Epilepsiye eşlik eden psikiyatrik bozukluklar

Epilepsy is a serious public health problem affecting approximately 40 million people around the world. Patients with epilepsy are usually thought to have more psychiatric problems than normal individuals. On the other hand, the incidence of epilepsy in psychiatric patients is also higher than that of general population samples. Affective disorders, psychosis and anxiety disorders are the most common presentations of psychiatric syndromes in epileptic patients. Interictal depression is the most common affective disorder observed in patients with epilepsy. The rate of depression appears to be highest in patients with medically intractable epilepsy being evaluated for epilepsy surgery in comparison with community and other patients with chronic disease. The reported incidence of suicide among these cases is believed to be at least 4-10 times higher than that of the general population indicating the need of special consideration by physicians for inquiry about suicidal ideation and intent in patients with epilepsy. A consensus on the classification of psychotic syndromes associated with epilepsy is lacking. The most appropriate approach would be separate diagnoses of epilepsy and the particular psychotic syndrome. Evidence suggests that psychosis is 6-12 times more likely to occur in epileptic patients than in the general population. Anxiety and related disorders may manifest as simple partial seizures (auras), psychological reactions to symptoms that alert the patient to a coming seizure, interictal panic attacks and atypical panic attacks. The interictal behavioral traits are circumstantiality, humorlessness, religiosity, viscosity (stickness, tendency to repetition), altered sexual interest which are seen mostly in temporal lobe epilepsy patients. Large scale studies are needed to delineate the interaction between epilepsy and psychiatric disorders.