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Neuropsychiatric morbidity in focal epilepsy

Abstract
Background

Previous work has identified elevated prevalence rates for psychiatric disorders in individuals with medically refractory focal epilepsy, particularly temporal lobe epilepsy. Many studies were undertaken before the advent of video electroencephalogram monitoring (VEM) and magnetic resonance imaging (MRI).

Aims

To investigate which characteristics of the focal epilepsy syndromes are associated with the presence of depression or psychosis.

Method

Three hundred and nineteen individuals with focal epilepsy admitted for VEM were seen over an 11-year period. The lifetime history of depression and psychosis, epileptic site, laterality and type of lesion were determined by clinical assessment, VEM and MRI scan.

Results

There was a significant association between the prevalence of depressive symptoms and non-lesional focal epilepsy. There were no significant differences in prevalence of neuropsychiatric disorders between the groups with temporal lobe epilepsy and those with extratemporal lobe epilepsy.

Conclusions

These findings contrast with previous findings in smaller cohorts. The association between non-lesional focal epilepsy and depression may be due to the effects of a more diffuse epileptogenic area.

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Copyright
Corresponding author
Sophia J. Adams, Melbourne Neuropsychiatry Centre, The University of Melbourne and Royal Melbourne Hospital, Level 2, John Cade Building, Melbourne, Australia. Email: Sophia.Adams@mh.org.au
Footnotes
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Declaration of interest

S.J.A. was supported for 1 year by a UCB Pharma Neurosciences scholarship awarded by the Epilepsy Society of Australia in 2004.

