Correlates of psychological distress in epileptic patients during the COVID-19 outbreak

Giordano, A.; Tessitore, A.; Tedeschi, G.; Siciliano, M.; De Micco, R.; Sant039,; elia, V.; Russo, A.; Giordano, Alfonso; Siciliano, Mattia; De Micco, Rosa; Elia, Valeria; Russo, Antonio; Tedeschi, Gioacchino; Tessitore, Alessandro

Background and aims: In late 2019, a novel coronavirus termed SARS-CoV-2 was isolated from human cases. To date no studies have analyzed the role played by the different dimensions of psychological distress quarantine induced in patients with epilepsy. Methods: We included a total of 40 patients, 18 suffered from generalized, and 22 from focal epilepsy. The patients previously seen in the outpatient clinic during the prelockdown period between January and February 2020 were re-evaluated after the lockdown period of March and April 2020. Psychological distress was evaluated by using the three subscales of Impact of Event Scale-Revised (IES-R) tapping intrusion, avoidance and hyperarousal related to traumatic event. Results: As for the overall sample, the number of epileptic attacks was significantly higher at post-lockdown than at pre-lockdown. The same pattern of results was observed for patients with high scores on IES-R Intrusion and IES-R Avoidance subscales. Multivariate logistic regression analyses showed that: 1) higher scores on IES-R Intrusion subscale were associated with higher age, female sex, and higher scores on HADS-Anxiety subscale;2) higher scores on IES-R Hyperarousal subscales were related to higher scores on HADS-Anxiety subscale;3) higher scores on IES-R Avoidance scale were associated with higher age, and higher scores on HADS-Anxiety subscale. Conclusion: The frequency of epileptic seizures increased during lockdown (months March and April) when compared to pre-lockdown period (months January and February). This pattern of increased frequency is particularly notable for older female patients which experienced with higher intrusivity and avoidance and suffered from more marked anxious symptoms.