Depression and suicide in adolescents with epilepsy

Depression and other disorders are underdiagnosed and undertreated in young people with epilepsy. Signs of depression are often dismissed as "normal" reactions, even though depression is a life-threatening disease and a risk factor for suicide. A strong correlation between epilepsy and depression has been demonstrated in a variety of studies; etiological factors include neurologic, genetic, and iatrogenic factors. At the time of the initial diagnostic evaluation, the physician who is managing the patient with seizure disorder should make a psychiatric and psychosocial assessment to identify the patient's risk for depression. This approach enables the physician to assess the impact of epilepsy on the patient and to detect gross signs of psychiatric disorder. Effective treatment options include both somatic and nonsomatic therapies as well as combinations thereof.