Patients with epilepsy have a high prevalence of psychiatric comorbid disorders. Many comorbidities have a significant impact on the medical management and quality of life of these patients. The main psychiatric complications in epilepsy include depression, anxiety disorders, and psychosis. Depression in epilepsy is very common, particularly among patients with partial seizures of temporal lobe origin. Despite its high prevalence, depression and other psychiatric complications remain often unrecognized and untreated in patients with epilepsy, and differential diagnosis may be difficult.. Comorbidity of epilepsy may be due to a shared pathophysiological mechanism, however, coincidence or selection bias cannot always be excluded. In addition, genetic, psychosocial and iatrogenic factors may also contribute to the comorbidity. In this review, we discuss the clinical impact of main psychiatric comorbidities and demonstrate that treatment of epilepsy extends far beyond seizure control.
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