Psychiatric Comorbidity in Epilepsy

Eun, Hun Jeong

Abstract

The History of epilepsy is closely associated with development of psychiatry. Epilepsy patients have been considered to be prone to psychopathology. Although there is substantial agreement on the definition of a seizure, there is much controversy about the wide range of psychological effects, seizure related behavioral manifestations, and medication-induced behavioral changes. The biopsychosocial model for understanding altered behaviors and a multidisciplinary approach for managing epilepsy are needed. Etiologic factors affecting the behavior in epilepsy patients are diverse and multifactorial. And biological and psychosocial varaiables are more important in etiologies. The important tasks and means for understanding psychiatric comorbidity are epidemiologic studies, Video-EEG monitoring examinations for behaviors, the definitions given for the seizure characteristics and psychiatric diagnoses. In this field, the relationships between epilepsy and psychiatric illness (psychosis, depression, personality problems, fear and anxiety disorder, aggression and violence, altered sexuality) are main issues. Besides, cognitive impairment in epilepsy, quality of life assessment and psychiatric or behavioral effects of antiepileptic drugs and relationships between psychopathology and epilepsy surgery are included as another important issues. The study of epilepsy and its psychiatric comorbidity gives us a unique opportunity to expand our understanding of brain-behavior relations. Modern care of persons with epilepsy goes beyond attempts to control seizures and requires consideration of broader issues related cognitive, psychiatric, and social functioning.