Phenomenology of depression in epilepsy

Sixty-six patients with epilepsy and depression were studied. Thirty-four had a family history of psychiatric illness; depression was the most common condition. Assessed using standardised rating scales, the severity of the depression was moderate and was endogenous in approximately 40% of patients. Attendant features were high state and trait anxiety and hostility. The EEGs of the patients and a control group were not significantly different. Patients receiving phenobarbital (PB) were more depressed, whereas those taking carbamazepine (CBZ) were both less depressed and less anxious. The phenomenology of the depression was not clearly influenced by epilepsy variables. We suggest that the depression in patients with epilepsy represents the outcome of multiple factors in genetically predisposed individuals.