Epilepsy and mental health disorders: current challenges and potential solutions
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.
Authors
- Andrea Cipriani (ORCID: https://orcid.org/0000-0001-5179-8321)
- Tessa Lomax (ORCID: https://orcid.org/0000-0002-4169-0971)
- Pablo Andrés-Camazón (ORCID: https://orcid.org/0000-0002-7322-1248)
- Emanuele F. Osimo (ORCID: https://orcid.org/0000-0001-6239-5691)
- Rongqin Yu (ORCID: https://orcid.org/0000-0001-7315-3348)
- Simona Lattanzi (ORCID: https://orcid.org/0000-0001-8748-0083)
- Bernhard T. Baune (ORCID: https://orcid.org/0000-0001-6548-426X)
- Celia Romero del Rincón (ORCID: https://orcid.org/0000-0002-0339-6616)
- Seena Fazel (ORCID: https://orcid.org/0000-0002-5383-5365)
- Ángel Aledo‐Serrano (ORCID: https://orcid.org/0000-0003-4889-3365)
- Tykeia Robinson (ORCID: https://orcid.org/0009-0006-8513-5079)
- Tomasz Bajorek (ORCID: https://orcid.org/0000-0002-1689-5000)
- E. Van Assche (ORCID: https://orcid.org/0000-0003-3472-3031)
- Arjune Sen (ORCID: https://orcid.org/0000-0002-8948-4763)
- Riccardo De Giorgi (ORCID: https://orcid.org/0000-0001-5984-8696)
- Javier Peña‐Ceballos (ORCID: https://orcid.org/0000-0001-7260-1292)
- Rohan Kandasamy (ORCID: https://orcid.org/0000-0001-8554-2658)
- Mahinda Yogarajah (ORCID: https://orcid.org/0000-0003-3509-3756)
- Giovanni Assenza (ORCID: https://orcid.org/0000-0003-3129-1982)
- Carmen Moreno (ORCID: https://orcid.org/0000-0003-0541-4846)
Institutions
- Marche Polytechnic University (IT)
- Università Campus Bio-Medico (IT)
- The University of Melbourne (AU)
- University of Münster (DE)
- University of Cambridge (GB)
- Florey Institute of Neuroscience and Mental Health (AU)
- Beaumont Hospital (IE)
- Botsford Hospital (US)
- Oxford Health NHS Foundation Trust (GB)
- John Radcliffe Hospital (GB)
- Warneford Hospital (GB)
- Hospital General Universitario Gregorio Marañón (ES)
- Epilepsy Research UK (GB)
- University of Oxford (GB)
- Bridge University (SS)
- Health Biomed (China) (CN)
- Hospital de Sabadell (ES)
- Beaumont Hospital, Dearborn (US)
- UCL Biomedical Research Centre (GB)
- Campus Bio Medico University Hospital (IT)
- Cambridgeshire and Peterborough NHS Foundation Trust (GB)
- Oxford BioMedica (United Kingdom) (GB)
- Epilepsy Foundation (AU)
- University College London (GB)
- Epilepsy Society (GB)
Publication Details
- Journal
- The British Journal of Psychiatry
- Published
- 2025-11-20
- DOI
- https://doi.org/10.1192/bjp.2025.10455
- Citations
- 1
- Primary Topic
- Epilepsy research and treatment
- Type
- article
- Field-Weighted Citation Impact
- 1.47
Funders
- Wellcome Trust
- National Institute for Health and Care Research
- Department of Health and Social Care
- European Commission
- Ministerio de Ciencia e Innovación
- Angelini Pharma
- National Institutes of Health
- Horizon 2020 Framework Programme
- HORIZON EUROPE Framework Programme
- Instituto de Salud Carlos III
- European Regional Development Fund
- National Institute of Mental Health