Download PDF
Nervenheilkunde 2010; 29(04): 210-215
DOI: 10.1055/s-0038-1628751
Epilepsie
Schattauer GmbH

Psychische Störungen bei Epilepsie

Mental disorders in patients with epilepsy
H.-B. Straub
1   Epilepsieklinik Tabor, Bernau
,
K. Bohlmann
1   Epilepsieklinik Tabor, Bernau
› Author Affiliations
Further Information

Publication History

Eingegangen am: 18 January 2010

angenommen am: 29 January 2010

Publication Date:
25 January 2018 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Psychische Begleiterkrankungen treten bei Menschen mit Epilepsien gehäuft auf. Ihre erfolgreiche Behandlung ist von entscheidender Bedeutung für die Lebensqualität der Betroffenen, insbesondere wenn keine Anfallsfreiheit erreicht werden kann. Trotzdem wird psychische Komorbidität bei Epilepsie oft übersehen und nicht angemessen behandelt. Neben einer zu starken Fokussierung auf die Therapie der Anfälle bestehen Schwierigkeiten bei der Abschätzung psychotroper Effekte der Antiepileptika oder der Diagnostik epilepsiespezifischer Störungsbilder wie z. B. der interiktalen dysphorischen Verstimmung. Auch unbegründete Befürchtungen, durch Psychopharmaka Anfälle auszulösen, spielen eine erhebliche Rolle. Gegen den Einsatz von z. B. SSRIs bei Epilepsie bestehen aber keine grundsätzlichen Kontraindikationen, es gibt klare Hinweise auf günstige Effekte bezüglich der Anfallsfrequenz. Der aktuelle Klassifikationsvorschlag der Kommission für Psychische Begleiterkrankungen der Internationalen Liga gegen Epilepsie erleichtert die Diagnostik. Bei schwierig gelagerten Fällen stehen spezialisierte ambulante und stationäre epileptologisch-psychiatrische Behandlungsangebote an Epilepsiezentren zur Verfügung.

Summary

Psychic comorbidity is observed more frequently in persons with epilepsy. Nevertheless psychic comorbidity in epilepsy is underdiagnosed and often remains untreated. Predominant focussing on the treatment of seizures, poor knowledge of psychic effects of antiepileptic drugs and difficulties in diagnosing epilepsy-specific disorders like interictal dysphoric disorder are typical problems. Often adequate psychopharmacological treatment is not established due to fears of provoking seizures. In contrast there is clear evidence of positive effects of SSRIs on seizure frequency. The International League against Epilepsy recently proposed an adequate system of classification, which offers support in diagnosis. Treatment should consistently use all options of psychopharmacological and psychotherapeutical therapy. In difficult cases epilepsy centers provide special epileptological-psychiatric treatment offers on an inand out-patient base.

