Impact of family support on psychiatric disorders and seizure control in patients with juvenile myoclonic epilepsy

Objective: Psychiatric disorders (PDs) are frequently observed in patients with juvenile myoclonic epilepsy (JME). In this study, we aimed to assess factors associated with PDs in patients with JME. Methods: Retrospective analysis of data of 90 consecutive patients with JME was performed. Assessment of DSM-IV Axis I clinical disorders was done using Structured Clinical Interview for Axis I. Diagnosis of PDs is made when the score exceeds the threshold provided by the DSM-IV. We also applied the Global Assessment of Functioning (GAF) scale which is part of the multiaxial evaluation of the DSM-IV (Axis-V). Using seizure frequency score at presentation, we classified subjects into controlled and uncontrolled groups. Results: In the current cohort, 29 (32.2%) patients were diagnosed with PDs. Fewer patients with PDs had family support (48.3% vs. 83.6%; p = 0.001). Lifetime prevalence of PDs was higher among patients with current PDs (96.6% vs. 18.0%; p < 0.0001). Subthreshold illness was not different between the groups (17.2% vs. 27.9%; p = 0.204). Mean GAF was higher in patients without PDs than in patients with PDs (89.19 +/- 6.92 vs. 64.22 +/- 9.76; p < 0.0001). Patients with PDs had lower seizure control (7.8% vs. 73.1%; p < 0.0001) compared with patients without PDs. Logistic regression analysis for factors associated with diagnosis of PDs revealed that none of the factors significantly affected the odds of seizure control. Patients with lack of family support had poor seizure control (0% vs. 36.9%; p < 0.0001); 51.7% of patients with JME with PDs reported lack of family support. Patients with family support had lower lifetime prevalence of PDs (30.8% vs. 76.0%; p < 0.0001), whereas patients with JME without family support had lower levels of education (8.0% vs. 35.4%; p = 0.009). Conclusion: Lack of family support is associated with poor seizure control and higher incidence of PDs in patients with JME. Lack of family support increases neither the odds of PDs nor seizure control. (c) 2014 Elsevier Inc. All rights reserved.