A Multicenter Study on the Prevalence of Psychiatric Disorders among New Referrals for Epilepsy in Japan

• Published in: Epilepsia (Copenhagen) Vol. 44; no. 1; pp. 107 - 114
• Main Authors: Matsuura, Masato, Oana, Yasunori, Kato, Masaaki, Kawana, Akinori, Kan, Rumiko, Kubota, Humio, Nakano, Takashi, Hara, Tsunekatsu, Horikawa, Naoshi
• Format: Journal Article
• Language: English
• Published: Malden, MA Blackwell 01.01.2003
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Child; Comorbidity; Cross-Sectional Studies; Epilepsy; Epilepsy - diagnosis; Epilepsy - epidemiology; Epilepsy - psychology; Epilepsy, Temporal Lobe - diagnosis; Epilepsy, Temporal Lobe - epidemiology; Epilepsy, Temporal Lobe - psychology; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Hospitals, Psychiatric - statistics & numerical data; Hospitals, University - statistics & numerical data; Humans; Intellectual Disability - diagnosis; Intellectual Disability - epidemiology; Intellectual Disability - psychology; Japan - epidemiology; Logistic Models; Male; Medical sciences; Mental Disorders - diagnosis; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental retardation; Middle Aged; Nervous system (semeiology, syndromes); Neurocognitive Disorders - diagnosis; Neurocognitive Disorders - epidemiology; Neurocognitive Disorders - psychology; Neurology; Outpatient Clinics, Hospital - statistics & numerical data; Psychiatric disorders; Referral and Consultation - statistics & numerical data; Risk Factors; Schizophrenia - diagnosis; Schizophrenia - epidemiology; Schizophrenia-spectrum disorders; Schizophrenic Psychology; Temporal lobe epilepsy; Asia; Japan; Human; Nervous system diseases; Prevalence; Epilepsy; Multicenter study; Central nervous system disease; Psychiatric disorders- Schizophrenia-spectrum disorders-Epilepsy-Mental retardation-Temporal lobe epilepsy; Psychopathology; Epidemiology; Cerebral disorder
• ISSN: 0013-9580; 1528-1167
• DOI: 10.1046/j.1528-1157.2003.25202.x

Purpose: To investigate the prevalence rate and risk factors of psychiatric disorders among new referrals for epilepsy, a multicenter study was conducted by using the International League Against Epilepsy (ILAE) criteria for epilepsy and the ICD‐10 criteria for psychiatric disorders. Methods: From April 2000 to March 2001, 398 patients with epilepsy, who were referred to nine neuropsychiatric outpatient clinics specialized for epilepsy in the Tokyo metropolitan area, were evaluated by using a newly developed five‐axis classification scheme. Results: Forty‐two percent of the subjects showed a psychiatric disorder. Twenty‐four percent of the total showed psychiatric disorders, including neurotic disorders in 8%, psychotic disorders in 7%, and affective disorders in 1%. In addition, 23% of the total showed mental retardation, and 18% showed personality disorders. A logistic regression analysis revealed that the three risk factors for a psychiatric disorder were mental retardation, temporal lobe epilepsy (as opposed to other subtypes), and a high seizure frequency. Conclusions: The presence of mental retardation was the primary risk factor for developing a psychiatric disorder, especially a schizophrenia‐spectrum disorder. The type of epilepsy alone is not a strong predictor of psychiatric illness, and intractable temporal lobe epilepsy with a high seizure frequency is accountable for the link between the epilepsy and the psychiatric illness.