Psychiatric comorbidities in epilepsy

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.