Insomnia moderates the association between recurrent seizures and emotional instability in persons with epilepsy
•Seizures and insomnia were associated with emotional instability.•This association was independent of anxiety.•The interaction between insomnia and seizures may have an effect on emotional instability.•Levetiracetam was independently associated with emotional instability. We investigated the modera...
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| Veröffentlicht in: | Epilepsy & behavior 2021-12, Vol.125, p.108414-108414, Article 108414 |
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| container_title | Epilepsy & behavior |
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| creator | Lee, Sang-Ahm Choi, Eun Ju Jeon, Ji-Ye Han, Su-Hyun Kim, Hyun-Woo Lee, Gha-Hyun Ryu, Han Uk Im, Kayeong Yang, Ha-rin |
| description | •Seizures and insomnia were associated with emotional instability.•This association was independent of anxiety.•The interaction between insomnia and seizures may have an effect on emotional instability.•Levetiracetam was independently associated with emotional instability.
We investigated the moderating effect of sleep disturbance on the association between seizure recurrence and emotional instability in patients with epilepsy, independent of psychological distress.
This was a cross-sectional study. Patients completed the short form of the Affective Lability Scale (ALS-18), Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). A stepwise linear regression analysis and an analysis of covariance with an interaction term were performed.
A total of 171 subjects (63.2% men) were included. The mean ALS-18 score was 15.6 ± 11.3. An ISI ≥ 15, PHQ-9 ≥ 10, and GAD-7 ≥ 7 were noted in 20.5%, 18.1%, and 23.4% of subjects, respectively. A stepwise linear regression analysis found that recurrent seizures in the last year, an ISI ≥ 15, a GAD-7 ≥ 7, and use of levetiracetam were significant and independent factors that were positively associated with higher ALS-18 scores. The coefficient of determination for the model was 0.331. The interaction between recurrent seizures and an ISI ≥ 15 had a significant effect on the ALS-18 scores (F = 6.812, p = 0.010, partial eta2 = 0.040). An ISI ≥ 15 was associated with ALS-18 scores in patients without seizure recurrence (p |
| doi_str_mv | 10.1016/j.yebeh.2021.108414 |
| format | Article |
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We investigated the moderating effect of sleep disturbance on the association between seizure recurrence and emotional instability in patients with epilepsy, independent of psychological distress.
This was a cross-sectional study. Patients completed the short form of the Affective Lability Scale (ALS-18), Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). A stepwise linear regression analysis and an analysis of covariance with an interaction term were performed.
A total of 171 subjects (63.2% men) were included. The mean ALS-18 score was 15.6 ± 11.3. An ISI ≥ 15, PHQ-9 ≥ 10, and GAD-7 ≥ 7 were noted in 20.5%, 18.1%, and 23.4% of subjects, respectively. A stepwise linear regression analysis found that recurrent seizures in the last year, an ISI ≥ 15, a GAD-7 ≥ 7, and use of levetiracetam were significant and independent factors that were positively associated with higher ALS-18 scores. The coefficient of determination for the model was 0.331. The interaction between recurrent seizures and an ISI ≥ 15 had a significant effect on the ALS-18 scores (F = 6.812, p = 0.010, partial eta2 = 0.040). An ISI ≥ 15 was associated with ALS-18 scores in patients without seizure recurrence (p < 0.001). This association almost reached significance (p = 0.084) in those with recurrent seizures. In contrast, the presence of recurrent seizures was associated with ALS-18 scores in patients with an ISI < 15 (p < 0.001), but not in those with an ISI ≥ 15 (p = 0.360).
The significant interaction between insomnia and seizure status may have an effect on emotional instability. These findings have clinical implications in the development of potential interventions for emotional instability in patients with epilepsy.</description><identifier>ISSN: 1525-5050</identifier><identifier>EISSN: 1525-5069</identifier><identifier>DOI: 10.1016/j.yebeh.2021.108414</identifier><identifier>PMID: 34798559</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Affective lability ; Cross-Sectional Studies ; Depression ; Emotional instability ; Epilepsy ; Epilepsy - complications ; Female ; Humans ; Insomnia ; Levetiracetam ; Male ; Seizures - complications ; Sleep disturbance ; Sleep Initiation and Maintenance Disorders - complications</subject><ispartof>Epilepsy & behavior, 2021-12, Vol.125, p.108414-108414, Article 108414</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-e888c8c09c7e1b10a423a5c41dcfc25122d5551b96f57d2711fe03f07805fad43</citedby><cites>FETCH-LOGICAL-c359t-e888c8c09c7e1b10a423a5c41dcfc25122d5551b96f57d2711fe03f07805fad43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.yebeh.2021.108414$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34798559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Sang-Ahm</creatorcontrib><creatorcontrib>Choi, Eun Ju</creatorcontrib><creatorcontrib>Jeon, Ji-Ye</creatorcontrib><creatorcontrib>Han, Su-Hyun</creatorcontrib><creatorcontrib>Kim, Hyun-Woo</creatorcontrib><creatorcontrib>Lee, Gha-Hyun</creatorcontrib><creatorcontrib>Ryu, Han Uk</creatorcontrib><creatorcontrib>Im, Kayeong</creatorcontrib><creatorcontrib>Yang, Ha-rin</creatorcontrib><title>Insomnia moderates the association between recurrent seizures and emotional instability in persons with epilepsy</title><title>Epilepsy & behavior</title><addtitle>Epilepsy Behav</addtitle><description>•Seizures and insomnia were associated with emotional instability.•This association was independent of anxiety.•The interaction between insomnia and seizures may have an effect on emotional instability.•Levetiracetam was independently associated with emotional instability.
