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Australas Psychiatry. 2016 Dec;24(6):526-528. Epub 2016 Jun 21.

Affective disorders and functional (non-epileptic) seizures in persons with epilepsy.

Author information

1
Consultant Neuropsychiatrist and Liaison Psychiatrist, Department of Consultation Liaison Psychiatry, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia Keith.Johnson@health.nsw.gov.au.
2
Consultant Neuropsychiatrist and Liaison Psychiatrist, Department of Consultation Liaison Psychiatry, Illawarra Shoalhaven Local Health District, Wollongong, NSW, and; Clinical Associate Professor, Graduate School of Medicine, University of Wollongong and Wollongong, NSW, Australia.
3
Associate Professor, Consultant Neuropsychiatrist and Director, Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, Australian National University Medical School, Canberra Hospital, Canberra, ACT, and; Clinical Associate Professor, Melbourne Neuropsychiatry Centre - Royal Melbourne Hospital, Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.

Abstract

OBJECTIVE:

This paper aims to describe the prevalence, assessment and management of affective disorders as well as functional (non-epileptic) seizures in people with epilepsy.

METHOD:

This paper comprises a selective review of the literature of the common affective manifestations of epilepsy.

RESULTS:

Affective disorders are the most common psychiatric comorbidity seen in people with epilepsy and assessment and management parallels that of the general population. Additionally, people with epilepsy may experience higher rates of mood instability, irritability and euphoria, classified together as a group, interictal dysphoric disorder and resembling an unstable bipolar Type II disorder. Functional seizures present unique challenges in terms of identification of the disorder and a lack of specific management.

CONCLUSIONS:

Given their high prevalence, it is important to be able to recognise affective disorders in people with epilepsy. Management principles parallel those in the general population with specific caution exercised regarding the potential interactions between antidepressant medications and antiepileptic drugs. Functional seizures are more complex and require a coordinated approach involving neurologists, psychiatrists, general practitioners, nursing and allied health. There is very limited evidence to guide psychological and behavioural interventions for neurotic disorders in epilepsy and much more research is needed.

KEYWORDS:

affective disorders; epilepsy; functional non-epileptic seizures; review

PMID:
27329644
DOI:
10.1177/1039856216654395
[Indexed for MEDLINE]

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