EEC 2026 | Psychiatric comorbidities in epilepsy: identifying, monitoring, and treatment considerations

Epilepsy is a lifelong condition and it’s characterized by psychiatric comorbidity all through the lifespan. So it’s affecting children and adults. But the comorbidity of psychiatric disorders differs in children and adults. So in children, it’s mainly intellectual disability and autism. And in adults, it’s other disorders, ADHD and depression. In children, if you have developmental disorders like severe intellectual disability or autism, that could prompt investigations such as genetic investigations, especially in the early years, in the first three years of life. And later, it’s more likely that clinical assessment would be of relevance. So, workup for ADHD and also assessment for depression. Depression is very prevalent in both persons with and without epilepsy. So, it’s important to have a setup where you can actually ensure that people have the correct placement in the system to meet the right doctors. At least in Denmark, in the hospital setting, they will only see very severe depression, not moderate depression, which is usually handled by the GPs. So there are certain drugs that are associated with psychiatric symptoms, so you may tailor your treatment according to that. It seems that all antiseizure medications are associated with a risk of suicidality. So that’s also very important to assess. And you need to assess that risk in the context of psychiatric comorbidity. So the risk of suicidality is much, much higher in persons with a psychiatric history than in those without. So when you initiate treatment, you really must consider the psychiatric history of that patient.

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