Psychiatric aspects of epilepsy DONALD

THE LAST 10 years have been marked by progress in the study of epilepsy. A new international classification of epilepsy has been put forward (Gastaut et al., 1964). Succinamides have been introduced for the treatment of petit mal (Heathfield & Jewsbery, 1961) and have become an established treatment, while sulthiame (Fenton, Serafetinedes & Pond, 1964; Liu, 1966) and carbamazepine (Bird et al., 1966) have been tried though their final place in therapy is uncertain. The social aspects of epilepsy have become more important and have been investigated thoroughly (Juul-Jensen, 1963). There has been an improvement in the attitude of the general public to epileptic patients. This hopeful trend was noted by Caveness et al. (1965) in the U.S.A. They found a decreasing incidence of prejudice not only in relation to employment but also to social intercourse in general over the years 1949-64. A full and coherent account of all aspects of epilepsy is given in the two-volume work by Lennox, Epilepsy and Related Disorders, published in 1960. However, this condition still presents many problems, particularly in relation to its psychological aspects and it is some of these that are chosen for discussion here. In the chapter 'The Epilepsies' in Clinical Psychiatry by Mayer-Gross, Slater & Roth (1960) many aspects are discussed but here attention is placed on the following themes: psychiatric and psychological effects of ictal disturbances, the schizophrenia-like psychoses, non-psychotic disorders, temporal lobectomy for psychiatric disorder and some aspects of brain damage and epilepsy in childhood.