Schlüsselwörter

Epilepsie - Komorbidität - psychische Störungen

Keywords

Epilepsy - comorbidity - mental health problems
 

  • Literatur

  • 1 Jacoby A, Snape D, Baker GA. Determinants of quality of life in people with epilepsy. Neurol Clin 2009; 27 (04) 843-863.
    CrossrefPubMedSearch in Google Scholar
  • 2 Johnson EK, Jones JE, Seidenberg M, Hermann BP. The relative impact of anxiety, depression, and clinical seizure features on health-related quality of life in epilepsy. Epilepsia 2004; 45 (05) 544-550.
    CrossrefPubMedSearch in Google Scholar
  • 3 Gilliam FG. Diagnosis and treatment of mood disorders in persons with epilepsy. Curr Opin Neurol 2005; 18 (02) 129-133.
    CrossrefPubMedSearch in Google Scholar
  • 4 Schiller Y, Najjar Y. Quantifying the response to antiepileptic drugs: effect of past treatment history. Neurology 2008; 70 (01) 54-65.
    CrossrefPubMedSearch in Google Scholar
  • 5 Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med 2000; 342 (05) 314-319.
    CrossrefPubMedSearch in Google Scholar
  • 6 Kanner AM. Depression in epilepsy: prevalence, clinical semiology, pathogenic mechanisms, and treatment. Biol Psychiatry 2003; 54 (03) 388-398.
    CrossrefPubMedSearch in Google Scholar
  • 7 Kondziella D, Asztely F. Don’t be afraid to treat depression in patients with epilepsy!. Acta Neurol Scand 2009; 119 (02) 75-80.
    CrossrefPubMedSearch in Google Scholar
  • 8 Alper K, Schwartz KA, Kolts RL, Khan A. Seizure incidence in psychopharmacological clinical trials: an analysis of Food and Drug Administration (FDA) summary basis of approval reports. Biol Psychiatry 2007; 62 (04) 345-354.
    CrossrefPubMedSearch in Google Scholar
  • 9 LaFrance Jr WC, Kanner AM, Hermann B. Psychiatric comorbidities in epilepsy. Int Rev Neurobiol 2008; 83: 347-383.
    CrossrefPubMedSearch in Google Scholar
  • 10 Edeh J, Toone B. Relationship between interictal psychopathology and the type of epilepsy: results of a survey in general practice. British Journal of Psychiatry 1987; 151: 95-101.
    CrossrefPubMedSearch in Google Scholar
  • 11 Blumer D. Antidepressant and double antidepressant treatment for the affective disorder of epilepsy. J Clin Psychiatry 1997; 58 (01) 3-11.
    CrossrefPubMedSearch in Google Scholar
  • 12 Trimble M. The psychoses of epilepsy. New York: Raven Press; 1991
    Search in Google Scholar
  • 13 Bruens J. Psychoses in Epilepsy. Psychiatr Neurol Neurochir 1971; 74: 175-192.
    PubMedSearch in Google Scholar
  • 14 Dongier S. Statistical study of clinical and electroencephalographic manifestations of 536 psychotic episodes occurring in 516 epileptics between clinical seizures. Epilepsia 1959; 01: 117-142.
    CrossrefPubMedSearch in Google Scholar
  • 15 Machanda R, Schaefer B, McLachlan R. Psychiatric disorders in candidates for surgery for epilepsy. J Neurol Neurosurg Psychiatry 1996; 61: 82-89.
    CrossrefPubMedSearch in Google Scholar
  • 16 Caplan R. et al. Formal thought disorders and psychopathology in pediatric primary generalized and complex partial epilepsy. J Am Acad Child Adolesc Psychiatry 1997; 36: 1286-1294.
    CrossrefPubMedSearch in Google Scholar
  • 17 Sherwin I. Psychosis associated with epilepsy: significance of laterality of the epileptogenic lesion. J Neurol Neurosurg Psychiatry 1981; 44: 83-85.
    CrossrefPubMedSearch in Google Scholar
  • 18 Taylor D. Mental state and temporal lobe epilepsy. A correlative account of 100 patients treated surgically. Epilepsia 1972; 13: 727-765.
    CrossrefPubMedSearch in Google Scholar
  • 19 Lindsay J, Ounsted C, Richards P. Longterm outcome in children with temporal lobe seizures. Dev Med Child Neurol 1979; 21: 630-636.
    PubMedSearch in Google Scholar
  • 20 Reutens D. et al. Results of surgical treatment in temporal lobe epilepsy with chronic psychosis. Brain 1997; 120: 1929-1936.
    CrossrefPubMedSearch in Google Scholar
  • 21 Jacoby A. Felt versus enacted stigma: a concept revisited. Soc Sci Med 1994; 38: 269-274.
    CrossrefPubMedSearch in Google Scholar
  • 22 Hermann BP, Trenerry MR, Colligan RC. Learned helplessness, attributional style and depression in epilepsy. Epilepsia 1996; 37: 680-686.
