The goal of this study is to compare psychiatric comorbidities in patients with temporal (TLE) and extra-temporal epilepsy (ETLE).

Patients with focal epilepsy have higher risk of psychiatric comorbidities including depression and anxiety, which are often under-diagnosed and under-treated in epilepsy populations.  Some evidence suggests those with temporal lobe epilepsy have even higher risk of comorbid depression or anxiety due to limbic system involvement. However, few studies examine the level of psychiatric comorbidities in sub-types of epilepsy. 

In this prospective observational study, 200 patients admitted to our level-4 EMU enrolled over a 12-month period completed standardized surveys including the Quality of Life in Epilepsy (QOLIE-31-P), Generalized Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire (PHQ-9) and Beck Depression Inventory-II (BDI-II).  Patients self-reported seizure frequency, number of anti-seizure medications, driving status, and work status. Patient age, gender, and diagnosis were extracted from electronic medical records. Survey scores were compared using two-sample t tests.

Of the 200 participants, 65 had diagnoses of TLE and 28 had diagnoses of ETLE. 107 were excluded due to diagnosis of generalized epilepsy, non-epileptic seizures, mixed disorder, or non-diagnostic evaluation. Patients with TLE and ETLE were similar in age, duration of the epilepsy, seizure frequency, number of anti-seizure medications, and work status.  In addition, there was no significant difference in mean anxiety or depression scores between TLE and ETLE groups, respectively (GAD-7: 9±6, 10±8, p=0.20; PHQ-9: 8±6, 7±6, p=0.22; BDI-II: 12±10, 11±7, p=0.40). There was no significant difference in self-reported quality of life between groups (QOLIE-31-P: 56±16, 58±19, p=0.352). 

Though patients with TLE are known to have increased rates of depression and anxiety, patients with focal ETLE reported similar levels of comorbid depression and anxiety. Thus, screening for psychiatric symptoms should be performed in all patients with focal epilepsy.