Depression in Epilepsy: A Socioeconomic and Pharmacologic Look Into the Factors Contributing to Undiagnosed Depression in Epileptics

Anand Gandhi

Abstract


Depression extends notably into the epileptic population in the U.S. in rates of up to 55%. Despite the relatively high rates of depression found in epileptic patients, the rate of diagnosis is significantly lower. This study evaluates socioeconomic trends found in depressed epileptics, as well as pharmacological factors surrounding depression in epilepsy, to ascertain possible reasons for the lack of diagnosis of depression in epileptic patients. The results demonstrate that epileptics suffer from increased economic burden due to the cost of antiepileptic and antidepressant care as well as comparatively high unemployment rates. Antidepressants, most notably SSRIs, possess significantly fewer side effects and interactions with anti-epileptics than antidepressants from older generations. Depression manifests itself differently in epileptics versus non epileptics. The features of epileptic depression are more endogenous than neurotic. Neurologists do not undergo extensive training in psychiatry nor do psychiatrists undergo training in neurology despite the characteristics of epileptic depression being a psychological as well as neurological disorder. Depression is often neglected in busy health clinics as epilepsy and other conditions are regarded to be of greater severity and importance than depression. In order to increase the diagnosis of depression in epileptics clinicians need to implement quick, non-DSM-IV-centered screening questionnaires, psychiatrists and neurologists need to collectively diagnose depression in epileptics, and residency programs should increase psychiatric training in neurologists and neurologic training in psychiatrists.

Keywords


Epilepsy; Depression; Questionnaire

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