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Anhedonia and Epilepsy

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Abstract

Mood and anxiety disorders represent the most frequent psychiatric comorbidity in patients with epilepsy and reasons for such a close link are both biological and psychosocial. On one hand, epilepsy is a chronic disorder that brings about a number of social limitations (e.g. driving license, job opportunities etc.) and social discriminations leading to demoralization, poor self-esteem and phobic avoidance. On the other hand, the biological contribution to this association is given by neuroanatomical and neurochemical principles such as the involvement of the mesiotemporal structures in temporal lobe epilepsy.

The issue of phenomenology of depression has been matter of debate for a long time. A number of authors pointed out that atypical features characterize depression in epilepsy and such atypical symptoms are poorly captured by conventional classificatory systems such as DSM. In general terms, the psychopathological spectrum of depression in epilepsy is likely to be large. On one hand, it is reasonable to hypothesize that patients with epilepsy can experience forms of mood disorders identical to those of patients without epilepsy. On the other hand, it is equally reasonable to assume that the underlying brain pathology can influence the final phenomenology of mood disorder symptoms making less evident some aspects or emphasizing others. A number of variables may account for such atypical features such as peri-ictal manifestations, the high comorbidity between mood and anxiety disorders (up to 73 %), the underlying neurologic condition and the psychotropic effect of AEDs.

In this chapter, the relationship between epilepsy and mood disorders is discussed with special attention to anhedonia, discussing phenomenology and pathophysiology in the context of epilepsy.

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Abbreviations

AEDs:

Antiepileptic drugs

IDD:

Interictal dysphoric disorder

DSM:

Diagnostic and statistical manual of mental disorders

ICD:

International classification of diseases

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Authors and Affiliations

  1. Division of Neurology Trinity Hospital, Borgomanero, Italy

    Marco Mula M.D., Ph.D.

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  1. Marco Mula M.D., Ph.D.
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Correspondence to Marco Mula M.D., Ph.D. .

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Editors and Affiliations

  1. Haifa & Sha'ar Menashe Mental Health Center, Israel Institute of Technology, Hadera, Israel

    Michael S. Ritsner

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Mula, M. (2014). Anhedonia and Epilepsy. In: Ritsner, M. (eds) Anhedonia: A Comprehensive Handbook Volume II. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-8610-2_12

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  • DOI: https://doi.org/10.1007/978-94-017-8610-2_12

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