We investigated the moderating effect of sleep disturbance on the association between seizure recurrence and emotional instability in patients with epilepsy, independent of psychological distress.
This was a cross-sectional study. Patients completed the short form of the Affective Lability Scale (ALS-18), Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). A stepwise linear regression analysis and an analysis of covariance with an interaction term were performed.
A total of 171 subjects (63.2% men) were included. The mean ALS-18 score was 15.6 ± 11.3. An ISI ≥ 15, PHQ-9 ≥ 10, and GAD-7 ≥ 7 were noted in 20.5%, 18.1%, and 23.4% of subjects, respectively. A stepwise linear regression analysis found that recurrent seizures in the last year, an ISI ≥ 15, a GAD-7 ≥ 7, and use of levetiracetam were significant and independent factors that were positively associated with higher ALS-18 scores. The coefficient of determination for the model was 0.331. The interaction between recurrent seizures and an ISI ≥ 15 had a significant effect on the ALS-18 scores (F = 6.812, p = 0.010, partial eta2 = 0.040). An ISI ≥ 15 was associated with ALS-18 scores in patients without seizure recurrence (p < 0.001). This association almost reached significance (p = 0.084) in those with recurrent seizures. In contrast, the presence of recurrent seizures was associated with ALS-18 scores in patients with an ISI < 15 (p < 0.001), but not in those with an ISI ≥ 15 (p = 0.360).
The significant interaction between insomnia and seizure status may have an effect on emotional instability. These findings have clinical implications in the development of potential interventions for emotional instability in patients with epilepsy.</description><subject>Affective lability</subject><subject>Cross-Sectional Studies</subject><subject>Depression</subject><subject>Emotional instability</subject><subject>Epilepsy</subject><subject>Epilepsy - complications</subject><subject>Female</subject><subject>Humans</subject><subject>Insomnia</subject><subject>Levetiracetam</subject><subject>Male</subject><subject>Seizures - complications</subject><subject>Sleep disturbance</subject><subject>Sleep Initiation and Maintenance Disorders - complications</subject><issn>1525-5050</issn><issn>1525-5069</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFO3DAQhi1EBXTLEyAhH7ns4nHiTXLgUCHaIq3EpT1bjj3RepXYweMULU9PlqUce5pfo29mNB9jVyBWIGB9u1vtscXtSgoJc6cuoTxhF6CkWiqxbk4_sxLn7CvRTggAVcAZOy_KqqmVai7Y-BgoDsEbPkSHyWQknrfIDVG03mQfA28xvyAGntBOKWHInNC_TmlGTXAch3jATM99oGxa3_u8nzMfMVEMxF983nIcfY8j7b-xL53pCS8_6oL9-fHw-_7XcvP08_H--2ZpC9XkJdZ1bWsrGlshtCBMKQujbAnOdlYqkNIppaBt1p2qnKwAOhRFJ6paqM64sliwm-PeMcXnCSnrwZPFvjcB40RaroWQdSlnIwtWHFGbIlHCTo_JDybtNQh9UK13-l21PqjWR9Xz1PXHgakd0H3O_HM7A3dHAOc3_3pMmqzHYNH52WTWLvr_HngDpeeS6A</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Lee, Sang-Ahm</creator><creator>Choi, Eun Ju</creator><creator>Jeon, Ji-Ye</creator><creator>Han, Su-Hyun</creator><creator>Kim, Hyun-Woo</creator><creator>Lee, Gha-Hyun</creator><creator>Ryu, Han Uk</creator><creator>Im, Kayeong</creator><creator>Yang, Ha-rin</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202112</creationdate><title>Insomnia moderates the association between recurrent seizures and emotional instability in persons with epilepsy</title><author>Lee, Sang-Ahm ; Choi, Eun Ju ; Jeon, Ji-Ye ; Han, Su-Hyun ; Kim, Hyun-Woo ; Lee, Gha-Hyun ; Ryu, Han Uk ; Im, Kayeong ; Yang, Ha-rin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-e888c8c09c7e1b10a423a5c41dcfc25122d5551b96f57d2711fe03f07805fad43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Affective lability</topic><topic>Cross-Sectional Studies</topic><topic>Depression</topic><topic>Emotional instability</topic><topic>Epilepsy</topic><topic>Epilepsy - complications</topic><topic>Female</topic><topic>Humans</topic><topic>Insomnia</topic><topic>Levetiracetam</topic><topic>Male</topic><topic>Seizures - complications</topic><topic>Sleep disturbance</topic><topic>Sleep