Abstracts

Rationale: Most epileptic patients live in developing world. This asymmetry in epilepsy prevalence might occur due to different etiologies for epilepsies. Thus, it is plausible that some clinical differences might be observed when comparing epileptics from different parts of the world. Psychiatric disorders are common in epileptic patients. However, the prevalence of psychiatric comorbidities might be different according with methodology used and geographic region where patients live. Some studies have evaluated psychiatric comorbidities in epileptic patients. However well-controlled studies using standardized diagnostic instruments are still lacking, especially in poor countries. The objective of this study is to evaluate the prevalence of major psychiatric comorbidities in a series of Southern Brazilian patients with temporal lobe epilepsy, using a validated structured clinical interview. Methods: We analyzed 79 patients with temporal lobe epilepsy regarding neuropsychiatric symptoms. All patients were diagnosed according to the localization-related concept of the 1989 International League Against Epilepsy (ILAE) Classification of Epilepsies and Epileptic Syndromes, and the localization and lateralization of the epileptogenic zone was established by using the clinical criteria, eletroencephalography and neuroimaging. All patients were submitted to neuropsychiatric evaluation using SCID (Structured Clinical Interview for DSM-IV axis I disorders). In our study we used SCID to divide the patients in four major categories of neuropsychiatric disorders: humor disorders, anxiety disorders, psychotic disorders, and drugs or alcohol abuse. The variables studied were age, age of epilepsy onset, duration of epilepsy, gender, familiar history for epilepsy, seizure frequency, seizure control and psychiatric diagnostics. Results: We evaluated 30 (38.0%) men and 49 (62.0%) women, with mean age of 43.2 years, and mean of 25.2 years of epilepsy duration. Forty nine patients (62%) were positive for major psychiatric comorbidities. Humor disorders were observed in 38 (48.1% of all patients), being the most common neuropsychiatric disorders in SCID positive patients (77.5%) Anxiety disorders were the second most frequent disorder, observed in 17 patients (21.5%). Psychotic disorders were observed in 6 patients (7.6%). Substance abuse were observed in 4 patients (5.1%). There were no differences among SCID positive and SCID negative patients regarding age, age of epilepsy onset, time of epilepsy duration, gender, familiar history for epilepsy, seizure frequency, and seizure control. Conclusions: We observed psychiatric disorder in 62% of our epileptic patients. Our results are in line with literature where most authors have reported psychiatric problems in 19 to 80% of epileptic patients. The large variation in percentages is probably attributable to the different patient groups investigated and the even greater variety of diagnostic methods. Nevertheless this study showed a large number of neuropsychiatric major disorders in patients with temporal lobe epilepsy in our population. Supported by FAPERGS and CNPq.