Year: 2025
Type: article
Abstract: Epilepsy affects ~50 million people worldwide and is associated with increased psychiatric comorbidities, including depression, anxiety, psychosis and suicidality. Despite this, current epilepsy management primarily focusses on seizure control, potentially overlooking mental health concerns. This article explores the challenges of integrating psychiatric care into epilepsy treatment and proposes solutions for a more holistic approach. Using a consensus development panel method, a multidisciplinary team of neurologists, psychiatrists and a lived-experience expert identified key challenges to optimising the mental health of people living with epilepsy, such as healthcare system fragmentation, underdiagnosis of mental health conditions and inadequate resources. Among the proposed solutions, the need for routine mental health screening, interdisciplinary support and collaboration, and increased research into the neuropsychiatric aspects of epilepsy were highlighted. A shift from a seizure-centric model to a patient-centred approach is advocated, emphasising biopsychosocial care and improved access to psychiatric services. We also discuss prospective practical strategies to tackle the issues identified, including collaborative care models, structured decision trees and AI-driven screening tools, to enhance diagnosis and treatment. Addressing these challenges through systemic change, research investment and service innovation should significantly improve the care and quality of life for individuals with an epilepsy and co-occurring mental health disorders.
Authors: Riccardo De Giorgi, Tessa Lomax, Carmen Moreno, Evelien Van Assche, Emanuele F. Osimo, Tomasz Bajorek, Arjune Sen, Seena Fazel, Bernhard T. Baune, Rohan Kandasamy, Rongqin Yu, Javier Peña-Ceballos, Simona Lattanzi, Pablo Andrés Camazón, Celia Romero del Rincon, Mahinda Yogarajah, Giovanni Assenza, Torie Robinson, Angel Aledo-Serrano, Andrea Cipriani
Institutions: Oxford Health NHS Foundation Trust, Warneford Hospital, University of Oxford, Instituto de Salud Carlos III, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental, University of Münster, University of Cambridge, Cambridgeshire and Peterborough NHS Foundation Trust, John Radcliffe Hospital, The University of Melbourne, Florey Institute of Neuroscience and Mental Health, UCL Queen Square Institute of Neurology, University College London, Beaumont Hospital, Marche Polytechnic University, Hospital Blua Sanitas Valdebebas, UCL Biomedical Research Centre, Epilepsy Society, Università Campus Bio-Medico, University Hospital Foundation, Campus Bio Medico University Hospital, Sparks, National Institute for Health and Care Research, NIHR Oxford Biomedical Research Centre
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,920
Funders: Wellcome Trust, National Institute for Health and Care Research, Department of Health and Social Care, European Commission, Ministerio de Ciencia e Innovación, Angelini Pharma, National Institutes of Health, Horizon 2020 Framework Programme, HORIZON EUROPE Framework Programme, Instituto de Salud Carlos III, European Regional Development Fund, National Institute of Mental Health
Awards: Bases etiopatológicas de la disregulación emocional en adolescentes con depresión, conect4children (COllaborative Network for European Clinical Trials For Children), Psych-STRATA - A Stratified Treatment Algorithm in Psychiatry: A program on stratified pharmacogenomics in severe mental illness, G2017605187, Running in the FAMILY - Understanding and predicting the intergenerational transmission of mental illness, G2606538822, G2628364946, G2792775314, Choosing the right antidepressant for depressive disorder, G3147750816, Boosting Societal Adaptation and Mental Health in a Rapidly Digitalizing, Post-Pandemic Europe, Estudio integral de variación genética y molecular de una cohorte española de trastornos del espectro autista y diseño de algoritmos de diagnóstico genético y de biotipos terapéuticos. Cohorte ESTEA., G4630814196, G4937468798, G5983053349, G6272113452, G7336256237, G7714202236, G8351277590, G8824911526, G8858395165
OpenAlex ID: W4416385691