Footnotes
References
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1 Gibbs FA, Gibbs EL, Furster B. Psychomotor epilepsy. Arch Neurol Psychiatry 1948; 60: 331–9.
2 Slater E, Beard AW. The schizophrenia-like psychoses of epilepsy, V: Discussion and conclusions. 1963. J Neuropsychiatry Clin Neurosci 1995; 7: 372–8.
3 Flor-Henry P. Psychosis and temporal lobe epilepsy. A controlled investigation. Epilepsia 1969; 10: 363–95.
4 Gaitatzis A, Trimble MR, Sander JW. The psychiatric comorbidity of epilepsy. Acta Neurol Scand 2004; 110: 207–20.
5 Sachdev P. Schizophrenia-like psychosis and epilepsy: the status of the association. Am J Psychiatry 1998; 155: 325–36.
6 Torta R, Keller R. Behavioral, psychotic, and anxiety disorders in epilepsy: etiology, clinical features, and therapeutic implications. Epilepsia 1999; 40 (suppl 10): s220.
7 Lishman WA. Organic Psychiatry. Blackwell Science, 1998.
8 Lambert MV, Schmitz B Ring H, Trimble M. Neuropsychiatry. Lippincott Williams & Wilkins, 2003.
9 Victoroff JI. DSM-III-R Psychiatric diagnoses in candidates for epilepsy surgery: lifetime prevalence. Neuropsychiatry Neuropsychology Behav Neurol 1994; 7: 8797.
10 Victoroff JI, Benson F, Grafton ST, Engel J Jr. , Mazziotta JC. Depression in complex partial seizures. Electroencephalography and cerebral metabolic correlates. Arch Neurol 1994; 51: 155–63.
11 Swinkels WAM, Kuyk J, van Dyck R, Spinhoven P. Psychiatric comorbidity in epilepsy. Epilepsy Behav 2005; 7: 3750.
12 Edeh J, Toone B. Relationship between interictal psychopathology and the type of epilepsy. Results of a survey in general practice. Br J Psychiatry 1987; 151: 95101.
13 Hesdorffer DC, Hauser WA, Annegers JF, Cascino G. Major depression is a risk factor for seizures in older adults. Ann Neurol 2000; 47: 246–9.
14 Qin P, Xu H, Laursen TM, Vestergaard M, Mortensen PB. Risk for schizophrenia and schizophrenia-like psychosis among patients with epilepsy: population based cohort study. BMJ 2005; 331: 23.
15 Stevens JR. Psychiatric aspects of epilepsy. J Clin Psychiatry 1988; 49(suppl): 4957.
16 Manchanda R, Schaefer B, McLachlan RS, Blume WT. Interictal psychiatric morbidity and focus of epilepsy in treatment-refactory patients admitted to an epilepsy unit. Am J Psychiatry 1992; 149: 1096–8.
17 Swinkels WA, Kuyk J, de Graaf EH, van Dyck R, Spinhoven P. Prevalence of Psychopathology in Dutch Epilepsy Inpatients: A Comparative Study. Epilepsy Behav 2001; 2: 441–7.
18 Parnas J, Korsgaard S. Epilepsy and psychosis. Acta Psychiatr Scand 1982; 66: 8999.
19 Stevens JR. Psychiatric implications of psychomotor epilepsy. Arch Gen Psychiatry 1966; 14: 461–71.
20 Small JG, Small IF, Hayden MP. Further psychiatric investigations of patients with temporal and nontemporal lobe epilepsy. Am J Psychiatry 1966; 123: 303–10.
21 Standage KF, Fenton GW. Psychiatric symptom profiles of patients with epilepsy: a controlled investigation. Psychol Med 1975; 5: 152–60.
22 Lowe AJ, David E, Kilpatrick CJ, Matkovic Z, Cook MJ, Kaye A, O'Brien TJ. Epilepsy surgery for pathologically proven hippocampal sclerosis provides long-term seizure control and improved quality of life. Epilepsia 2004; 45: 237–42.
23 International League Against Epilepsy. Proposal for classification of the epilepsies and epileptic syndromes. Epilepsia 1985; 26: 268–78.
24 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). APA, 1994.
25 Gureje O. Interictal psychopathology in epilepsy. Prevalence and pattern in a Nigerian clinic. Br J Psychiatry 1991; 158: 700–5.
26 Gudmundsson G. Epilepsy in Iceland. A clinical and epidemiological investigation. Acta Neurol Scand 1966; 43(suppl 25): 1124.
27 Rodin EA, Katz M, Lennox K. Differences between patients with temporal lobe seizures and those with other forms of epileptic attacks. Epilepsia 1976; 17: 313–20.
28 Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561–71.
29 Quiske A, Helmstaedter C, Lux S, Elger CE. Depression in patients with temporal lobe epilepsy is related to mesial temporal sclerosis. Epilepsy Res 2000; 39: 121–5.
30 Sutula TP, Hagen J, Pitkanen A. Do epileptic seizures damage the brain? Curr Opin Neurol 2003; 16: 189–95.
31 Taylor DC. Mental state and temporal lobe epilepsy. A correlative account of 100 patients treated surgically. Epilepsia 1972; 13: 727–65.
32 Roberts GW, Done DJ, Bruton C, Crow TJ. A ‘mock up’ of schizophrenia: temporal lobe epilepsy and schizophrenia-like psychosis. Biol Psychiatry 1990; 28: 127–43.
33 Carne RP, O'Brien TJ, Kilpatrick CJ, MacGregor LR, Hicks RJ, Murphy MA, Bowden SC, Kay AH, Cook MJ. MRI-negative PET-positive temporal lobe epilepsy: a distinct surgically remediable syndrome. Brain 2004; 127: 2276–85.
34 Salzberg M, Taher T, Davie M, Carne R, Hicks RJ, Cook M, Murphy M, Vinton A, O'Brien TJ. Depression in temporal lobe epilepsy surgery patients: an FDG–PET study. Epilepsia 2006; 47: 2125–30.
35 Bromfield EB, Altshuler L, Leiderman DB, Balish M, Ketter TA, Devinsky O, Post RM, Theodore WH. Cerebral metabolism and depression in patients with complex partial seizures. Arch Neurol 1992; 49: 617–23.
36 Gallhofer B, Trimble MR, Frackowiak R, Gibbs J, Jones T. A study of cerebral blood flow and metabolism in epileptic psychosis using positron emission tomography and oxygen. J Neurol Neurosurg Psychiatry 1985; 48: 201–6.
37 Blumer D, Montouris G, Hermann B. Psychiatric morbidity in seizure patients on a neurodiagnostic monitoring unit. J Neuropsychiatry Clin Neurosci 1995; 7: 445–56.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Neuropsychiatric morbidity in focal epilepsy

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