Description of the prevalence of psychiatric disturbances in patients with refractory epilepsy

Abstract

Introduction

Psychiatric morbidity in epilepsy is high, with prevalence rates of up to 50%, being higher in treatment-refractory cases. This co-morbidity worsen the quality of life. Psychiatric comorbidities are hampered by atypical presentations or disorders, which do not appear in the DSM-IV or ICD.

Objectives

To describe the psychiatric morbidity in a group of patients with refractory-epilepsy.

Aims

To provide evidence of the high morbidity and show the prevalence of the different psychiatric disorders.

Methods

We cross-sectional assessed psychiatric disturbances in resistant-epileptic patients using SCID for DSM-IV and clinical interview for epileptic specific psychiatric conditions. We grouped psychiatric disturbances into six clusters:

– affective disorders;

– anxiety disorders;

– psychotic disorders;

– eating disorders;

– conduct disorder;

– substance use disorder.

We also considered epilepsy specific conditions as Interictal Psychotic Disorder (IPI) and Interictal Dysphoric Disorder (IDD) characterized by 3/8 symptoms: depressive mood, anergia, pain, insomnia, fear, anxiety, irritability, and euphoric mood.

Results

The sample consist on 153 patients, with a mean age of 37. In total, 42.5% were males. One or more axis I diagnoses was seen in 38% of the patients. The most common condition was IDD (27.1%), followed by affective disorders (22%), anxiety disorders (15.3%), psychotic disorders (4%) and drug use (2%). There were no patients with eating or conduct disorders or IPI.

Conclusions

Psychiatric morbidity is frequent in resistant-epilepsy. Despite 38% of patients suffered from at least one axis I diagnoses, IDD was the most prevalent condition and not included in SCID interview.

Disclosure of interest

The authors have not supplied their declaration of competing interest.