The Comorbidity Between Epilepsy and Psychiatric Disorders: Assessing the Integration of Neuropsychiatric Care

Psychiatric symptoms are extremely pervasive in epilepsy patient populations and represent a significant burden on quality of life for people with epilepsy (PWE). Despite growing awareness of this reality, mental illness (MI) in PWE continues to be under-diagnosed and under-treated. Recent developments in our understanding of the bidirectional relationship between seizures and psychopathology inform an increased need for collaboration of healthcare providers from neurology and psychiatry disciplines. This article highlights present institutional barriers to diagnosis and treatment of PWE with comorbid MI (PWE/MI), including poor interdisciplinary communication, limited opportunities for cross-specialty training, and the arbitrary theoretical divide between neurology and psychiatry, which distinguishes their approach to managing complex brain disorders. We discuss recent progress towards improving quality of care, both through advancements in our understanding of the common risk factors for epilepsy and MI and through practical interventions, such as increased behavioral health screenings. While these developments have demonstrated a positive impact on patient outcomes, there remains a clear need for system-wide change.

Keywords: epilepsy, psychiatric co morbidities, psychiatric complications, treatment-resistant epilepsy, patient-centered, educat ion, interdisciplinary colla boration, management, neurology, psychiatry

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