[Epilepsy and psychiatric disorders (epi-psy)].

Abstract

EPILEPSY AND PSYCHIATRIC DISORDERS (EPI-PSY). Epilepsy is not only a brain pathology characterized by a lasting predisposition to generate seizures, it is also associated with cognitive, behavioral, psychological, and social disorders. The interaction between psychiatric pathologies and epilepsy is bidirectional and complex. This association is summarized in the neologism Epi-Psy. Psychiatric pathologies affect at least one third of epileptic patients and up to 80% in cases of drug-resistant epilepsy. The diagnostic approach should distinguish between peri-ictal disorders (chronologically linked to the seizure: pre-ictal, ictal, or post-ictal) and inter-ictal disorders (not chronologically linked to the seizures: iatrogenic, specific to epilepsy or non-specific). The main psychiatric disorders related to epilepsy are psychosis, depression, anxiety and substance use. The impact on quality of life is significant. The therapeutic strategy is both pharmacological and psychotherapeutic. The prescription of selective serotonin reuptake inhibitors (SSRIs) is possible and desirable for anxiety or depressive disorders, with no contraindication for epilepsy. Collaboration between general practitioners, epileptologists, and psychiatrists is valuable in the field of Epi-Psy.