Psychiatric comorbidity in refractory focal epilepsy: A study of 490 patients

Abstract We studied the prevalence and associated factors of psychiatric comorbidities in 490 patients with refractory focal epilepsy. Of these, 198 (40.4%) patients had psychiatric comorbidity. An Axis I diagnosis was made in 154 patients (31.4%) and an Axis II diagnosis (personality disorder) in another 44 (8.97%) patients. After logistic regression, positive family history of psychiatric comorbidities (O.R. = 1.98; 95% CI = 1.10–3.58; p = 0.023), the presence of Axis II psychiatric comorbidities (O.R. = 3.25; 95% CI = 1.70–6.22; p < 0.0001), and the epileptogenic zone located in mesial temporal lobe structures (O.R. = 1.94; 95% CI = 1.25–3.03; p = 0.003) remained associated with Axis I psychiatric comorbidities. We concluded that a combination of clinical variables and selected structural abnormalities of the central nervous system contributes to the development of psychiatric comorbidities in patients with focal epilepsy.