Psychopathology refers to the manifestation of behaviors or experiences that may be indicative of mental illness or psychological impairment. The term is broad, encompassing all phenomena that might, but might not, reach significance for a psychiatric diagnosis. As a result, the debate about the occurrence of psychopathology in people with epilepsy has been long and intense. If behavior is the manifest aspect of psychic life, then aberrations of behavior are usually attributed to some form of abnormal mental state1; there can be no doubt that this is a significant issue in people with epilepsy. There is further difficulty in interpreting psychopathology or behavioral disorders in people with intellectual disabilities (ID), particularly in people with severe ID. How, then, do we understand the issues surrounding psychopathology in people with ID and epilepsy?
In this chapter we will seek to look at these issues in more detail, describing findings in people with ID without epilepsy, in the general population with epilepsy, and then, where possible, looking for ID-specific research in the field of epilepsy.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Engel J, Taylor DC. (1997) Neurobiology of behavioural disorders. In: Engel J, Pedley TA (eds.). Epilepsy — A comprehensive textbook. Philadelphia: Lippincot-Raven, 2045 -52.
Tymchuk AJ, Lakin KC, Luckasson R. (2001) Life at the margins: Intellectual, demographic, economic, and social circumstances of adults with mild cognitive limitations. In: Tymchuk AJ, Lakin KC, Luckasson R (eds.). The forgotten generation: The status and challenges of adults with mild cognitive limitations. Baltimore: Paul H.Brookes.
World Health Organization. (1992) The ICD-10 Classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva: WHO.
American Psychiatric Association. (1995) Diagnostic and statistical manual of mental disorders, Third Edition Revised. (DSM-IV) Washington, DC.
Smiley E. (2005) Epidemiology of mental health problems in adults with learning disability: An update. Adv Psychiatr Treatment 11: 214-22.
Hermann B, Whitman S. (1992) Psychopathology in epilepsy. The role of psychology in altering paradigms of research, treatment, and prevention. Am Psychol 47: 1134-8.
Oostrom KJ, Schouten A, Kruitwagen CL, et al. (2002) Attention deficits are not characteristic of schoolchildren with newly diagnosed idiopathic or cryptogenic epilepsy. Epilepsia 43: 301-10.
Lewis JN, Tonge BJ, Mowat DR, et al. (2000) Epilepsy and associated psychopathology in young people with intellectual disability. J Paediatr Child Health 36: 172-5.
Scheepers M, Kerr M. (2003) Epilepsy and behaviour. Curr Opin Neurol. 16: 183-7.
Lopez-Rodriguez F, Altshuler L, Kay J, et al. (1999) Personality disorders among medically refractory epileptic patients. J Neuropsychiatr Clin Neurosci 11: 464-9.
Marsh L, Rao V. (2002) Psychiatric complications in patients with epilepsy: A review. Epilepsy Res 49: 11-33.
Piazzini A, Canger R. (2001) Depression and anxiety in patients with epilepsy. Epilepsia 42(Suppl 1): 29-31.
Bortz JJ. (2003) Neuropsychiatric and memory issues in epilepsy. Mayo Clin Proc. 78: 781-7.
Gilliam F, Kanner AM. (2002) Treatment of depressive disorders in epilepsy patients. Epilepsy Behav 3(5S) 2-9.
Brookes G, Crawford P. (2002) The associations between epilepsy and depressive illness in secondary care. Seizure 11: 523-6.
Barry JJ. (2003) The recognition and management of mood disorders as a comorbidity of epilepsy. Epilepsia 44(Suppl 4): 30-40.
Kanner AM. (2003) Depression in epilepsy: Prevalence, clinical semiology, pathogenic mechanisms, and treatment. Biol Psychiat. 54: 388-98.
Kanner AM, Balabanov A. (2002) Depression and epilepsy: How closely related are they? Neurology 58(8 Suppl 5): S27-S39.
Schmitz EB, Robertson MM, Trimble MR. (1999) Depression and schizophrenia in epilepsy: Social and biological risk factors. Epilepsy Res 35: 59-68.
Trostle JA, Hauser WA, Sharbrough FW. (1989) Psychologic and social adjustment to epilepsy in Rochester, Minnesota. Neurology. 39: 633-7.
Fukuchi T, Kanemoto K, Kato M, et al. (2002) Death in epilepsy with special attention to suicide cases. Epilepsy Res 51: 233-6.
