Psychiatric co morbidity in Temporal lobe Epilepsy
Abstract
Psychiatric co-morbidities are frequently encountered in patients of temporal lobe epilepsy but remain unnoticed. So this study was conducted to assess psychiatric co-morbidities and their severity in patients suffering from temporal lobe epilepsy (TLE). This study was conducted on 50 diagnosed cases of Temporal lobe epilepsy, attending Neurology OPD and who were on medications for more than 1 year. GHQ-12 was applied and patients scoring higher on GHQ 12(>2) were further assessed by psychiatrist and diagnosed accordingly as per ICD-10 diagnostic criteria. Afterwards, Hamilton depression rating scale, Hamilton anxiety rating scale and Brief Psychiatric rating scales were applied for assessing the severity of psychiatric illness in diagnosed patients. Out of total 50 cases of TLE, 29 (58%) presented psychiatric co-morbidities. Majority of these patients had Depression (20%) followed by Generalized Anxiety disorder (10%), Bipolar affective disorder (8%), Panic Disorder (6%), Schizophrenia (6%), Acute transient psychotic disorder (4%) and OCD (4%). Among TLE patient with depression, 40% had moderate to severe depression, similarly among TLE patients with anxiety, 63% had moderate to severe anxiety and among TLE patients with psychosis, 80% had moderate to severe psychosis. This study concludes that high psychiatric co-morbidity in TLE patients emphasizes the need of proper psychiatric evaluation of all the patients with temporal lobe epilepsy.
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Introduction
Epilepsy is the most common neurological disorder. Worldwide prevalence of epilepsy is estimated to be around 0.5-1.5%.1 In India an estimate shows that around 12 million people suffer from this disease, which accounts for one sixth of the epileptic population worldwide.2
On the basis of its nature epilepsy can be classified into Idiopathic (generalized) epilepsy and Focal (partial) epilepsy. About 66% of focal epileptic disorders are temporal in nature.3
Many of studies4-10 reported that prevalence of psychiatric morbidity is higher in epileptic patients than in general population or healthy control groups.
Prevalence of psychiatric disorders in epileptic patients vary from 19 to 80%. 4-11 This wide variation in prevalence of psychiatric disorders in epileptic patients might be a result of heterogeneity of research methods applied across studies and geographical regions where these studies were conducted.
Conclusion
In the present study, psychiatric co-morbidity observed in 58% of TLE patients. Patients presenting with Temporal lobe epilepsy should be routinely assessed for presence of psychiatric disorder to improve the treatment outcome.