13(1):25-31. [DOI:10.1016/j.yebeh.2008.01.011] [DOI:10.1016/j.yebeh.2008.01.011]
11. Dawson TM, Golde TE, Lagier-Tourenne C. Animal models of neurodegenerative diseases. Nat Neurosci. 2018; 21(10):1370-9. [DOI:10.1038/s41593-018-0236-8] [PMID] [DOI:10.1038/s41593-018-0236-8]
12. Acharya JN, Acharya VJ. Epilepsy in the elderly: Special considerations and challenges. Ann Indian Acad Neurol. 2014; 17(Suppl 1):S18-26. [DOI:10.4103/0972-2327.128645] [DOI:10.4103/0972-2327.128645]
13. Pugh MJ, Copeland LA, Zeber JE, Cramer JA, Amuan ME, Cavazos JE, et al. The impact of epilepsy on health status among younger and older adults. Epilepsia. 2005; 46(11):1820-7. [DOI:10.1111/j.1528-1167.2005.00291.x] [DOI:10.1111/j.1528-1167.2005.00291.x]
14. Peña-Salazar C, Alfonso-Ramos M, Arroyo-Uriarte P, Serrano-Blanco A, Aznar-Lou I. Is epilepsy related to psychiatric disorders in people with intellectual disability? A systematic review. J Intellectual Disabil. 2022; 4:17446295221116506. [DOI:10.1177/17446295221116506] [DOI:10.1177/17446295221116506]
15. Mohammadi MR, Ghanizadeh A, Davidian H, Mohammadi M, Norouzian M. Prevalence of epilepsy and comorbidity of psychiatric disorders in Iran. Seizure. 2006; 15(7):476-82. [DOI:10.1016/j.seizure.2006.05.011] [DOI:10.1016/j.seizure.2006.05.011]
16. Nigussie K, Lemma A, Sertsu A, Asfaw H, Kerebih H, Abdeta T. Depression, anxiety and associated factors among people with epilepsy and attending outpatient treatment at primary public hospitals in northwest Ethiopia: A multicenter cross-sectional study. Plos One. 2021; 16(8):e0256236. [DOI:10.1371/journal.pone.0256236] [DOI:10.1371/journal.pone.0256236]
17. Mufaddel A. Epilepsy and its management in relation to psychiatry. Int J Neurorehabilitation. 2014; 1(3):1000121.[DOI:10.4172/2376-0281.1000121] [DOI:10.4172/2376-0281.1000121]
18. Ricciardi E. Social capital and geriatric depression during ageing: Could this association be mediated by perceived social support and perceived social cohesion among neighbors? Iconocrazia. 2023; 1(23):21-37. [Link]
19. Verma A, Kumar A. Clinical and etiological profile of epilepsy in elderly: A hospital-based study from rural India. Acta Neurol Belgica. 2017. 117(1):139-44. [DOI:10.1007/s13760-016-0719-x] [DOI:10.1007/s13760-016-0719-x]
20. Subota A, Pham T, Jette N, Sauro K, Lorenzetti D, Holroyd‐Leduc J. The association between dementia and epilepsy: A systematic review and meta‐analysis. Epilepsia. 2017; 58(6):962-72. [DOI:10.1111/epi.13744] [DOI:10.1111/epi.13744]
21. Najafi M, Ahmadi P, Tabrizi Z. [Comparison of clinical characteristics of epilepsy in two age groups of 20-60 and more than 60 years old among the patients referred to Isfahan city, Iran, epilepsy clinics during 2014-2015 (Persian)]. J Isfahan Med Sch. 2017; 34(411):1523-30. [Link]
22. McLaughlin DP, Pachana NA, Mcfarland K. Stigma, seizure frequency and quality of life: The impact of epilepsy in late adulthood. Seizure. 2008; 17(3):281-7. [DOI:10.1016/j.seizure.2007.09.001] [DOI:10.1016/j.seizure.2007.09.001]
23. Burley SK, Bhikadiya C, Bi C, Bittrich S, Chen L, Crichlow GV, et al. RCSB protein data bank: Powerful new tools for exploring 3D structures of biological macromolecules for basic and applied research and education in fundamental biology, biomedicine, biotechnology, bioengineering and energy sciences. Nucleic Acids Res. 2021; 49(D1):D437-51. [DOI:10.1093/nar/gkaa1038] [DOI:10.1093/nar/gkaa1038]
