11. Depressive Disorders in Epilepsy
- Andres M. Kanner MD1,2,3
Published Online: 4 JUL 2012
Copyright © 2012 Blackwell Publishing Ltd
Depression in Neurologic Disorders: Diagnosis and Management
How to Cite
Kanner, A. M. (2012) Depressive Disorders in Epilepsy, in Depression in Neurologic Disorders: Diagnosis and Management (ed A. M. Kanner), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118348093.ch11
Departments of Neurological Sciences and Psychiatry, Rush Medical College at Rush University, Chicago, IL, USA
Laboratory of EEG and Video-EEG-Telemetry, Chicago, IL, USA
Section of Epilepsy and Rush Epilepsy Center, Rush University Medical Center, Chicago, IL, USA
- Published Online: 4 JUL 2012
- Published Print: 24 AUG 2012
Print ISBN: 9781444330588
Online ISBN: 9781118348093
- major depressive disorders;
- interictal dysphoric disorder;
- anxiety disorder;
- bidirectional relation
Depressive disorders are the most frequent psychiatric comorbidity in epilepsy, occurring in one out of every three to four patients in the course of their life. Unfortunately, depressive disorders remain underrecognized and undertreated. The presence of a depressive disorder can impact the life of patients with epilepsy (PWE) at several levels because they can significantly worsen quality of life, increase suicidal risk, and worsen the response of seizure disorders to pharmacological and surgical treatment. Depressive disorders in PWE may mimic primary depressive disorders; however, in a significant percentage of patients they present with atypical clinical manifestations as a pleomorphic disorder associated with frequent symptoms of anxiety, irritability, and pain.
Depressive disorders have a bidirectional relationship with epilepsy, which is explained by the existence of common pathogenic mechanisms operant in both conditions. This bidirectional relationship explains the relatively high comorbidity of depressive disorders in PWE and may provide answers regarding the worse prognosis of the seizure disorder in depressed patients.
The use of screening self-rating scales may help to identify depressive episodes in PWE, but a diagnosis cannot be established without an additional, in-depth evaluation. Given the negative impact of depression in PWE, its timely recognition and treatment is of the essence in epilepsy patients.