José Augusto Bragatti, Carolina Machado Torres, Gustavo Rassier Isolan and Marino Muxfeldt Bianchin
People with epilepsy (PWE) have an increased risk for cognitive, behavioral, and psychosocial disorders. The presence of comorbidities may directly affect quality of life of PWE. For example, there is an increased risk for suicide in PWE, compared to the general population. Association between epilepsy and mental disorders is a condition known since Antiquity, and its ranges from 20 to 50%, reaching 80% in selected populations, like individuals with temporal lobe epilepsy (TLE), and medically intractable patients, candidates to surgical treatment, and these indices are far superior to those found in general population (10-20%). Risk factors for the main psychiatric comorbidities in PWE (depression, anxiety and psychosis) are classified in (1) neurobiological, (2) psychosocial, and (3) pharmacological
factors. There is a bidirectional relationship between epilepsy and mental disorders, namely, not only the epileptic disorder can antedate settlement of psychiatric symptoms in a given patient, but also the diagnosis of mood and behavioral disorders may be made before a first epileptic seizure. This bidirectionality suggests that structural and functional modifications of one disease increase the risk for the development of the other. In this review, we included the most recent articles concerning the terms “mental disorders”, “epilepsy”, and “risk factors” in PubMed. Book chapters were also referred for this work. We gave preference for population-based studies, especially those with
more than 100 patients studied.