[Emotional and affective disorders in epilepsy]

The wide spectrum of comorbid mental disorders in epilepsy includes anxiety, affective, and personality disorders and psychosis. While the prevalence of mental disorders in the general epileptic population is listed at 6%, this rate is considerably higher in focal epilepsies, especially temporal lobe epilepsy, and the numbers given in the literature range from 20% to 70%, of which anxiety and depression are the most prominent. According to the Diathesis Stress Model, the effects of previously existing vulnerability and neurobiologic, iatrogenic, and psychosocial stress factors vary in the development of mental disorders in epilepsy. Roles are also played by learned reactions in responce to psychosocial stress as well as structural and functional disturbances in the limbic neuronal networks regulating affective, emotional, and social behaviors. Therapeutic measures may also contribute to the development of mental health problems. Several antiepileptic drugs have proven valuable in psychiatric treatment of mental disorders but also may have psychiatric side effects. Although established as a successful treatment option for focal epilepsies, surgery is also reported to influence mental health.