Psychiatric And Social Aspects Of Epilepsy

A person with epilepsy, particularly if seizures are not immediately controlled, carries an increased risk of developing psychiatric complications. These may be related to the psychological burden of a disorder that is characterized by unpredictable loss of control and is often stigmatized in modern societies. Other risk factors are biological and include the consequences of recurrent epileptic cerebral dysfunction as well as the potentially negative psychotropic effects of AEDs. Psychoses in epilepsy can occur in direct relationship to seizure activity, most often triggered by a series of seizures. They may also occur when seizures are controlled—so-called ''alternative psychoses'' due to ''forced normalization.'' More common than psychoses are depressive syndromes, and suicide accounts for about 10% of all deaths in persons with epilepsy. Other psychiatric disorders that are common in epilepsy are anxiety disorders and the coexistence of epileptic and nonepileptic pseudoseizures.

Epileptic seizures have a significant impact on the social life of a person with epilepsy. Depending on the type and frequency of seizures, patients are restricted in terms of their professional options as well as their leisure time activities. In all countries there are restrictions on driving. Patients and relatives often have false ideas about the nature and course ofepilepsy and therefore need to be informed about individual dangers, restrictions, and liberties. Therefore, optimal treatment of epilepsy is a multidisciplinary and enduring task, in which not only the doctor but also the social worker and the psychologist play a significant role.

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