Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-22T16:09:09.789Z Has data issue: false hasContentIssue false

Epileptic Psychosis: An Evaluation of PSE Profiles

Published online by Cambridge University Press:  29 January 2018

M. M. Perez
Affiliation:
St. Georges Hospital, London
M. R. Trimble*
Affiliation:
The National Hospital and The Institute of Neurology, Queen Square, London
N. M. F. Murray
Affiliation:
The National Hospital Queen Square, London
I. Reider
Affiliation:
Medical Centre, Ichilov Hospital, Tel Aviv, Israel
*
Correspondence

Summary

Data are presented on 24 patients with epilepsy and psychosis whose clinical presentation was rated using the Present State Examination (PSE). Seventeen had complex partial seizures and a diagnosis of temporal lobe epilepsy, seven had generalised epilepsy. An association between a CATEGO category of nuclear schizophrenia (NS) and a lesion of the left side was noted. No clear link between depressive symptoms and a right-sided focus was discovered. Affective disorders were noted in both groups of epileptic patients, although paranoid psychoses were commoner in the temporal lobe group. There was also a tendency for the latter to have more delusions of persecution, ideas of reference, and special features of depression. The group rated as NS appear less likely to show evidence of intellectual deterioration than the other psychotic patients; in addition, the interval between the onset of their epilepsy and the onset of their psychosis is shorter. Radiological assessment by CAT reveals few differences between groups, but the psychotic samples do show higher than expected values on a number of variables, in particular the bilateral septum-caudate distance and the size of the third and fourth ventricle.

