The psychiatric comorbidity of epilepsy

Abstract

Several studies have assessed the prevalence of psychiatric disorders in epilepsy. They are characterized by considerable heterogeneity, because of differences in the population setting and type of study. A non-systematic review of the literature allows us to draw some useful, although not definite, conclusions. Six per cent of people with epilepsy in the general population appear to suffer from a psychiatric disorder, while this rises to 10-20% in populations with temporal lobe and/or refractory epilepsy. Mood disorders are the most common culprit (24-74%), particularly depression (30%), followed by anxiety disorders (10-25%), psychoses (2-7%) and personality disorders (1-2%). This comorbidity appears to be related to endogenous and exogenous (including iatrogenic) factors and to the severity and chronicity of epilepsy. Conditions such as schizophrenia-like psychosis of epilepsy and interictal dysphoric disorder are represented only in epilepsy. Adequate recognition and treatment of psychiatric conditions in epilepsy is essential for patient management because of their considerable burden in morbidity and quality of life.

Anxiety disorders in people with epilepsy

“…It seems to be reported by 10%-15% patients with partial seizures (Gaitatzis et al, 2004), is more common in women than men (Chiesa et al, 2007, Toth et al, 2010 and seems to have a poor prognostic value for surgery (Feichtinger et al, 2001). Ictal anxiety can be differentiated through a careful history taking with special attention to the association between the duration of the attacks and the presence of accompanying non-paroxysmal symptoms of an anxiety disorder like avoidance behavior or the "circle of fear".…”

The interictal dysphoric disorder of epilepsy: Legend or reality?

“…In fact, among patients with a diagnosis of IDD, about 50% present symptoms with a clear-cut relationship with epileptic seizures either presenting pre-ictally or post-ictally [33]. Premonitory symptoms are reported by one-third of patients with temporal lobe epilepsy, usually preceding secondary generalized tonic-clonic seizures [34]. Prodromal mood changes may occur hours to days before a seizure and are often relieved by the convulsion [35].…”

Surgical Treatment of Temporal Lobe Epilepsy Before and After Depression, Anxiety and Quality of Life Evaluation

“…Ölçekten alınan toplam puanların yük-sekliği, bireyin yaşadığı anksiyetenin şiddetini gösterir. [2][3][4][5] SF-36 yaşam kalitesini değerlendirmek amacıyla kullanılan, epilepside güvenirliliği kanıtlanmış bir testtir. [6] Sekiz boyutun ölçümünü sağlayan 36 maddeden oluşmaktadır.…”