To investigate anxiety symptoms in epilepsy monitoring unit (EMU) patients, in relation to clinical and psychosocial factors.

Epilepsy potentially produces more anxiogenic factors than any other psychopathology. Epidemiology indicates anxiety is twice as high in people with epilepsy as those without. Incidence in EMUs has rarely been explored, particularly in relation to underlying factors. Similarly, little is known about which anxiety symptoms are more common in the EMU setting. Stress influences EEG recording and predicts the development of depression and readmissions. In this regard, better understanding of EMU anxiety states will improve clinical practice and patient care.  

This study included 96 patients from the EMU, Hamad General Hospital, Doha. Symptoms were screened using the Generalized Anxiety Disorder 7-item scale with scores of ≥10 and ≥15 indicating moderate and severe anxiety. Clinical and psychosocial characteristics were also recorded. T-tests and Fisher’s Exact tests were used to compare and associate clinically significant anxiety with different sub-groups.

Overall, 35.4% of patients presented with moderate-severe anxiety. Feeling nervous was the most common symptom, with restlessness the least (80.2% vs 46.8%). Patients diagnosed with epilepsy within the prior 12 months were more likely to have severe anxiety (p=0.02). These patients also reported ‘being irritable’ and ‘afraid something awful might happen’ nearly every day, more often (p=0.05 and p=0.04). Depression was found in 61.2% of moderately, and 100% of severely, anxious patients (p=0.001). People with temporal lobe involvement reported significantly less nervousness (p=0.01) and patients taking two or more drugs had greater ‘difficulty relaxing’ nearly every day (p=0.02).

Our data confirm anxiety is a serious problem in hospital EMUs, especially in patients diagnosed within the past 12 months. The findings support routine screening and treatment of anxiety in epilepsy patients and the selection of medications which optimize mood when possible.