Symptoms of epilepsy and organic brain dysfunctions in patients with acute, brief depression combined with other fluctuating psychiatric symptoms: a controlled study from an acute psychiatric department

摘要

Background: In psychiatric acute departments some patients present with brief depressiveperiods accompanied with fluctuating arrays of other psychiatric symptoms like psychosis, panic ormania. For the purpose of the present study we call this condition Acute Unstable DepressiveSyndrome (AUDS).The aims of the present study were to compare clinical signs of organic brain dysfunctions andepilepsy in patients with AUDS and Major Depressive Episode (MDE).Methods: Out of 1038 consecutive patients admitted to a psychiatric acute ward, 16 patients withAUDS and 16 age- and gender-matched MDE patients were included in the study. Usingstandardized instruments and methods we recorded clinical data, EEG and MRI.Results: A history of epileptic seizures and pathologic EEG activity was more common in theAUDS group than in the MDE group (seizures, n = 6 vs. 0, p = 0.018; pathologic EEG activity, n =8 vs. 1, p = 0.015). Five patients in the AUDS group were diagnosed as having epilepsy, whereasnone of those with MDE had epilepsy (p = 0.043). There were no differences between the groupsregarding pathological findings in neurological bedside examination and cerebral MRI investigation.Conclusion: Compared to patients admitted with mood symptoms fulfilling DSM 4 criteria of amajor depressive disorder, short-lasting atypical depressive symptoms seem to be associated witha high frequency of epileptic and pathologic EEG activity in patients admitted to psychiatric acutedepartments.