A study of epileptic psychoses - 150 cases

One hundred and fifty patients of epileptic psychosis, registered over a period of five years in neuropsychiatry clinics at NIMHANS were studied. Patients with organic causes which may produce both epilepsy and psychosis were excluded. The epileptic psychosis ratio to epilepsy was 1:23 and the epileptic psychosis ratio to psychosis was 1:75. The mean age at the onset of epilepsy was 19.4 years, while the mean age at the onset of psychosis was 29 years and thus the mean duration of epilepsy at the onset of psychosis was 9.4 years. With regard to type of seizures, 93 (62%) had grandmal, 50 (33.3%) had temporal lobe epilepsy and 7 (4.7%) had partial motor or sensory epilepsy with generalization. With regard to type of psychosis, 64 (42.7 %) had post-ictal and/or inter-ictal psychosis, 15(10%) paranoid schizophrenia, 9 (6%) mania, 2 (1.3%) depression and 60 (40%) unspecified psychoses. The mean duration of epilepsy was significantly less (p < 0.05) at the onset of acute psychosis than chronic psychosis. Family history of epilepsy and mental illness, premorbid personality and frequencies of seizures were not significantly associated with pathogenesis of epileptic psychosis.