What is Depression in Epilepsy?

IntroductIon Psychiatry, in terms of neuropsychiatry, has experienced an impressive revival in the field of neurology over the past two decades. This especially holds true for epileptology (Reynolds and Trimble, 2009). A large number of studies have addressed depressive and other affective disorders in patients with seizures. Depression is now widely acknowledged as a frequent psychiatric comorbidity of seizure disorders (Barry et al., 2008; LaFrance et al., 2008). Here we critically explore the concept of depression as a comorbidity in epilepsy (see also Hoppe and Elger, 2011). First, we address criteria which differentiate between transiently altered mood states and psychiatric mood disorders. We then show that depression in epilepsy provides a perfect model for the biopsychosocial etiology of depression and discuss related therapeutic approaches. Finally, we provide some general remarks on what is required to maintain or restitute emotional well-being in patients with therapy–refractory epilepsy.