Blumer D, Montouris G, Davies K, et al. (2002) Suicide in epilepsy: Psychopathology, pathogenesis, and prevention. Epilepsy Behav 3: 232-41.
McLachlan RS. (2003) Psychosis and epilepsy: A neurologist’s perspective. Seishin Shinkeigaku Zasshi 105: 433-9.
Trimble MR, van Elst LT. (2003) The amygdala and psychopathology studies in epilepsy. Ann NY Acad Sci. 985: 461-8.
Appleton R. (2003) Aetiology of epilepsy and learning disorders: Specific epilepsy syndromes; genetic, chromosomal and sporadic syndromes. In: Trimble MR (ed.). Learning disability and epilepsy: An integrative approach. Guildford: Clarius Press, 47-64.
Alper KR, Barry JJ, Balabanov AJ. (2002) Treatment of psychosis, aggression, and irritability in patients with epilepsy. Epilepsy Behav 3(5S):13-18.
Onuma T. (2000) Classification of psychiatric symptoms in patients with epilepsy. Epilepsia 41(Suppl 9): 43-8.
Adachi N, Onuma T, Nishiwaki S, et al. (2000) Inter-ictal and post-ictal psychoses in frontal lobe epilepsy: A retrospective comparison with psychoses in temporal lobe epilepsy. Seizure 9: 328-35.
Trimble MR, Schmitz EB. (1997) The psychoses of epilepsy/schizophrenia. In: Engel J, Pedley TA (eds.). Epilepsy: A comprehensive textbook. Philadelphia: Lipincott-Raven, 2071-82.
Tebartz VE, Baeumer D, Lemieux L, et al. (2002) Amygdala pathology in psychosis of epilepsy: A magnetic resonance imaging study in patients with temporal lobe epilepsy. Brain 125: 140-9.
Marsh L, Sullivan EV, Morrell M, et al. (2001) Structural brain abnormalities in patients with schizophrenia, epilepsy, and epilepsy with chronic interictal psychosis. Psychiatr Res. 108: 1-15.
Leutmezer F, Podreka I, Asenbaum S, et al. (2003) Postictal psychosis in temporal lobe epilepsy. Epilepsia 44: 582-90.
Getz K, Hermann B, Seidenberg M, et al. (2002) Negative symptoms in temporal lobe epilepsy. Am J Psychiat 159: 644-51.
Krishnamoorthy ES, Trimble MR. (1999) Forced normalization: Clinical and therapeutic relevance. Epilepsia 40(Suppl 10): S57-S64.
Deb S. (1997) Mental disorder in adults with mental retardation and epilepsy. Compr Psychiat 38: 179-84.
Krishnamoorthy ES. (2003) Neuropsychiatric epidemiology at the interface between learning disability and epilepsy. In: Trimble MR (ed.). Learning disability in epilepsy: An integrative approach. Guildford: Clarius Press, 17-26.
. Frost S, Crawford P, Mera S. (2002) National statement of good practice for the treatment and care of people who have epilepsy. Joint Epilepsy Council.
Deb S, Hunter D. (1991) Psychopathology of people with mental handicap and epilepsy. II. Psychiatric illness. Br J Psychiat 159: 826-4.
Besag FM. (2003) Psychopathology in people with epilepsy and intellectual disability. J Neurol Neurosurg Psychiat 74: 1464.
Lund J. (1985). Epilepsy and psychiatric disorder in the mentally retarded adult. Acta Psychiat Scand. 72: 557-62.
Espie CA, Pashley AS, Bonham KG, et al. (1989). The mentally handicapped person with epilepsy: A comparative study investigating psychosocial functioning. J Ment Defic Res 33: 123-35.
Gillies JB, Espie C, Montgomery J. (1989). The social and behavioural functioning of people with mental handicaps attending Adult Training Centres: A comparison of those with and without epilepsy. Ment Handicap Res 2: 129-36.
Deb S, Hunter D. (1991) Psychopathology of people with mental handicap and epilepsy. I. Maladaptive behaviour. Br J Psychiat 159: 822-4.
Deb S, Hunter D. (1991) Psychopathology of people with mental handicap and epilepsy. III. Personality disorder. Br J Psychiat 159: 830-4.
Deb S. (1994) Effect of folate metabolism on the psychopathology of adults with mental retardation and epilepsy. Am J Ment Retard. 98: 717-23.
Deb S. (1995) Electrophysiological correlates of psychopathology in individuals with mental retardation and epilepsy. J Intellect Disabil Res 39: 129-35.