Type
Research Article
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bruens, J. H. (1971) Psychoses in epilepsy. Psychiatria, Neurologia. Neurochirurgia, 74, 174192.Google Scholar
Crow, T. (1980) Molecular pathology of schizophrenia: more than one disease process. British Medical Journal. 280, 6668.CrossRefGoogle ScholarPubMed
Dewan, M. J., Pandurangi, A. K., Lee, S. H., et al. (1983) Central brain morphology in chronic schizophrenic patients: a controlled CT study. Biological Psychiatry. 18, 11331139.Google Scholar
Evans, W. A. (1942) An encephalographic ratio for estimating the size of the cerebral ventricles. Archives of Neurology and Psychiatry, 47, 931937.CrossRefGoogle Scholar
Ferrier, I. N., Crow, T., Roberts, G. W., Johnstone, E. C., Owens, D. G. C. et al (1984) Alterations in neuropeptides in the limbic lobe in schizophrenia. In Psychopharmacology of the Limbic System, (eds. Trimble, M. R. & Zarifian, E.). Oxford: Oxford University Press.Google Scholar
Flor-Henry, P. (1969) Psychosis and temporal lobe epilepsy. Epilepsia, 10, 363395.CrossRefGoogle ScholarPubMed
Gibbs, F. A. (1951) Ictal and non-ictal psychiatric disorders in temporal lobe epilepsy. Journal of Nervous and Mental Diseases, 113, 522528.Google ScholarPubMed
Goddard, G. V., McIntyre, D. C. & Leech, C. K. (1969) A permanent change in brain function resulting from daily electrical stimulation. Experimental Neurology. 25, 295330.Google Scholar
Gregoriadis, A., Fragos, E., Kapsalakis, Z., & Mandouralos, B. (1971) A correlation between mental disorders and EEG and AEG findings in temporal lobe epilepsy. Proceedings of the Vth World Congress of Psychiatry. Mexico.Google Scholar
Gruzelier, J. H. (1981). Cerebral laterality and psychopathology. Fact or fiction. Psychological Medicine, 11, 219227.Google ScholarPubMed
Gyldensted, C. & Kosteljaneiz, M. (1975) Measurements of the normal hemispheric sulci with computer tomography: a preliminary study on 44 adults. Neuroradiology, 10, 147149.Google Scholar
Gyldensted, C. (1977) Measurement of the normal ventricular system and hemispheric sulci of 100 adults with computed tomography of the brain. Neuroradiology. 14, 183192.CrossRefGoogle Scholar
Hara, T., Hoshi, A., Takase, M. & Saito, S. (1980) Factors related to psychiatric episodes in cpilcptics. Folia Psychiatrica et Neurologica Japonica, 34, 329330.Google Scholar
Hill, D. (1953) Psychiatric disorders of epilepsy. The Medical Press, 229, 473475.Google Scholar
Hillbom, E. (1960) After cffects of brain injuries. Acta Psychiatrica et Neurologica Scandanavica, 35, Suppl. 142.Google Scholar
Jensen, I. & Larsen, J. K. (1979) Psychoses in drug resistant temporal lobe epilepsy. Journal of Neurology. Neurosurgery & Psychiatry. 42, 948954.CrossRefGoogle ScholarPubMed
Kristensen, O. & Sindrup, E. H. (1978) Psychomotor epilepsy and psychosis. Acta Neurologica Scandanavica. 57, 361370.CrossRefGoogle ScholarPubMed
Koller, W. C., Glait, S. L., Perlick, S., Huckman, M. S., & Fox, J. H. (1981) Cerebellar atrophy demonstrated by computed tomography. Neuroradiology. 31, 405412.Google ScholarPubMed
MacLean, P. D. (1969) The paranoid streak in man. In Beyond Reductionism. (eds Koestler, A. & Smythies, J. R.). London: Hutchinson.Google Scholar
Ounsted, C. & Lindsay, J. (1981)The long-term outcome of temporal lobe epilepsy in childhood. In Epilepsy and Psychiatry (eds Reynolds, E. H. & Trimble, M. R.). Edinburgh: Churchill Livingstone.Google Scholar
Perez, M. M. & Trimble, M. R. (1980) Epileptic psychosis—diagnostic comparison with process schizophrenia. British Journal of Psychiatry, 137, 245249.Google Scholar
Pond, D. A. (1957) Psychiatric aspects of epilepsy. Journal of the Indian Medical Profession. 3, 14411451.Google Scholar
Sherwin, I. (1981) Psychosis associated with epilepsy: significance of laterality of the epileptogenic lesion. Journal of Neurology, Neurosurgery & Psychiatry, 44, 8385.CrossRefGoogle ScholarPubMed
Sherwin, I. (1982) The effect of the location of an epileptogenic lesion on the occurence of psychosis in epilepsy. In Temporal Lobe Epilepsy, Mania, Schizophrenia and the Limbic System (eds. Koella, W. P. & Trimble, M. R.). Basel: Karger.Google Scholar
Slater, E. & Beard, A. W. (1963) The schizophrenia-like psychoses of epilepsy. British Journal of Psychiatry, 109, 95150.Google Scholar
Stevens, J. R. (1980) Biological background of psychoses in epilepsy. In Advances in Epileptology (eds Canger, , Angeleri, and Penry, ). New York: Raven Press.Google Scholar
Stevens, J. R. (1982) Risk factors for psychopathology in individuals with epilepsy. In Temporal Lobe Epilepsy. Mania, Schizophrenia and the Limbic System, (eds. Koella, W. P. & Trimble, M. R.). Basel: Karger.Google Scholar
Taylor, D. C. (1975) Factors influencing the occurrence of schizophrenia like psychosis in patients with temporal lobe epilepsy. Psychological Medicine, 5, 249254.CrossRefGoogle ScholarPubMed
Thompson, P. J. & Trimble, M. R. (1982) Anticonvulsant drugs and cognitive functions. Epilepsia, 23, 531544.Google Scholar
Toone, B. (1982) Psychoses of epilepsy. In Epilepsy and Psychiatry (eds Reynolds, E. H. & Trimble, M. R.). Edinburgh: Churchill Livingstone.Google Scholar
Toone, B. K., Dawson, J. & Driver, M. V. (1982) Psychoses of epilepsy. A radiological evaluation. British Journal of Psychiatry, 140, 244248.CrossRefGoogle ScholarPubMed
Trimble, M. R. (1981) Anticonvulsant drugs, behaviour and cognitive abilities. In: Current Developments in Psychopharmacology (eds. Essman, W. B. & Valzelli, ). New York: Spectrum Publications.Google Scholar
Trimble, M. R. (1983) Interictal behaviour and temporal lobe epilepsy. In Recent Advances in Epilepsy (eds Pedley, T. & Meldrum, B.). Edinburgh: Churchill Livingstone.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, , (1974) The description and classification of psychiatric symptoms, London. Cambridge University Press.Google Scholar
Woods, B. T. & Wolf, J. (1983) A reconsideration of the relation of ventricular enlargement to duration of illness in schizophrenia. American Journal of Psychiatry, 140, 15641570.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.