Psychiatric treatment in a comprehensive care setting for patients with epilepsy

The prevalence of psychopathology in patients with epilepsy is increased compared with non-epileptic controls. However, psychiatric comorbidity seems to be underrecognized and under-treated. If a psychiatric disorder in a person with epilepsy occurs, a substantial complexity has to be considered, and general psychiatric therapeutic strategies have to be modified accordingly. This complexity is exemplified with regards to anxiety disorders. Different epilepsy-related types of affective disorders and psychoses, as well as personality disorders are discussed, and comprehensive therapy using psychopharmacological drugs, psychotherapy, psycho-education and social support is presented. An integration of psychiatric treatment and epilepsy therapy should be preferred to referral from one specialist to another.