Psychiatric symptoms, such as those of anxiety disorders, depression, and schizophrenia-like psychosis, are common clinical presentations in people with epilepsy, which impact their quality of life more than seizures. People with temporal lobe epilepsy are at particularly great risk of developing psychosis. Clinical features such as aggression or the so-called Geschwind syndrome complicate the expression of psychiatric symptoms in temporal lobe epilepsy. Psychiatric adverse effects of antiepileptic drug and psychological distress specific to people with epilepsy are also important factors that largely affect their mental state. Several studies have suggested the existence of a bidirectional relationship between epilepsy and psychiatric disorders, especially depression. These findings lead us to assume that there is a common biological basis between epilepsy and some psychiatric disorders. Neurobiological findings such as malfunction of the hypothalamus-pituitary-adrenal axis, neuroinflammation, or autoimmune pathology might explain the mechanisms underlying the bidirectional relationship.
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