Literature DB >> 20708951

Psychiatric disorders in temporal lobe epilepsy: an overview from a tertiary service in Brazil.

Guilherme Nogueira M de Oliveira1, Arthur Kummer, João Vinícius Salgado, Eduardo Jardel Portela, Sílvio Roberto Sousa-Pereira, Anthony S David, Antônio Lúcio Teixeira.   

Abstract

PURPOSE: To evaluate the frequency and intensity of psychiatric disorders in a group of temporal lobe epilepsy (TLE) patients from a tertiary-care center.
METHODS: Clinical and sociodemographic data of 73 patients were collected and a neuropsychiatric evaluation was performed with the following instruments: Mini-Mental State Examination (MMSE), structured clinical interview (MINI-PLUS), Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D), Brief Psychiatric Rating Scale (BPRS).
RESULTS: Patients with TLE showed a high frequency of lifetime psychiatric disorders (70%), the most frequent being mood disorders (49.3%). At assessment, 27.4% of the patients were depressed and 9.6% met criteria for bipolar disorder. Nevertheless, depression had not been properly diagnosed nor treated. Anxiety disorders were also frequent (42.5%), mainly generalized anxiety disorder (GAD) (21.9%). Obsessive compulsive disorder (OCD) was present in 11.0% and psychotic disorders in 5.5% of the sample. Patients with left mesial temporal sclerosis (LMTS) exhibited more psychopathologic features, mainly anxiety disorders (p=0.006), and scored higher on HAM-A and HAM-D (p<0.05 in both).
CONCLUSION: TLE is related to a high frequency of psychiatric disorders, such as anxiety and depression, which are usually underdiagnosed and undertreated. Damage to the left mesial temporal lobe, seen in LMTS, seems to be an important pathogenic lesion linked to a broad range of psychopathological features in TLE, mainly anxiety disorders. The present study prompts discussion on the recognition of the common psychiatric disorders in TLE, especially on the Brazilian setting.
Copyright © 2010 British Epilepsy Association. All rights reserved.

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Year:  2010        PMID: 20708951     DOI: 10.1016/j.seizure.2010.07.004

Source DB:  PubMed          Journal:  Seizure        ISSN: 1059-1311            Impact factor:   3.184


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