Psychiatric comorbidity in chronic epilepsy: Identification, consequences,and treatment of major depression

The purpose of this article is to review the topic of interictal psychiatri c comorbidity among adult patients with chronic epilepsy, focusing specific ally on those studies that have used contemporary psychiatric nosology. Fiv e specific issues are addressed: (a) the risk and predominant type(s) of ps ychiatric comorbidity in chronic epilepsy, (b) adequacy of recognition and treatment of psychiatric comorbidity, (c) the additional burdens that comor bid psychiatric disorders impose upon patients with chronic epilepsy, (d) t he etiology of these disorders, and (e) strategies for treatment. Current a ppreciation for these issues in epilepsy is contrasted to related fields (e .g., primary care, psychiatry, and epidemiology), whew considerable attenti on has been devoted to the identification, consequences, and treatment of p sychiatric comorbidity. The issue of psychiatric comorbidity in epilepsy is reviewed with the aim of identifying a clinical and research agenda that w ill advance understanding of at least one important psychiatric condition a ssociated with epilepsy-namely, major depression.