Brain health and mental health: Common vascular risk factors and practical implications.

The pandemic dramatized the close links among cognitive, mental, and social health; a change in one reflects others. This realization offers the opportunity to bridge the artificial separation of brain and mental health, as brain disorders have behavioral consequences and behavioral disorders affect the brain. The leading causes of mortality and disability, namely stroke, heart disease, and dementia, share the same risk and protective factors.

Peri-ictal and ictal cognitive dysfunction in epilepsy.

Disturbances in cognitive function, particularly memory, are a common complaint of patients with epilepsy. Factors contributing to cognitive dysfunction are the type of epilepsy, type and frequency of seizures, anti-epileptic drugs and the location of underlying brain lesions. Whilst a great deal of attention has been paid to permanent cognitive impairment, the nature and underlying mechanisms of ictal and peri-ictal cognitive changes are poorly understood.

Best clinical and research practice in adult epileptology.

To properly address the psychosocial health of people with epilepsy, service and resource allocation, standards of care, and research should reflect the differing needs of patients presenting at different care levels and in different parts of the world. Ideally, people with epilepsy should have access, according to need, to adequately trained primary care physicians and nurse practitioners; to dedicated secondary care epilepsy clinics staffed by trained multidisciplinary teams; and to tertiary level dedicated staff, able to offer a range of psychosocial interventions and supported by comprehensive assessment tools for psychosocial screening, diagnosis, and management. Established protocols linking the various tiers of care would be important, as would a dedicated, nationally applicable online EMR system.

A differential role for the hippocampus and amygdala in neuropsychiatric disorders.

There may be a differential role for the amygdala, hippocampus and possibly other temporal structures, in the development and/or the expression of psychopathology

Depression in epilepsy: phenomenology, diagnosis and management.

1) Depression is a common and important accompaniment of epilepsy. 2) Depression in epilepsy is phenomenologically different from the usual forms of depression and it is essential that treating physicians assess for these varied forms as well. 3) Depression in epilepsy may be managed more effectively if the relationship to the ictus is better understood.

The evaluation of behavioral disturbances in epilepsy.

The evaluation of behavioral disturbances in epilepsy is an area fraught with complexity. On the one hand, there are no instruments that have been developed specifically for the assessment of behavioral disturbances in epilepsy. On the other hand, the phenomenology and pathophysiology of behavioral disturbances in epilepsy are unique and defy conventional descriptions in the psychiatric literature.

Prevalence of stroke among Chinese, Malay, and Indian Singaporeans: a community-based tri-racial cross-sectional survey.

Background And Purpose: Stroke prevalence data among mixed Asian populations are lacking. Prevalence rates of stroke were studied among Singaporeans aged > or =50 years of Chinese, Malay, and Indian origin.

Methods: Study participants were selected by disproportionate stratified random sampling by race.

Mesial temporal structures and comorbid anxiety in refractory partial epilepsy.

We used quantitative magnetic resonance imaging (MRI) to examine the mesial temporal structures in subjects with refractory partial epilepsy and comorbid anxiety and found preservation with a right-sided preponderance. The findings indicate a role for this brain region in the genesis of anxiety.

Treatment of depression in patients with epilepsy: problems, pitfalls, and some solutions.

Many people with epilepsy suffer from comorbid depression. Despite this, there have been few studies addressing the treatment of depression in this population, and the literature on psychiatric management techniques in patients with epilepsy is composed largely of opinions rather than evidence from randomized, controlled trials or other systematic investigations. Antidepressant drugs, including tricyclics and selective serotonin reuptake inhibitors, can be used to treat patients with epilepsy and comorbid depression.

Personality and Psychopathology in Nonepileptic Attack Disorder and Epilepsy: A Prospective Study.

To study the nature of personality and psychopathology in nonepileptic attack disorder (NEAD) and epilepsy, we prospectively assessed 45 consecutive attendees to a specialist assessment unit for epilepsy. Patients with NEAD were more likely to report clinically significant symptoms of anxiety, worry, disordered eating, and somatoform disorder. An ICD-10 diagnosis of anxiety or phobic disorder was significantly more common in NEAD patients.

Abulia: a delphi survey of British neurologists and psychiatrists.

Abulia is the relatively uncommon yet debilitating lack of spontaneous, goal-directed behaviour that is seen predominantly with lesions of the basal ganglia and the frontal lobes. We sought to confirm the existence of abulia as an entity recognized by clinicians, to generate a set of items characteristic of the condition, and to see how clinicians differentiate between overlapping disorders. The Delphi technique was used to survey consultant neurologists and psychiatrists at three hospitals in London.