Clinical aspects of epileptic psychosis in Brazil

We investigated a series of patients with epileptic psychosis in Brazil and compared our findings with those of other authors. We evaluated 38 outpatients with epileptic psychosis with a semistructured clinical interview, Annett inventory for hand dominance, international classifications for seizures and syndromes, and DSM-IV for psychosis diagnoses. We studied course and outcome for epilepsy and psychosis. Gender distribution was approximately even. Epilepsy and psychiatric disorders among relatives and early CNS insults in personal histories were frequent findings. Mean age of epilepsy onset was 9.3 years. Epilepsy started before psychosis in all cases, and evolved to clinical refractoriness. There was a predominance of temporal lobe epilepsy. Mean age of psychosis onset was 27.4 years, after a mean duration of epilepsy of 18.1 years, with predominance of schizophrenic presentations with interictal onset, frequent psychiatric admissions, suicide attempts, and postpsychosis functional decline. Tumors or lesions of an embryologic nature were uncommon, but mesial temporal sclerosis was frequent.