DSM-III-R PSYCHIATRIC DIAGNOSES IN CANDIDATES FOR EPILEPSY SURGERY - LIFETIME PREVALENCE

Many past studies have assessed psychiatric symptoms among epileptic p atients, but little is known about the lifetime frequency of psychiatr ic disorders meeting modern diagnostic criteria in this group. In orde r to evaluate specific psychiatric syndromes in patients with complex partial seizures and clarify the relationship between behavioral distu rbance and epilepsy-related variables, a standardized method of neurop sychiatric assessment was applied to a well-characterized population o f patients with epilepsy. The Structured Clinical Interview for DSM-II I-R-Patient Version (SCID-P), a reliable and widely used diagnostic in strument, was administered to 60 patients with medically intractable c omplex partial seizures (CPS). The interview was modified with additio nal questions exploring the relationship between psychiatric complaint s and epilepsy course. 42 patients (70%) had histories of one or more DSM-III-R Axis I diagnoses. 35 (58.33%) had histories of depressive di sorders. 19 (31.67%) had histories of anxiety disorders. 8 (13.33%) ha d histories of psychotic disorders. Personality disorders were diagnos ed in 11 cases (18.33%). Axis I disorders were more common among the p atients without a history of birth trauma. Anxiety disorders were asso ciated with a history of head trauma. Psychotic disorders were more co mmon among patients with both CPS and generalized seizures. Psychiatri c disorders meeting DSM-III-R criteria are very common among patients with severe CPS. Depressive disorders in patients with epilepsy often exhibited the typical clinical syndrome of major depressive episodes, while psychotic and personality disorders were often atypical.