Psychiatric disorders in temporal lobe epilepsy: an overview from a tertiary service in Brazil.
OBJECTIVE
To evaluate the frequency and intensity of psychiatric disorders in a group of temporal lobe epilepsy (TLE) patients from a tertiary-care center.


METHODS
Clinical and sociodemographic data of 73 patients were collected and a neuropsychiatric evaluation was performed with the following instruments: Mini-Mental State Examination (MMSE), structured clinical interview (MINI-PLUS), Hamilton Anxiety Scale (HAM-A), Hamilton Depression Scale (HAM-D), Brief Psychiatric Rating Scale (BPRS).


RESULTS
Patients with TLE showed a high frequency of lifetime psychiatric disorders (70%), the most frequent being mood disorders (49.3%). At assessment, 27.4% of the patients were depressed and 9.6% met criteria for bipolar disorder. Nevertheless, depression had not been properly diagnosed nor treated. Anxiety disorders were also frequent (42.5%), mainly generalized anxiety disorder (GAD) (21.9%). Obsessive compulsive disorder (OCD) was present in 11.0% and psychotic disorders in 5.5% of the sample. Patients with left mesial temporal sclerosis (LMTS) exhibited more psychopathologic features, mainly anxiety disorders (p=0.006), and scored higher on HAM-A and HAM-D (p<0.05 in both).


CONCLUSIONS
TLE is related to a high frequency of psychiatric disorders, such as anxiety and depression, which are usually underdiagnosed and undertreated. Damage to the left mesial temporal lobe, seen in LMTS, seems to be an important pathogenic lesion linked to a broad range of psychopathological features in TLE, mainly anxiety disorders. The present study prompts discussion on the recognition of the common psychiatric disorders in TLE, especially on the Brazilian setting.
de Oliveira
Guilherme Nogueira M
GN
Neuropsychiatric Unit, Neurology Division, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. guilherme.de_oliveira@kcl.ac.uk
Kummer
Arthur
A
Salgado
João Vinícius
JV
Portela
Eduardo Jardel
EJ
Sousa-Pereira
Sílvio Roberto
SR
David
Anthony S
AS
Teixeira
Antônio Lúcio
AL
D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004833:Epilepsy, Temporal Lobe / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology; D011618:Psychotic Disorders / Q000453:epidemiology; D055815:Young Adult