24. Domínguez-Aguilera MC, Muñiz-Landeros CE. Prevalence of psychiatric disorders in patients with epilepsy in a tertiary level care hospital: Detection through the MINI PLUS International Structured Interview. Med Univ. 2017; 19(74):3-6. [DOI:10.1016/j.rmu.2016.11.003] [DOI:10.1016/j.rmu.2016.11.003]
25. Dewar S, Eliashiv D, Walshaw PD, Engel J, Fried I, Moseley BD. Safety, efficacy, and life satisfaction following epilepsy surgery in patients aged 60 years and older. J Neurosurg. 2016; 124(4):945-51. [DOI:10.3171/2015.3.JNS142317] [DOI:10.3171/2015.3.JNS142317]
26. Edefonti V, Bravi F, Turner K, Beghi E, Canevini MP, Ferraroni M, et al. Health-related quality of life in adults with epilepsy: The effect of age, age at onset and duration of epilepsy in a multicentre Italian study. BMC Neurol. 2011; 11:1-3. [DOI:10.1186/1471-2377-11-33] [DOI:10.1186/1471-2377-11-33]
27. Cloyd J, Hauser W, Towne A, Ramsay R, Mattson R, Gilliam F, et al. Epidemiological and medical aspects of epilepsy in the elderly. Epilepsy Res. 2006; 68:39-48. [DOI:10.1016/j.eplepsyres.2005.07.016] [DOI:10.1016/j.eplepsyres.2005.07.016]
28. Hughes JR. Behavior, Gamma, fast, and ultrafast waves of the brain: Their relationships with epilepsy and behavior. Epilepsy Behav. 2008; 13(1):25-31. [DOI:10.1016/j.yebeh.2008.01.011] [DOI:10.1016/j.yebeh.2008.01.011]
29. Dawson TM, Golde TE, Lagier-Tourenne C. Animal models of neurodegenerative diseases. Nat Neurosci. 2018; 21(10):1370-9. [DOI:10.1038/s41593-018-0236-8] [PMID] [DOI:10.1038/s41593-018-0236-8]
30. Acharya JN, Acharya VJ. Epilepsy in the elderly: Special considerations and challenges. Ann Indian Acad Neurol. 2014; 17(Suppl 1):S18-26. [DOI:10.4103/0972-2327.128645] [DOI:10.4103/0972-2327.128645]
31. Pugh MJ, Copeland LA, Zeber JE, Cramer JA, Amuan ME, Cavazos JE, et al. The impact of epilepsy on health status among younger and older adults. Epilepsia. 2005; 46(11):1820-7. [DOI:10.1111/j.1528-1167.2005.00291.x] [DOI:10.1111/j.1528-1167.2005.00291.x]
32. Peña-Salazar C, Alfonso-Ramos M, Arroyo-Uriarte P, Serrano-Blanco A, Aznar-Lou I. Is epilepsy related to psychiatric disorders in people with intellectual disability? A systematic review. J Intellectual Disabil. 2022; 4:17446295221116506. [DOI:10.1177/17446295221116506] [DOI:10.1177/17446295221116506]
33. Mohammadi MR, Ghanizadeh A, Davidian H, Mohammadi M, Norouzian M. Prevalence of epilepsy and comorbidity of psychiatric disorders in Iran. Seizure. 2006; 15(7):476-82. [DOI:10.1016/j.seizure.2006.05.011] [DOI:10.1016/j.seizure.2006.05.011]
34. Nigussie K, Lemma A, Sertsu A, Asfaw H, Kerebih H, Abdeta T. Depression, anxiety and associated factors among people with epilepsy and attending outpatient treatment at primary public hospitals in northwest Ethiopia: A multicenter cross-sectional study. Plos One. 2021; 16(8):e0256236. [DOI:10.1371/journal.pone.0256236] [DOI:10.1371/journal.pone.0256236]
35. Mufaddel A. Epilepsy and its management in relation to psychiatry. Int J Neurorehabilitation. 2014; 1(3):1000121.[DOI:10.4172/2376-0281.1000121] [DOI:10.4172/2376-0281.1000121]
36. Ricciardi E. Social capital and geriatric depression during ageing: Could this association be mediated by perceived social support and perceived social cohesion among neighbors? Iconocrazia. 2023; 1(23):21-37. [Link]
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