Psychiatric comorbidities in epilepsy

Abstract

Psychiatric comorbidities, including mood, anxiety, and psychotic disorders, are common in epilepsy, often occurring at rates 2–3-fold or higher than in the general population without epilepsy. This article discusses the epidemiology of psychiatric disorders in epilepsy, hypotheses regarding the pathogenesis of these comorbidities, and treatment implications. More specifically, it addresses: (1) How common are major depressive disorder, anxiety disorders, and psychotic disorders in epilepsy? (2) How does one screen for these psychiatric disorders in persons with epilepsy? (3) Why do psychiatric conditions occur in epilepsy? (4) Is the treatment of psychiatric comorbidity in epilepsy associated with seizures? The important topic of suicide and suicidal ideation in epilepsy, risk factors for their occurrence, and how to screen for these co-existent conditions is also discussed. Finally, gaps in knowledge regarding psychiatric conditions in epilepsy are briefly discussed.

Keywords:

• Mental health
• depression
• anxiety
• psychosis
• epidemiology

Acknowledgements

C. Josephson has nothing to disclose. N. Jetté is the holder of a Canada Research Chair in Neurological Health Services Research.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

N. Jette holds operating grants as a principal or co-principal investigator from NINDS (NIH U54), the Canadian Institutes for Health Research, the University of Calgary Brain and Mental Health Research Strategy, Alberta Health, and the University of Calgary Hotchkiss Brain Institute.