Deb S. (1997) Mental disorder in adults with mental retardation and epilepsy. Compr Psychiat 37: 179-84.
Andrews TM, Everitt AD, Sander JW. (1999) A descriptive survey of long-term residents with epilepsy and intellectual disability at the Chalfont Centre: Is there a relationship between maladaptive behaviour and magnetic resonance imaging findings? J Intellect Disabil Res 43: 475-83.
Matson J, Bamburg JW, Mayville EA, et al. (1999) Seizure disorders in people with intellectual disability: An analysis of differences in social functioning, adaptive functioning and maladaptive behaviours. J Intell Dis Res 43: 531-9.
Chung MC, Cassidy G. (2001) A preliminary report on the relationship between challenging behaviour and epilepsy in learning disability. Eur J Psychiat 15: 23-32.
Espie CA, Gillies JB, Montgomery JM. (1990) Antiepileptic polypharmacy, psychosocial behaviour and locus of control orientation among mentally handicapped adults living in the community. J Ment Defic Res 34: 351-60.
Matsuura M, Oana Y, Kato M, et al. (2003). A multicenter study on the prevalence of psychiatric disorders among new referrals for epilepsy in Japan. Epilepsia. 44: 107-14.
Cowley A, Holt G, Bouras N, et al. (2004) Descriptive psychopathology in people with mental retardation. J Nerv Ment Dis 192: 232-7.
Matsuura M, Adachi N, Muramatsu R, et al. (2005) Intellectual disability and psychotic disorders of adult epilepsy. Epilepsia 46(Suppl 1):11-14.
Espie CA, Watkins J, Curtice L, et al. (2003) Psychopathology in people with epilepsy and intellectual disability: An investigation of potential explanatory variables. J Neurol Neurosurg Psychiat 74: 1485-92.
Hermann BP, Whitman S. (1991) Neurobiological, psychosocial, and pharmacological factors underlying interictal psychopathology in epilepsy. Adv Neurol 55: 439-52.
Pond DA. (1967) Behaviour disorders in brain-damaged children. Mod Trends Neurol 4: 125-34.
Berney T. (1997) Behavioural Phenotypes. In: Russell O (ed.). Seminars in the Psychiatry of Learning Disability. London: Gaskell, 63-80.
Prasher VP. (1995) Epilepsy and associated effects on adaptive behaviour in adults with Down syndrome. Seizure. 4:53-6.
Collacott RA. (1993) Epilepsy, dementia and adaptive behaviour in Down’s syndrome. J Intellect Disabil Res 37: 153-60.
Turk J, Hill P. (1995) Behavioural phenotypes in dysmorphic syndromes. Clin Dysmorphol 4: 105-15.
O’Callaghan FJ, Harris T, Joinson C, et al. (2004) The relation of infantile spasms, tubers, and intelligence in tuberous sclerosis complex. Arch Dis Child. 89: 530-3.
. Tuberous Sclerosis Association. (2002) Clinical guidelines for the care of patients with tuberous sclerosis complex: Summary.
. The Velo-cardio-facial syndrome Education Foundation. (2006) Specialist fact sheet. http://www.vcfsef.org.
Hermann BP, Whitman S, Wyler AR, et al. (1990) Psychosocial predictors of psychopathology in epilepsy. Br J Psychiat 156: 98-105.
Fischenbacher E. (1982) Effect of reduction of anticonvulsants on wellbeing. Br Med J. 285: 423-4.
Clinical guidelines for the management of epilepsy in adults with an intellectual disability. (2001) Seizure 10: 401-9.
Kerr M. (2003) Anti-epileptic drug treatments in patients with learning disability. In: Trimble MR (ed.). Learning disability and epilepsy: An integrative approach. Guildford: Clarius Press, 141-60.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer Science + Business Media, LLC
About this chapter
Cite this chapter
Dolman, J., Scheepers, M. (2008). Psychopathology in People with Epilepsy and Intellectual Disabilities. In: Prasher, V.P., Kerr, M.P. (eds) Epilepsy and Intellectual Disabilities. Springer, London. https://doi.org/10.1007/978-1-84800-259-3_10
Download citation
DOI: https://doi.org/10.1007/978-1-84800-259-3_10
Publisher Name: Springer, London
Print ISBN: 978-1-84800-258-6
Online ISBN: 978-1-84800-259-3
eBook Packages: MedicineMedicine (R0)