Psychiatric morbidity in epilepsy: a case controlled study of adults receiving disability benefits

Abstract

Objective-To compare the prevalence of non-organic psychiatric disorders among disabled patients of normal intelligence with epilepsy with the prevalence of similar psychiatric disorders among age and sex matched disabled patients with other somatic diseases. Methods-A case-control study was carried out in Iceland among people receiving disability benefits using information available at the State Social Security Institute. There were 344 patients with epilepsy in Iceland 16 to 66 years of age (inclusive) receiving disability benefits in 1995. By excluding mentally retarded patients, autistic patients, and patients with organic psychoses, 241 index cases with epilepsy qualified for the study. For each case two age and sex matched controls were selected from all patients receiving disability benefits who had cardiovascular diseases, respiratory diseases, or arthropathies. The same exclusion criteria were applied to the controls as the index cases. In both patient groups psychiatric diagnoses were classified into one of the four following categories: (1) psychotic illness; (2) neurotic illness or personality disorders; (3) alcohol or drug dependence or misuse; and (4) other mental disorders. Results-Psychiatric diagnosis was present among 35% ( 85/241) of the cases compared with 30% (143/482) of the controls (p=0.15). There was a diVerence in the distribution of the two groups into diVerent psychiatric categories (p=0.02). This was mainly due to an excess of men in the index group with psychosis, particularly schizophrenia or paranoid states. Conclusion-The results suggest that there is not a diVerence in the prevalence of non-organic psychiatric disorders among disabled patients of normal intelligence with epilepsy compared with patients with other disabling somatic diseases. However, the data indicate that when psychopathology is present disabled patients with epilepsy are more likely to have psychotic illness than the other disabled patients. (J Neurol Neurosurg Psychiatry 1998;64:238-241)

Prevalence of psychiatric comorbidities in temporal lobe epilepsy in a Southern Brazilian population

“…For example, community-based studies of epileptic patients with structured interviews have found prevalences of psychiatric comorbidities varying between 23.5% and 37.5%, always higher than in the general population (10-20%). In contrast, studies using ICD diagnoses and data from administrative registries have shown greater variation (16.8 to 60%) 5,15 . Larger prevalence was found in populations extracted from lists of individuals with some other associated disease, and therefore probably with a selection bias 5,15 .…”

“…In contrast, studies using ICD diagnoses and data from administrative registries have shown greater variation (16.8 to 60%) 5,15 . Larger prevalence was found in populations extracted from lists of individuals with some other associated disease, and therefore probably with a selection bias 5,15 . The prevalence of psychiatric disorders seems to increase according with the severity of neurological disorders (Figure), in the following sequence: patients with chronic non-neurological diseases, patients with nonepileptic neurological diseases, patients with generalized epilepsies, patients with extratemporal focal epilepsies, patients with non-surgically treatable TLE, and finally, patients eligible for surgery 16 .…”

Psychiatrische Störungen bei Menschen mit Epilepsien und Intelligenzminderung

“…Dabei ist wichtig zu betonen, dass die körperliche Behinderung, die in der Gruppe der mental retardierten Patienten deutlich häufiger ist, keinen ausreichenden Grund liefert, um Unterschiede zu erklären, wie eine Case-control-Studie von behinderten normalintelligenten Menschen zeigte [29].…”

“…Andererseits bieten die Wohnbereiche behinderter Menschen eine sehr gute Möglichkeit für Langzeitbeobachtungen [14,15,16]. Mit der Einschränkung durch die genannten methodischen und diagnostischen Probleme kommen die meisten Studien zu dem Schluss, dass wahnhafte (meist schizophreniforme) Psychosen häufiger bei Menschen mit Epilepsien und Behinderung auftreten als bei normalintelligenten Menschen [4,20,29].…”

The relationship between schizophrenia and epilepsy: the history and current state of the problem

“…В одном из исследований [30] были установлены бо-лее высокие показатели ассоциации психотических со-стояний с эпилепсией по сравнению с заболеваниями со-матическими: частота возникновения психозов у мужчин в основной группе по сравнению с контрольной была в 3 раза выше (6,2 и 2,3% соответственно). По мнению G. Gudmundsson [31], такого рода данные не только сви-детельствуют о тесной связи эпилепсии и шизофрении, но и, возможно, объясняют виктимность пациентов с ши-зофренией (склонность к опрометчивым поступкам и провокационным действиям, которые приводят к не-счастным случаям, травмам).…”