Abstract
Psychiatric comorbidities are relatively frequent in patients with epilepsy (PWE), with lifetime prevalence rates ranging between 30% and 35%. Mood and anxiety disorders are the most frequently recognized conditions in adults whereas attention-deficit hyperactivity disorder (ADHD) is the most frequently identified comorbidity in children.
Psychiatric disorders have been typically considered to reflect a complication of the seizure disorder. Yet, population-based studies have also demonstrated that patients with a primary psychiatric disorder are at an increased risk of developing epilepsy. Furthermore, the presence of psychiatric comorbidities, preceding the onset of epilepsy has been associated with an increased risk of developing treatment-resistant epilepsy with antiepileptic drugs (AEDs), and a lifetime history of depression has been associated with a lower likelihood to achieve complete seizure freedom in intractable patients who undergo a temporal lobectomy. In addition, psychiatric comorbidities have been associated with a worse tolerance to AEDs, an increased suicidal risk, and a worse quality of life.
Thus, an early recognition of psychiatric disorders in PWE is of the essence to ensure a timely treatment and avert these complications.