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    ABSTRACT: Psychiatric morbidity was assessed in a sample of 88 adult epileptic patients drawn from general practices in South London. Using the Clinical Interview Schedule, 48% emerged as psychiatric cases. When either total CIS score or caseness status was used for comparison, group differences were evident; patients with temporal lobe epilepsy and focal non-TLE did not differ, but each was significantly more impaired than those with primary generalised epilepsy. The groups also differed in their psychiatric symptom profiles. The results suggest that the increased prevalence of interictal psychopathology commonly associated with TLE may also be a feature of other forms of focal epilepsy.
    The British Journal of Psychiatry 08/1987; 151:95-101. DOI:10.1192/bjp.151.1.95 · 7.34 Impact Factor
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    ABSTRACT: The field of epilepsy and behavior is rich with controversial issues. In anticipation of an upcoming new feature of Epilepsy & Behavior called Controversial Issues in Epilepsy and Behavior, several highly debated issues are reviewed in this article. These include whether epilepsy is a neuropsychiatric disorder, the relationship between epilepsy and depression and the possible "bidirectional" interaction between the two disorders, and the differences in clinical expression of depression and psychotic disorders in epileptic and nonepileptic patients and the associated implications with respect to diagnosis and treatment. In addition, forced normalization and the very limited involvement of psychiatrists in the evaluation and management of patients with epilepsy are discussed.
    Epilepsy & Behavior 02/2001; 2(1):8-12. DOI:10.1006/ebeh.2001.0152 · 2.06 Impact Factor
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    ABSTRACT: Current knowledge of the relationship between epilepsy and schizophrenia-like psychosis is examined, and the proposed pathogenetic mechanisms are evaluated. The author provides an overview of the published literature on epilepsy and schizophrenia-like psychosis. The schizophrenia-like psychoses of epilepsy are inadequately categorized by the current classifications. Their categorization into ictal, postictal, and interictal psychoses is clinically useful, but it does not imply distinct pathophysiology for each. The recent interest in postictal psychoses has opened an important avenue for research. Brief interictal psychoses, involving alternation between epilepsy and psychosis and accompanied by forced normalization, are uncommon. Many aspects of the relationship with chronic interictal psychosis remain controversial. The majority of investigators support a special but not exclusive relationship with mediobasal temporal lobe epilepsy, and left temporal bias receives only limited support. The chronic psychosis resembles schizophrenia phenomenologically. Some suggested risk factors are severe and intractable epilepsy, epilepsy of early onset, secondary generalization of seizures, certain anticonvulsant drugs, and temporal lobectomy. Different neuropathological studies suggest the presence of cortical dysgenesis or diffuse brain damage. There are many mechanisms by which epilepsy may be associated with schizophrenia-like psychosis. It is likely that structural brain abnormalities, e.g., cortical dysgenesis or diffuse brain lesions, underlie both epilepsy and psychosis, and that the seizures modify the presentation of the psychosis, and vice versa, thus producing a clinical picture of both an affinity and an antagonism between the two disorders.
    American Journal of Psychiatry 03/1998; 155(3):325-36. DOI:10.1176/ajp.155.3.325 · 13.56 Impact Factor
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