# The Most Frequent Psychiatric Comorbidities in Bulgarian Patients With Epilepsy: Their Connection With the Main Clinical Characteristics and Quality of Life

## TL;DR

This study examines how common psychiatric conditions in Bulgarian epilepsy patients relate to their clinical features and quality of life.

## Contribution

The study identifies specific psychiatric comorbidities in epilepsy patients and their impact on clinical outcomes and quality of life in a Bulgarian population.

## Key findings

- Psychiatric comorbidities are linked to more frequent seizures and worse quality of life in epilepsy patients.
- Patients with psychiatric comorbidities reported higher unwanted drug effects and lower QOL scores.
- The study highlights the need for comprehensive care addressing both epilepsy and psychiatric conditions.

## Abstract

Aim: The objective of this study is to determine and compare the relationship of the most common psychiatric comorbidities in Bulgarian patients with epilepsy with the main clinical characteristics, as well as to evaluate their impact on certain aspects of the quality of life.

Clinical rationale: Psychiatric comorbidities occur in about one-third of people with epilepsy throughout their lifetime, and their incidence is much greater in high-risk groups such as patients with treatment-resistant epilepsy.

Material and methods: The study group consisted of 129 participants, of whom 104 were divided into four groups according to the presence of one of the most frequently diagnosed psychiatric comorbidities in our patients with epilepsy: personality and behavioral disorder (PBD) (n=25), mild to moderate depressive disorder (n=26), anxiety disorder (n=32), and dissociative and conversion disorders (n=21). A control group was also formed with a similar number of participants with epilepsy (n=25) without psychiatric comorbidity. Some sociodemographic and clinical characteristics of epilepsy were analyzed in all patients. All patients filled out two questionnaires: the Bulgarian version of quality of life in epilepsy - 89 (QOLIE-89) and the Bulgarian version of SIDAED (assessing SIDe effects in antiepileptic drugs (AED) treatment).

Results: The analysis revealed a negative influence of psychiatric comorbidity on the presence of epileptic seizures, unwanted drug effects, and lower scores for all aspects of the quality of life of patients with epilepsy.

Conclusion and clinical implications: The main conclusion of our study is the presence of an interaction between psychiatric comorbidity, the clinical course of the disease, and the deteriorated quality of life (QOL) in patients with epilepsy. Further attention, comprehensive care, and targeted research are needed to analyze individual psychiatric comorbidities in patients with epilepsy for early detection and treatment.