Psychiatric aspects of epilepsy.

The frequency of severe psychiatric disorders in patients with epilepsy depends first and foremost on what populations of patients are studied. In random surveys seeking prevalence of epilepsy in the community, the prevalence of associated psychiatric disorder is low. In specialty referral clinics for epilepsy, particularly those serving indigent populations, the prevalence is 25% to 50%. Among epileptics in mental hospitals or psychiatric clinics, the prevalence is, naturally, 100%. This discussion is focused on the evidence for a causal or physiological relationship between epilepsy and psychosis, depression, aggression, and sexual disturbances, and treatment of these disorders. Particular attention is given to possible relationships between temporal lobe (limbic) epilepsy and schizophrenic disorders.