Epilepsy & behavior : E&B · 2026
Impact of antiseizure medications burden on patients' emotional states: an investigation of the interaction effects of urban-rural differences.
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Tang Jialin, Zhao Yuping, Xi Zhiqin, Wang Xuefeng, Xiao Zheng, Wang Liang
Аннотация
BACKGROUND: Patients with epilepsy frequently experience comorbid anxiety and depressive symptoms. While polytherapy is known to increase depressive risk in epilepsy, it remains unclear whether social environments modify this association.
OBJECTIVE: To examine the association between antiseizure medication burden and emotional states (anxiety and depression), and to evaluate whether urban-rural residence moderates this relationship.
METHODS: A total of 406 patients with epilepsy were included. Anxiety and depression were assessed using the GAD-7 and C-NDDI-E. Three multiple linear regression models were constructed: Model 1 (ASM count only), Model 2 (adjusted for variables with p < 0.10 in univariate analyses), and Model 3 (fully adjusted). The interaction between residence and the number of ASMs was tested, and simple effects were examined using estimated marginal means. Sensitivity analyses were performed to assess robustness.
RESULTS: The number of ASMs was positively associated with both anxiety and depression scores (both p < 0.001). In the fully adjusted model, a significant interaction was observed between residential setting and the number of ASMs for depression (β = 2.379, p < 0.01), whereas no such interaction was found for anxiety Sensitivity analyses yielded consistent results, with the interaction effect remaining stable across models.
CONCLUSION: The number of ASMs is significantly associated with emotional states in patients with epilepsy, and its impact on depression is moderated by residential setting. Polytherapy confers a more pronounced detrimental effect on depressive symptoms among rural patients.
OBJECTIVE: To examine the association between antiseizure medication burden and emotional states (anxiety and depression), and to evaluate whether urban-rural residence moderates this relationship.
METHODS: A total of 406 patients with epilepsy were included. Anxiety and depression were assessed using the GAD-7 and C-NDDI-E. Three multiple linear regression models were constructed: Model 1 (ASM count only), Model 2 (adjusted for variables with p < 0.10 in univariate analyses), and Model 3 (fully adjusted). The interaction between residence and the number of ASMs was tested, and simple effects were examined using estimated marginal means. Sensitivity analyses were performed to assess robustness.
RESULTS: The number of ASMs was positively associated with both anxiety and depression scores (both p < 0.001). In the fully adjusted model, a significant interaction was observed between residential setting and the number of ASMs for depression (β = 2.379, p < 0.01), whereas no such interaction was found for anxiety Sensitivity analyses yielded consistent results, with the interaction effect remaining stable across models.
CONCLUSION: The number of ASMs is significantly associated with emotional states in patients with epilepsy, and its impact on depression is moderated by residential setting. Polytherapy confers a more pronounced detrimental effect on depressive symptoms among rural patients.