Interictal dysphoric disorder and aggressive behavior in drug-resistant epilepsy: clinical insights
R. Sánchez-González, E. Monteagudo-Gimeno, L. Pintor-PérezIntroduction
The relationship between aggressive or violent behavior and epilepsy has been a subject of extensive debate. Proposed links between aggression and epilepsy involve multiple factors, including postictal psychoses and rare instances of ictal aggression. However, unlike periictal or ictal violence, interictal violent behavior is generally considered unrelated to epilepsy or specific EEG abnormalities. Furthermore, there is a notable scarcity of research addressing aggressive behavior in the context of Interictal Dysphoric Disorder (IDD), particularly among patients with severe drug-resistant epilepsy (DRE).
Objectives
The primary objective of this study was to examine the potential association between aggressive behavior and interictal psychiatric symptoms, specifically IDD in patients with DRE.
Methods
This cross-sectional, descriptive study included 453 patients with DRE from the Epilepsy Unit at Hospital Clinic, spanning the years 2008 to 2018. Sociodemographic and clinical variables were analyzed. Aggressive behavior was evaluated using the Hostility Subscale of the Symptom Checklist-90, which assesses thoughts, feelings, and actions characteristic of anger, including resentment, irritability, aggression, and rage. Statistical analyses were performed using IBM SPSS Statistics version 23 (Armonk, NY: IBM Corp.) for Microsoft Office 2013. Student’s t-test was employed to compare quantitative variables.
Results
Out of the 453 patients, 132 (29.1%) were diagnosed with Interictal Dysphoric Disorder (IDD), while 321 (70.9%) were not. A statistically significant association was observed between IDD and scores on the Hostility Subscale of the Symptom Checklist-90, with mean scores of 1.22 in the IDD group compared to 0.83 in the non-IDD group (P = 0.000). Table 1 presents the sociodemographic and clinical characteristics of the study sample.
Table 1. Long description.