    CrossrefPubMedSearch in Google Scholar
  • 23 Schmitz B, Robertson M, Trimble M. Depression and schizophenia in epilepsy: social and biological risk factors. Epilepsy Res 1999; 35: 59-68.
    CrossrefPubMedSearch in Google Scholar
  • 24 Beck AT, Rush AJ, Shaw BF, Emery G. Kognitive Therapie der Depression. Weinheim: Beltz; 2001
    Search in Google Scholar
  • 25 Krishnamoorthy ES, Trimble MR, Blumer D. The classification of neuropsychiatric disorders in epilepsy: a proposal by the ILAE Commission on Psychobiology of Epilepsy. Epilepsy Behav 2007; 10 (03) 349-353.
    CrossrefPubMedSearch in Google Scholar
  • 26 Hamilton M. Hamilton rating scale for depression. 1960
    PubMedSearch in Google Scholar
  • 27 Beck AT. Beck Depression Inventory (BDI, BDI-II). 1961
    PubMedSearch in Google Scholar
  • 28 Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. The British Journal of Psychiatry 1979; 134: 382-389.
    CrossrefPubMedSearch in Google Scholar
  • 29 Barraclought B. Suicide and epilepsy. In: Reynolds EH, Trimble MR. (Eds.). Epilepsy and psychiatry. Edinburgh: Churchill Livingstone; 1981
    Search in Google Scholar
  • 30 Betts T. Epilepsy, Psychiatry and learning difficulty. London: Martin Dunitz Publishers; 1998
    Search in Google Scholar
  • 31 Blumer D, Altshuler LL. Affective disorders. In: Engel J, Pedley TA. (eds.). Epilepsy: A comprehensive textbook (Vol. 2). Philadelphia: Lippincott, Raven Publishers; 1997
    Search in Google Scholar
  • 32 Heinemann U, Rating D, Thorbecke R, Wolf P. Epilepsie–Bericht 1998. Berlin: Einfälle; 1998
    Search in Google Scholar
  • 33 Krishnamoorthy ES. Psychiatric issues in epilepsy. Current Opinion Neurology 2001; 14: 217-224.
    Search in Google Scholar
  • 34 Swinkels WA. et al. Prevalence of Psychopathology in Dutch Epilepsy Inpatients: A Comparative Study. Epilepsy Behav 2001; 02 (05) 441-447.
    CrossrefPubMedSearch in Google Scholar
  • 35 Vazquez B, Devinsky O. Epilepsy and anxiety. Epilepsy Behav 2003; 04 (Suppl. 4): 20-25.
    Search in Google Scholar
  • 36 Wolf P. Praxisbuch Epilepsien: Diagnostik, Behandlung, Rehabilitation. Stuttgart: Kohlhammer; 2003
    Search in Google Scholar
  • 37 Beyenburg S, Schmidt D. Epilepsiepatienten mit Angsterkrankungen. Erkennen und Behandeln. Nervenarzt 2005; 76: 1077-1091.
    CrossrefPubMedSearch in Google Scholar
  • 38 Goldstein MA, Harden CL. Epilepsy and Anxiety. Epilepsy Behav 2000; 01 (04) 228-234.
    CrossrefPubMedSearch in Google Scholar
  • 39 Matthes A, Schneble H. Epilepsien: Diagnostik und Therapie für Klinik und Praxis. Stuttgart: Georg Thieme Verlag; 1999
    Search in Google Scholar
  • 40 McConnell HW, Duncan D. Treatment of psychiatric comorbidity in epilepsy. In: McConnell HW, Snyder PJ. (eds.). Psychiatric comorbidity in epilepsy: basic, mechanisms, diagnosis and treatment. Washington: American Psychiatric Press Inc; 1998
    Search in Google Scholar
  • 41 Edlund MJ, Swann AC, Clothier J. Patients with panic attacks and abnormal EEG results. Am J Psychiatry 1987; 144 (04) 508-509.
    CrossrefPubMedSearch in Google Scholar
  • 42 McNamara ME, Fogel BS. Anticonvulsant-responsive panic attacks with temporal lobe EEG abnormalities. J Neuropsychiatry Clin Neurosci 1990; 02 (02) 193-196.
    CrossrefPubMedSearch in Google Scholar
  • 43 Perini GI. et al. Interictal mood and personality disorders in temporal lobe epilepsy and juvenile myoclonic epilepsy. Journal of Neurology, Neurosurgery, and Psychiatry 1996; 61: 601-605.
    CrossrefPubMedSearch in Google Scholar
  • 44 Spielberger CD. STAI manual. Palo Alto: Consulting Psychologists in Press; 1996
    Search in Google Scholar
  • 45 Janz D. Die Epilepsien. Stuttgart: Thieme; 1969
    Search in Google Scholar
  • 46 Heckmann JG, Lang CJ, Stefan H, Neundörfer B. The vegetarian who ate a sausage with curry sauce. Lancet Neurol 2003; 02 (01) 62.
    CrossrefPubMedSearch in Google Scholar
  • 47 Devinsky O. Psychiatric comorbidity in patients with epilepsy: Implications for diagnosis and treatment. Epilepsy Behav 2003; 04: 2-10.
    Search in Google Scholar
