Depression, traumatic dissociation and epileptic-like phenomena.

OBJECTIVES: According to recent findings trauma and stress are important etiological factors in pathogenesis of depression. As characteristic features of depressive cognition have been reported intrusive thoughts and memory disturbances similar to posttraumatic symptoms known in patients with posttraumatic stress disorder or dissociative disorders. Hypothetically is also suggested a close relationship of traumatic dissociation and epileptic-like phenomena.

SETTINGS AND DESIGN: In the clinical study were assessed 70 adult people with a diagnosis of depression and 50 healthy controls. In the assessment were used 6 measures for symptoms of dissociation, depression, traumatic stress and psychosenzoric symptoms of epileptic origin (the so-called complex partial seizure-like symptoms).

RESULTS: Reported data show that a great number of depressive patients who met the cut-off score for dissociative disorders (34.2%, N=24) had significantly higher traumatization, depression, subjectively experienced stress and complex partial seizure-like symptoms than the whole group of patients and the controls. Most significant traumatization has been found in patients who met the cut-off score of psychosenzoric epileptic-like symptoms which is characteristic for the epilepsy spectrum disorder (5.7%, N=4).

MAIN FINDINGS: Significant correlations of these assessed symptoms suggest close relationship between traumatic stress and dissociation in depression. This close relationship of dissociative symptomatology and traumatic stress also implicates an important role of dissociative processes in depression as a typical manifestation of depressive cognition. Assessed relationship between traumatic distress and complex partial seizure-like symptoms suggests a possible role of epileptic-like phenomena in dissociative states related to depression.

CONCLUSIONS: Assessed relationship between traumatization, depression and epileptic-like phenomena in the patients who met cut-off score for epilepsy spectrum disorder can contribute to the problem of indication of several depressive patients to anticonvulsant therapy because of reported evidence that a clear majority of patients with epilepsy spectrum disorder respond well to anticonvulsant treatment. Careful assessment of this test battery thus may be useful also for anticonvulsant treatment strategy.