TY - JOUR
AU - R. De Giorgi
AU - T. Lomax
AU - C. Moreno
AU - E. Van Assche
AU - E. F. Osimo
AU - T. Bajorek
AU - A. Sen
AU - S. Fazel
AU - B. T. Baune
AU - R. Kandasamy
AU - R. Yu
AU - J. Peña-Ceballos
AU - S. Lattanzi
AU - P. A. Camazón
AU - C. R. Del Rincon
AU - M. Yogarajah
AU - G. Assenza
AU - T. Robinson
AU - A. Aledo-Serrano
AU - A. Cipriani
A1 - 
AB - Epilepsy affects ~50 million people worldwide and is associated with increased psychiatric comorbidities, including depression, anxiety, psychosis and suicidality. Despite this, current epilepsy management primarily focusses on seizure control, potentially overlooking mental health concerns. This article explores the challenges of integrating psychiatric care into epilepsy treatment and proposes solutions for a more holistic approach. Using a consensus development panel method, a multidisciplinary team of neurologists, psychiatrists and a lived-experience expert identified key challenges to optimising the mental health of people living with epilepsy, such as healthcare system fragmentation, underdiagnosis of mental health conditions and inadequate resources. Among the proposed solutions, the need for routine mental health screening, interdisciplinary support and collaboration, and increased research into the neuropsychiatric aspects of epilepsy were highlighted. A shift from a seizure-centric model to a patient-centred approach is advocated, emphasising biopsychosocial care and improved access to psychiatric services. We also discuss prospective practical strategies to tackle the issues identified, including collaborative care models, structured decision trees and AI-driven screening tools, to enhance diagnosis and treatment. Addressing these challenges through systemic change, research investment and service innovation should significantly improve the care and quality of life for individuals with an epilepsy and co-occurring mental health disorders.
AD - Department of Psychiatry, https://ror.org/052gg0110University of Oxford, Warneford Hospital, Oxford, UK.; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón University General Hospital, IiSGM, CIBERSAM, ISCIII, School of Medicine, Complutense University, Madrid, Spain.; Department of Psychiatry, University of Münster, Münster, Germany.; Department of Psychiatry, University of Cambridge, Cambridge, UK.; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.; Department of Psychological Medicine, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, UK.; Centre for Global Epilepsy, Wolfson College, University of Oxford, Oxford, UK.; Department of Psychiatry, University of Melbourne, Melbourne, Australia.; The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Victoria, Australia.; Department of Epilepsy, Queen Square Institute of Neurology, University College London, London, UK.; Department of Neurology, Beaumont Hospital, Dublin, Ireland.; Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy.; Epilepsy Unit, Clinical Neuroscience Department, Blua Sanitas Valdebebas Hospital, Madrid, Spain.; Chalfont Centre for Epilepsy, Chalfont St Peter, UK.; NIHR University College London Hospitals Biomedical Research Centre, London, UK.; Operative Research Unit of Neurology, Campus Bio-Medico, University Hospital Foundation, Rome, Italy.; Research Unit of Neurology, Neurophysiology and Neurobiology, Department of Medicine and Surgery, Campus Bio-Medico, University of Rome, Rome, Italy.; Epilepsy Sparks, London, UK.; Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, UK.; NIHR Oxford Health Clinical Research Facility, Warneford Hospital, Oxford, UK.
AN - 41261735
BT - Br J Psychiatry
C5 - Healthcare Disparities
DA - Nov 20
DO - 10.1192/bjp.2025.10455
DP - NLM
ET - 20251120
JF - Br J Psychiatry
LA - eng
N2 - Epilepsy affects ~50 million people worldwide and is associated with increased psychiatric comorbidities, including depression, anxiety, psychosis and suicidality. Despite this, current epilepsy management primarily focusses on seizure control, potentially overlooking mental health concerns. This article explores the challenges of integrating psychiatric care into epilepsy treatment and proposes solutions for a more holistic approach. Using a consensus development panel method, a multidisciplinary team of neurologists, psychiatrists and a lived-experience expert identified key challenges to optimising the mental health of people living with epilepsy, such as healthcare system fragmentation, underdiagnosis of mental health conditions and inadequate resources. Among the proposed solutions, the need for routine mental health screening, interdisciplinary support and collaboration, and increased research into the neuropsychiatric aspects of epilepsy were highlighted. A shift from a seizure-centric model to a patient-centred approach is advocated, emphasising biopsychosocial care and improved access to psychiatric services. We also discuss prospective practical strategies to tackle the issues identified, including collaborative care models, structured decision trees and AI-driven screening tools, to enhance diagnosis and treatment. Addressing these challenges through systemic change, research investment and service innovation should significantly improve the care and quality of life for individuals with an epilepsy and co-occurring mental health disorders.
PY - 2025
SN - 0007-1250
SP - 1
EP - 8+
ST - Epilepsy and mental health disorders: current challenges and potential solutions
T1 - Epilepsy and mental health disorders: current challenges and potential solutions
T2 - Br J Psychiatry
TI - Epilepsy and mental health disorders: current challenges and potential solutions
U1 - Healthcare Disparities
U3 - 10.1192/bjp.2025.10455
VO - 0007-1250
Y1 - 2025
ER -