  • 48 Krishnamoorthy ES. Neuropsychiatric disorders in epilepsy – Epidemiology and classification. In: Trimble M, Schmitz B. (eds.). The neuropsychiatry of epilepsy. Cambridge: University Press; 2002
    Search in Google Scholar
  • 49 Trimble MR, Schmitz B. The psychoses of epilepsy/ schizophrenia. In: Engel J, Pedley TA. (eds.). Epilepsy: A comprehensive textbook (Vol. 2). Philadelphia: Lippincott, Raven Publishers; 1997
    Search in Google Scholar
  • 50 Tandon R, DeQuardo JR. Psychoses and epilepsy. In: Sackellares CJ, Berent S. (eds.). Psychological disturbances in epilepsy. Newton: Butterworth-Heinemann; 1996
    Search in Google Scholar
  • 51 Tsopelas ND, Saintfort R, Fricchione GL. The relationship of psychiatric illnesses and seizures. Current Psychiatry Reports 2001; 03: 235-242.
    CrossrefPubMedSearch in Google Scholar
  • 52 Smith PF, Darlington CL. Neural mechanisms of psychiatric disturbances in patients with epilepsy. In: McConnell HW, Snyder PJ. (eds.). Psychiatriccomorbidity in epilepsy: Basic mechanisms, diagnosis, and treatment. Washington: American Psychiatric Press Inc; 1998
    Search in Google Scholar
  • 53 Slater E, Beard AW, Glithero E. The schizophrenialike psychoses of epilepsy. Br J Psychiatry 1963; 109: 95-150.
    CrossrefPubMedSearch in Google Scholar
  • 54 Landolt H. Some clinical electroencephalographical correlations in epileptic psychoses (twilight states). Electroencephalography and Clinical Neurophysiology 1953; 05: 121.
    Search in Google Scholar
  • 55 Jacobi RME, Claussen PC, Wolf P. (Hrsg.). Die Wahrheit der Begegnung. Würzburg: Könighausen & Neumann; 2001
    Search in Google Scholar
  • 56 Tellenbach H. Schwermut, Wahn und Fallsucht in der abendländischen Dichtung. Hürtgenwald: Guido Pressler; 1992
    Search in Google Scholar
  • 57 Blanchet P, Frommer GP. Mood change preceding epileptic seizures. J Nerv Ment Dis 1986; 174: 471-476.
    CrossrefPubMedSearch in Google Scholar
  • 58 Kanner AM, Balabanov A. Depression and epilepsy: how closely related are they?. Neurology 2002; 58 (8Suppl. 5): S27-S39.
    PubMedSearch in Google Scholar
  • 59 Schwartz JA. The social apraxia of epilepsy. In: Sackellares JC, Berent S. (eds.). Psychological disturbances in epilepsy. Newton: Butterworth-Heinemann; 1996
    Search in Google Scholar
  • 60 Ketter TA, Post RM, Theodore WH. Positive and negative psychiatric effects of antiepileptic drugs in patients with seizure disorders. Neurology 1999; 53 (5 Suppl. 2): 53-67.
    Search in Google Scholar
  • 61 Wolf P, Inoue Z, Röder-Wanner U, Tsai J. Psychiatric complications of absence therapy and their relations to alteration of sleep. Epilepsia 1984; 25: 56-59.
    CrossrefPubMedSearch in Google Scholar
  • 62 McDanal C, Bolman W. Delayed idiosyncratic psychosis with diphenylhydantoin. JAMA 1975; 231: 1063.
    CrossrefPubMedSearch in Google Scholar
  • 63 Cummings JL, Trimble MR. Concise guide to neuropsychiatry and behavioral neurology. Washington: American Psychiatric Press Inc; 1995
    Search in Google Scholar
  • 64 Devinsky et al. Postictal psychosis: a case control series of 20 patients and 150 controls. Epilepsy Research 1995; 20: 247-253.
    CrossrefPubMedSearch in Google Scholar
  • 65 Bohlmann K, Straub HB. Slow titration of levetiracetam reduces incidence of psychiatric adverse effects. Epilepsia 2008; 49 (suppl. 7): 425.
    CrossrefPubMedSearch in Google Scholar
  • 66 Friedo AL, Bohlmann K, Straub HB. First experiences with rufinamide – tolerability and clinical effectiveness in clinical practice. Epilepsia 2009; 50 (suppl. 4): 211.
    Search in Google Scholar
  • 67 Andermann LF. et al. Psychosis after resection of ganglioglioma or DNET: evidence for an association. Epilepsia 1999; 40 (01) 83-87.
    CrossrefPubMedSearch in Google Scholar
  • 68 Koch-Stöcker S. Psychiatric effects of surgery for temporal lobe epilepsy. In: Trimble MR, Schmitz B. (eds). The Neuropsychiatry of Epilepsy. Cambridge: University Press; 2002
    Search in Google Scholar
  • 69 Schmitz B, Trimble M. Psychiatrische Epileptologie: Psychiatrie für Epileptologen – Epileptologie für Psychiater. Stuttgart: Thieme; 2005
    Search in Google Scholar