Authors :
Presenting Author: Glauber Lopim, PhD – Faculty Uniterp - Facterp
Mayra Ricci, MD – Dr. Adolfo Bezerra de Menezes Hospital
Augustus Polimeno, MD, M.Sc. – Polimental Clinic
Tulio Polimeno, MD – Dr. Adolfo Bezerra de Menezes Hospital
Gerardo de Araújo Filho, MD, PhD – Faculdade de Medicina de São José do Rio Preto
Rationale:
Psychiatric comorbidity in people with epilepsy (PWE) can occur before, during, or after another psychiatric disorder (PD). It may be primary or secondary to the illness. Between 10% and 15% of psychiatric inpatient units have patients with epilepsy (Blumer, 2000). PD in PWE can reduce quality of life, increase disability, cause job loss, and raise medical costs. The most common PD are anxiety and depression, but 32% may have other epilepsy-related disorders (Hermann et al., 2000). Risk factors include family history, female gender, low income, medication side effects, frequent seizures, low education, prolonged illness, non-adherence to treatment, poor quality of life, and chronic medical conditions (Bifftu et al., 2015). Understanding prevalence and traits of psychiatric comorbidities helps address the clinical needs of PWE.Methods:
Following approval from the Research Ethics Committee (#80575624.2.0000.8083), the medical records of patients admitted to a psychiatric institution over the past decade (2014–2024) were analyzed. Results:
Among 430 psychiatric admissions that occurred in the period, 89 patients presented a comorbidity with epilepsy (20.6%). Patients predominantly comprised males (77.5%), with a mean age of 43±14.83 years. The most prevalent psychiatric diagnoses included mental and behavioral disorders attributable to alcohol use (15.7%), disorders related to the use of multiple drugs or other psychoactive substances (5.61%), schizophrenia (10.1%), unspecified non-organic psychosis (5.61%), and severe or moderate depressive episodes (5.61%). Among antiseizure medications, valproate (20.2%), carbamazepine (14.6%), and phenobarbital (12.4%) were most frequently prescribed. The most utilized psychiatric medications were risperidone (18%), haloperidol (15.73%), levomepromazine (9%), and sertraline (9%). Concerning behavioral characteristics, heteroaggressiveness was identified in 52.8% of cases, verbal aggressiveness in 50.6%, self-aggressiveness in 38.2%, suicidal ideation in 10.11%, and insomnia in 18% of the examined patients. Conclusions:
The findings indicate a high prevalence of psychiatric and behavioral comorbidities among institutionalized individuals with epilepsy, emphasizing the significant use of psychoactive substances and aggressive manifestations. The medication profile underscores the necessity for integrated clinical and psychiatric management, highlighting the importance of multidisciplinary approaches to optimize seizure control, reduce complications, and enhance quality of life.
Funding: No funding