Initiation and Maintenance Disorders - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Sang-Ahm</creatorcontrib><creatorcontrib>Choi, Eun Ju</creatorcontrib><creatorcontrib>Jeon, Ji-Ye</creatorcontrib><creatorcontrib>Han, Su-Hyun</creatorcontrib><creatorcontrib>Kim, Hyun-Woo</creatorcontrib><creatorcontrib>Lee, Gha-Hyun</creatorcontrib><creatorcontrib>Ryu, Han Uk</creatorcontrib><creatorcontrib>Im, Kayeong</creatorcontrib><creatorcontrib>Yang, Ha-rin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Epilepsy & behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Sang-Ahm</au><au>Choi, Eun Ju</au><au>Jeon, Ji-Ye</au><au>Han, Su-Hyun</au><au>Kim, Hyun-Woo</au><au>Lee, Gha-Hyun</au><au>Ryu, Han Uk</au><au>Im, Kayeong</au><au>Yang, Ha-rin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Insomnia moderates the association between recurrent seizures and emotional instability in persons with epilepsy</atitle><jtitle>Epilepsy & behavior</jtitle><addtitle>Epilepsy Behav</addtitle><date>2021-12</date><risdate>2021</risdate><volume>125</volume><spage>108414</spage><epage>108414</epage><pages>108414-108414</pages><artnum>108414</artnum><issn>1525-5050</issn><eissn>1525-5069</eissn><abstract>•Seizures and insomnia were associated with emotional instability.•This association was independent of anxiety.•The interaction between insomnia and seizures may have an effect on emotional instability.•Levetiracetam was independently associated with emotional instability.
We investigated the moderating effect of sleep disturbance on the association between seizure recurrence and emotional instability in patients with epilepsy, independent of psychological distress.
This was a cross-sectional study. Patients completed the short form of the Affective Lability Scale (ALS-18), Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). A stepwise linear regression analysis and an analysis of covariance with an interaction term were performed.
A total of 171 subjects (63.2% men) were included. The mean ALS-18 score was 15.6 ± 11.3. An ISI ≥ 15, PHQ-9 ≥ 10, and GAD-7 ≥ 7 were noted in 20.5%, 18.1%, and 23.4% of subjects, respectively. A stepwise linear regression analysis found that recurrent seizures in the last year, an ISI ≥ 15, a GAD-7 ≥ 7, and use of levetiracetam were significant and independent factors that were positively associated with higher ALS-18 scores. The coefficient of determination for the model was 0.331. The interaction between recurrent seizures and an ISI ≥ 15 had a significant effect on the ALS-18 scores (F = 6.812, p = 0.010, partial eta2 = 0.040). An ISI ≥ 15 was associated with ALS-18 scores in patients without seizure recurrence (p < 0.001). This association almost reached significance (p = 0.084) in those with recurrent seizures. In contrast, the presence of recurrent seizures was associated with ALS-18 scores in patients with an ISI < 15 (p < 0.001), but not in those with an ISI ≥ 15 (p = 0.360).
The significant interaction between insomnia and seizure status may have an effect on emotional instability. These findings have clinical implications in the development of potential interventions for emotional instability in patients with epilepsy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34798559</pmid><doi>10.1016/j.yebeh.2021.108414</doi><tpages>1</tpages></addata></record> |
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| ispartof | Epilepsy & behavior, 2021-12, Vol.125, p.108414-108414, Article 108414 |
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| subjects | Affective lability Cross-Sectional Studies Depression Emotional instability Epilepsy Epilepsy - complications Female Humans Insomnia Levetiracetam Male Seizures - complications Sleep disturbance Sleep Initiation and Maintenance Disorders - complications |
| title | Insomnia moderates the association between recurrent seizures and emotional instability in persons with epilepsy |
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