Research article

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

Arne E Vaaler^1,3 , Gunnar Morken^1,4,5 , Olav M Linaker^1,5 , Trond Sand^1,6 , Kjell A Kvistad^2,7 and Geir Bråthen^1,6

¹Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

²Department of Circulation and Diagnostic Imaging, NTNU, Trondheim, Norway

³Division of Psychiatry, Haukeland University Hospital, Bergen, Norway

⁴Division of Psychiatry, Department Østmarka, St. Olavs University Hospital, Trondheim, Norway

⁵Division of Psychiatry, Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway

⁶Department of neurology and clinical neurophysiology, St. Olavs University Hospital, Trondheim, Norway

⁷Department of Diagnostic Imaging, St Olavs University Hospital, Trondheim, Norway

author email corresponding author email

BMC Psychiatry 2009, 9:63doi:10.1186/1471-244X-9-63

Published:	30 September 2009

Abstract

Background

In psychiatric acute departments some patients present with brief depressive periods accompanied with fluctuating arrays of other psychiatric symptoms like psychosis, panic or mania. For the purpose of the present study we call this condition Acute Unstable Depressive Syndrome (AUDS).

The aims of the present study were to compare clinical signs of organic brain dysfunctions and epilepsy in patients with AUDS and Major Depressive Episode (MDE).

Methods

Out of 1038 consecutive patients admitted to a psychiatric acute ward, 16 patients with AUDS and 16 age- and gender-matched MDE patients were included in the study. Using standardized instruments and methods we recorded clinical data, EEG and MRI.

Results

A history of epileptic seizures and pathologic EEG activity was more common in the AUDS 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, whereas none of those with MDE had epilepsy (p = 0.043). There were no differences between the groups regarding pathological findings in neurological bedside examination and cerebral MRI investigation.

Conclusion

Compared to patients admitted with mood symptoms fulfilling DSM 4 criteria of a major depressive disorder, short-lasting atypical depressive symptoms seem to be associated with a high frequency of epileptic and pathologic EEG activity in patients admitted to psychiatric acute departments.

Trial registration

NCT00201474