title: Anxiety in patients with epilepsy: systematic review and suggestions for clinical management.
abstract: Up to 50 or 60% of patients with chronic epilepsy have various mood disorders including depression and anxiety. Whereas the relationship between epilepsy and depression has received much attention, less is known about anxiety disorders. It is now recognized that anxiety can have a profound influence on the quality of life of patients with epilepsy. The relationship between anxiety disorders and epilepsy is complex. It is necessary to distinguish between different manifestations of anxiety disorder: ictal, postictal, and interictal anxiety. Preexisting vulnerability factors, neurobiological factors, iatrogenic influences (antiepileptic drugs, epilepsy surgery), and psychosocial factors are all likely to play a role, but with considerable individual differences. Despite the high prevalence of anxiety disorders in patients with epilepsy, there are no systematic treatment studies or evidence-based guidelines for best treatment practice. Nevertheless, a practical approach based on the temporal relationship between anxiety and epileptic seizures allows clinicians to consider appropriate treatment strategies to reduce the psychiatric comorbidity in patients with epilepsy.
authors.affiliation: Department of Neurology, Centre Hospitalier de Luxembourg, Rue Barblé 4, L-1210 Luxembourg, Luxembourg. beyenburg.stefan@chl.lu
authors.forename: Stefan
authors.initials: S
authors.lastname: Beyenburg
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Mitchell
authors.forename: Dieter
authors.initials: D
authors.lastname: Schmidt
authors.forename: Christian E
authors.initials: CE
authors.lastname: Elger
authors.forename: Markus
authors.initials: M
authors.lastname: Reuber
mesh_terms: D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D004827:Epilepsy / Q000150:complications* / Q000628:therapy; D006287:Health Planning Guidelines; D006296:Health Services; D006801:Humans; D011613:Psychotherapy; D012306:Risk
chemical_list: D014151:Anti-Anxiety Agents; D000927:Anticonvulsants