The relationship of psychiatric comorbidities and symptoms, quality of life, and stigmatization in patients with epilepsy.

OBJECTIVE: Research around the frequency of psychiatric diseases and psychosocial consequences caused by seizures and stigmatization in patients with epilepsy is important, in terms of multidimensional evaluation of the condition, increasing quality of life, and controlling the frequency of seizures. This prospective study aimed to evaluate relationship between comorbid psychiatric diseases and clinical and sociodemographic data, patients' quality of life and perceived stigma in patients with epilepsy. METHODS: In this prospective single-center study, we evaluated clinical and demographic data, and characteristics of epilepsy. We used the Symptom Check List 90-Revised (SCL-90-R) as a screening test for psychiatric comorbidities and the Mini International Neuropsychiatric Interview (MINI) test for patients who had an SCL90-R general symptom index (GSI) score of ≥1. The frequency of psychiatric comorbidities, the association between comorbid psychiatric disorders and quality of life, and the level of stigmatization in patients with epilepsy was assessed using the Quality of Life in Epilepsy Inventory (QOLIE-10) and Perceived Stigma Scale. RESULTS: SCL90-R GSI scores of ≥1 were found in 122 of 300 patients. Psychiatric comorbidities were found in 24.8% (n = 69) of patients with epilepsy in the MINI test, major depression was found in 16.9 %, (n = 47), and generalized anxiety disorder was the most common (5.7 %, n = 16). The number of anti-seizure medications (p = 0.007), high seizure frequency (p = 0.01), seizure in previous 12 months (p = 0.003), history of epilepsy surgery (p = 0.032) and psychiatric disease (p < 0.001), and high perceived stigma (p < 0.001) and QOLIE-10 (p < 0.001) scores were all correlated with psychiatric comorbidities. CONCLUSIONS: According to the results of our study, an important correlation was determined between psychiatric comorbidities and a history of psychiatric disease, poor quality of life, and high perceived stigma scores in patients with epilepsy. This suggests that screening patients for comorbid psychiatric conditions in epilepsy outpatient clinics is critical, as is establishing a strong collaboration with the psychiatry clinic, to reduce psychosocial issues and the economic burden of stigmatization and improve quality of life.

A rare dementing disease: adult neuronal ceroid lipofuscinoses.

To emphasize the importance of clinical and ultrastructural findings for diagnosing adult neuronal ceroid lipofuscinosis (ANCL), the authors retrospectively reviewed six patients with biopsy-proven ANCL. In all cases, ophthalmologic examinations were normal, and electron microscopic studies demonstrated characteristic granular osmiophilic deposits within the eccrine epithelial cells. The inheritance and mechanism of ANCL remain unknown, and the diagnosis is based on clinical features and ultrastructural examination of the cerebral tissue or extracerebral accumulation of lipopigments. This study suggests that ANCL should be considered as a possible diagnosis in patients with early-onset dementia.

Resuspension of soil as a source of airborne lead near industrial facilities and highways.

Geologic materials are an important source of airborne particulate matter less than 10 microm aerodynamic diameter (PM10), but the contribution of contaminated soil to concentrations of Pb and other trace elements in air has not been documented. To examine the potential significance of this mechanism, surface soil samples with a range of bulk soil Pb concentrations were obtained near five industrial facilities and along roadsides and were resuspended in a specially designed laboratory chamber. The concentration of Pb and other trace elements was measured in the bulk soil, in soil size fractions, and in PM10 generated during resuspension of soils and fractions. Average yields of PM10 from dry soils ranged from 0.169 to 0.869 mg of PM10/g of soil. Yields declined approximately linearly with increasing geometric mean particle size of the bulk soil. The resulting PM10 had average Pb concentrations as high as 2283 mg/kg for samples from a secondary Pb smelter. Pb was enriched in PM10 by 5.36-88.7 times as compared with uncontaminated California soils. Total production of PM10 bound Pb from the soil samples varied between 0.012 and 1.2 mg of Pb/kg of bulk soil. During a relatively large erosion event, a contaminated site might contribute approximately 300 ng/m3 of PM10-bound Pb to air. Contribution of soil from contaminated sites to airborne element balances thus deserves consideration when constructing receptor models for source apportionment or attempting to control airborne Pb emissions.