Relationship between cognition and psychopathology in drug-resistant epilepsy: a systematic review

• E. Monteagudo-Gimeno ^[1] ; R. Sánchez-González ^[1] ; A. Rodríguez Urrutia ^[2] ; F. Fonseca-Casals ^[3] ; V. Pérez-Sola ^[1] ; A. Bulbena-Vilarrasa ^[3] ; L. Pintor-Pérez ^[4]
  1. [1] Universitat Autònoma de Barcelona

     Universitat Autònoma de Barcelona

     Barcelona, España

     
  2. [2] Hospital Clinico Universitario de Valencia

     Hospital Clinico Universitario de Valencia

     Valencia, España

     
  3. [3] Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain / IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
  4. [4] Consultation-Liaison Service, Department of Psychiatry. Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) – Universitat de Barcelona, CERCA Programme/Generalitat de Catalunya, Barcelona, Spain

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• Localización: European journal of psychiatry, ISSN 0213-6163, Vol. 34, Nº 3, 2020, págs. 109-119
• Idioma: inglés
• DOI: 10.1016/j.ejpsy.2020.03.002
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  • Background and objectives Cognitive deficits and psychiatric comorbidities are frequent complications of epilepsy. These deleterious effects are thought to be present to a greater extent in drug-resistant epilepsy. A significant association between cognition, psychopathology and drug-resistant epilepsy is expected to exist. The objective of this review is to examine the relationship between cognitive and psychiatric symptoms in drug-resistant epilepsy.

    Methods PRISMA guidelines were followed. A literature search of PubMed, Cochrane Central Register of Controlled Trials and Embase was performed as well as a manual search of references from evaluated studies. Search strategy combined MeSH Terms and keywords. All studies except for case and report series were included. Study quality was evaluated by using the Newcastle-Ottawa Scale for nonrandomized studies and the Jadad Scale for randomized controlled trials.

    Results A final selection of 11 articles were selected after considering inclusion and exclusion criteria, evaluating 772 subjects in total, 562 with a diagnosis of resistant or hard-to-control epilepsy. Three studies demonstrated a positive association, two studies showed no association and one study showed controversial results while five studies investigated the impact of antiepileptic drugs or certain interventions.

    Conclusion Patients with treatment-resistant seizures appear to present broader impairment related to both cognitive deficits and psychopathological alterations. Worse seizure control seems to be associated with worse cognitive performance and higher expression of psychiatric symptoms, characterizing a subgroup with a more severe disorder. Specific attention should be devoted to determine a protocolized assessment. Further investigation of potential correlates between cognition and psychopathology is required.