International consensus clinical practice statements for the treatment of neuropsychiatric conditions associated with epilepsy
Open accessAbstract
In order to address the major impact on quality of life and epilepsy management caused by associated neuropsychiatric conditions, an international consensus group of epileptologists met with the aim of developing clear evidence-based and practice-based statements to provide guidance on the management of these conditions. Using a Delphi process, this group prioritized a list of key management areas. These included: depression, anxiety, psychotic disorders, nonepileptic seizures, cognitive dysfunction, antiepileptic drug (AED)-related neurobehavioral disorders, suicidality, disorders in children and adolescents, disorders in children with intellectual disability, and epilepsy surgery. Clinical practice statements were developed for each area and consensus reached among members of the group. The assessment and management of these conditions needs to combine knowledge of psychiatric disorders, knowledge of the impact of epilepsy and its treatment on psychopathology, and an ability to deliver care within epilepsy services. The aim of these statements is to provide guidance on quality care for people with epilepsy that have a range of neuropsychiatric disorders.
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There is insufficient evidence for the effectiveness of psychological treatments for epilepsy, making it easy for healthcare purchasers to ignore guideline references to such treatments.
“To date it has been relatively easy for healthcare purchasers to ignore references to the provision of psychological treatments in epilepsy treatment guidelines because there is insufficient evidence for the effectiveness of such interventions [9, 10].”
From A prospective service evaluation of acceptance and commitment therapy for patients with refractory epilepsy (2015) · cites this paper as [9]
The Conclusion (page not available in our copy) says that management of neuropsychiatric conditions associated with epilepsy lacks high-quality evidence and calls for trials of nonpharmacologic interventions. It does not say that healthcare purchasers ignore guideline references to psychological treatments, or establish that the evidence gap makes it easy for them to do so. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThere is a lack of accessible and cost-effective psychological and behavioural interventions for epilepsy that are supported by high quality empirical evidence.
“However, there is a lack of accessible and cost-effective psychological and behavioural interventions that are supported by high quality empirical evidence.”
From A prospective service evaluation of acceptance and commitment therapy for patients with refractory epilepsy (2015) · cites this paper as [9]
The Conclusion (page unavailable) identifies a dearth of high-quality evidence for managing neuropsychiatric conditions associated with epilepsy and calls for trials of nonpharmacologic interventions. The management statements note resource challenges and recommend CBT ‘where available,’ but the paper does not establish a lack of cost-effective psychological or behavioural interventions. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe lack of accessible and cost-effective psychological and behavioural interventions is likely one of the reasons why the treatment need for psychosocial interventions in epilepsy remains largely unmet.
“This is likely to be one of the reasons why this treatment need therefore remains largely unmet [9, 11].”
From A prospective service evaluation of acceptance and commitment therapy for patients with refractory epilepsy (2015) · cites this paper as [9]
The section on assessment and management of depressive disorders recommends CBT ‘where available’ and says patients should have access to guided self-help, supporting the concern about availability. It does not say that a lack of accessible, cost-effective interventions causes psychosocial treatment needs to remain largely unmet. (LLM, conf=0.80)
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Psychiatric Care in Epilepsy Surgery: Who Needs It?
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Do antipsychotic drugs increase seizure frequency in epilepsy patients?
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Clinical utility of the Metacognitions Questionnaire 30 in people with epilepsy
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PNES Epidemiology: What is known, what is new?
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Treatment of postsurgical psychiatric complications
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Self-citationFeatures of autism spectrum disorder (ASD) in childhood epilepsy: a population-based study.
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Self-citationChapter 3. Neuropsychological Assessment
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- Authors
- Kerr, M. P., Mensah, S., Besag, F., de Toffol, B., Ettinger, A., Kanemoto, K., Kanner, A., Kemp, S., Krishnamoorthy, E., LaFrance Jr, W. C., Mula, M., Schmitz, B., van Elst, L. T., Trollor, J., & Wilson, S. J.
- Affiliations
- University of Wales (GB)
- Cardiff and Vale University Health Board (GB)
- South Essex Partnership University Foundation NHS Trust (GB)
- Long Island Jewish Medical Center (US)
- Aichi Medical University (JP)
- Rush University Medical Center (US)
- Voluntary Health Services Hospital (IN)
- Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT)
- Charité – Universitätsmedizin Berlin (DE)
- UNSW Sydney (AU)
- The University of Melbourne (AU)
- Corresponding author
- Kerr, Mike P.
- ORCID
- Venue
- Epilepsia
- Publisher
- Wiley
- Published
- 2011-09-28
- Volume
- 52
- Issue
- 11
- Pages
- 2133-2138
- ISSN
- 0013-9580 (ISSN-L)
- OpenAlex
- W1536128866
- Cited by
- 425
- References
- 9
- Citations by year
- 2026: 14 · 2025: 20 · 2024: 31 · 2023: 19 · 2022: 26 · 2021: 30 · 2020: 46 · 2019: 31 · 2018: 60 · 2017: 28 · 2016: 25 · 2015: 37 · 2014: 19 · 2013: 24 · 2012: 13
- FWCI
- 12.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epilepsia (publishedVersion)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- epilepsy, neuropsychiatric disorders, depression, anxiety, psychosis, non-epileptic seizures, cognitive impairment, suicidality, pediatric epilepsy, intellectual disability, epilepsy surgery, Delphi consensus
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Mental Disorders, Child, Cognition Disorders, Depressive Disorder, Epilepsy, Humans, Intellectual Disability, Psychotic Disorders, Practice Guidelines as Topic
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