RESUMEN
BACKGROUND: Psychiatric comorbidities in patients with drug-resistant epilepsy (DRE) are frequently observed before and after epilepsy surgery. Impulsivity, defined as behaviors that are poorly conceived, are also frequent among patients with epilepsy. The aim of this study was to determine the presence of comorbid impulsivity in patients with DRE after one year of epilepsy surgery. METHODS: Patients who underwent epilepsy surgery for DRE and completed the postsurgical assessment protocol one year after surgery were included. All patients underwent a presurgical protocol comprising of neurological, psychiatric, neuropsychological, video-EEG and MRI assessments. The psychiatric evaluation was performed before and one year after surgery using SCID-I, SCID-II, GAF scale of DSM IV, and Beck Depression Inventory II. One year after surgery, Barratt Impulsiveness Scale 11, and Engel classification of seizures, were administered. RESULTS: A total of 38 patients were included in this study, 21 women (55.3%) and 17 men (44.7%), mean age 36â¯years (SDâ¯=â¯9.4). Higher impulsivity was associated with a worse epilepsy seizure outcome (pâ¯<â¯0.05), one year after surgery. According to the multiple linear regression analysis, a worse epilepsy seizure outcome was associated with higher levels of nonplanning impulsivity (pâ¯<â¯0.05) (pâ¯<â¯0.05, ß -0.5, r2 0.25). The GAF score was negatively associated with motor score (pâ¯<â¯0.05, ß -0.584, r2 0.42) and with the total BIS-11 score (pâ¯<â¯0.05, ß -0.557, r2 0.39). CONCLUSIONS: Impulsivity has been associated with a worse post-surgical seizure outcome. Larger studies about impulsivity might confirm these preliminary findings.
RESUMEN
Empirical research suggested that individuals with anxiety and/or depression exhibited action on the spur of the moment, with little consideration for the consequences of their actions. However, it remains unclear whether the precise mechanisms underlying the impacts of anxiety and depression on impulsivity. The present study examined how anxiety and depression influence impulsivity, as well as the mediating and moderating role of cognitive flexibility. A sample of 477 Chinese university students was recruited. All participants finished self-report measures of anxiety, depression, impulsivity, and cognitive flexibility. No significant gender difference was found in anxiety, depression, cognitive flexibility, and three subscale scores of impulsivity. Greater scores of anxiety and depression were associated with lower scores of cognitive flexibility and higher levels of impulsivity. Depression and cognitive flexibility could predict attention impulsivity and nonplanning impulsivity, while anxiety and cognitive flexibility could predict motor impulsivity. Cognitive flexibility served as a mediator in the links of anxiety and three subscales of impulsivity. Furthermore, cognitive flexibility moderated the impact of anxiety on motor impulsivity.