Epilepsy Versus Psychotic Depression in an Adolescent: A Case Report

Authors

  • Rakshita Satish Senior Resident, Department of Psychiatry,Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal,Karnataka Author https://orcid.org/0009-0005-9846-1896
    • Divya R Nair Assistant Professor, Department of Psychiatry, Father Muller Medical College, Mangalore, Karnataka Author https://orcid.org/0009-0000-4813-9210
      • Supriya Hegde Aroor Professor and Head of Department, Department of Psychiatry, Father Muller Medical College, Mangalore, Karnataka Author
        • Rahul M Rao Assistant Professor, Department of Psychiatry, Father Muller Medical College, Mangalore, Karnataka Author
          • Gale Crasta Assistant Professor, Department of Psychiatry, Father Muller Medical College, Mangalore, Karnataka Author
            • Clinton Castelino Senior Resident, Department of Psychiatry, Father Muller Medical College, Mangalore, Karnataka Author https://orcid.org/0009-0000-2583-2426

              DOI:

              https://doi.org/10.30834/KJP.38.1.2025.501

              Keywords:

              Depression, Epilepsy, Psychosis, Antidepressants, Antipsychotics

              Abstract

              Epilepsy has often been linked with multiple psychiatric symptoms. Psychotic symptoms are often seen in pre-ictal, interictal, and post-ictal periods. Differentiating between neurological and psychiatric disorders in adolescents poses significant diagnostic challenges due to overlapping clinical features. We present the case of a 15-year-old boy who exhibited depressive symptoms, seizures, and psychotic symptoms, raising concerns both for epilepsy and psychotic depression. This led to an interplay between the symptoms of these two disorders. While treating one condition often complicates the other, such cases require efficient multidisciplinary care between neurology and psychiatry. This case highlights the complexity of diagnosis considerations in adolescent neuropsychiatry and underscores the importance of interdisciplinary collaborations for accurate diagnosis and management.

              References

              Ebuenyi ID, Chikezie UE, Stanley PC. Complex partial seizure with severe depression and conduct disorder in a 15 year old female adolescent: a case report. Pan Afr Med J. 2015 Nov 27; 22:311. DOI: 10.11604/pamj.2015.22.311.6961

              Maryam S, Parviz B. Depression in children and adolescents with epilepsy: a 15 year research review of prevalence, and demographic and seizure related correlates. Iran J Pediatr. 2013 Feb;23(1):1-7. PMCID: PMC3574984

              Coppola G, Operto FF, Matricardi S, Verrotti A. Monitoring And Managing Depression In Adolescents With Epilepsy: Current Perspectives. Neuropsychiatr Dis Treat. 2019 Sep 24; 15:2773-2780. DOI: 10.2147/NDT.S192714

              Mula M, Kanner AM, Jetté N, Sander JW. Psychiatric Comorbidities in People With Epilepsy. Neurol Clin Pract. 2021 Apr;11(2): e112-e120. DOI: 10.2147/NDT.S192714

              Adachi N, Matsuura M, Hara T, Oana Y, Okubo Y, Kato M, Onuma T. Psychoses and epilepsy: are interictal and postictal psychoses distinct clinical entities? Epilepsia. 2002 Dec; 43(12):1574-82. DOI: 10.1046/j.1528-1157.2002.22402.x

              Lu E, Pyatka N, Burant CJ, Sajatovic M. Systematic Literature Review of Psychiatric Comorbidities in Adults with Epilepsy. J Clin Neurol. 2021 Apr; 17(2):176-186. DOI: 10.3988/jcn.2021.17.2.176

              Kanner AM. Depression and epilepsy: A bidirectional relation? Epilepsia. 2011;52(Suppl 1):21–27. Kanner AM. Depression and epilepsy: A bidirectional relation? Epilepsia. 2011 Jan;52 Suppl 1:21-7. DOI: 10.1111/j.1528-1167.2010.02907.x

              Caplan R, Siddarth P, Gurbani S, Hanson R, Sankar R, Shields WD. Depression and anxiety disorders in pediatric epilepsy. Epilepsia. 2005 May; 46(5):720-30. DOI: 10.1111/j.1528-1167.2005.43604.x

              Trimble M, Schmitz B, editors. The Neuropsychiatry of Epilepsy. Cambridge: Cambridge University Press; 2002. https://doi.org/10.1017/CBO9780511544354

              Kanner AM, Dunn DW. Diagnosis and management of depression and psychosis in children and adolescents with epilepsy. J Child Neurol. 2004 Aug; 19 Suppl 1:S65-72. DOI: 10.1177/088307380401900108

              Mula M, Schmitz B. Depression in epilepsy: mechanisms and therapeutic approach. Ther Adv Neurol Disord. 2009 Sep; 2(5):337-44. DOI: 10.1177/1756285609337340

              Hesdorffer DC, Hauser WA, Olafsson E, Ludvigsson P, Kjartansson O. Depression and suicide attempt as risk factors for incident unprovoked seizures. Ann Neurol. 2006 Jan; 59(1):35-41. DOI:10.1002/ana.20685

              Torta R, Keller R. Behavioral, psychotic, and anxiety disorders in epilepsy: etiology, clinical features, and therapeutic implications. Epilepsia. 1999;40 Suppl 10:S2-20. DOI: 10.1111/j.1528-1157.1999.tb00883.x

              Jaballah F, Romdhane I, Nasri J, Ferhi M, Bellazrag N, Saidi Y, Mannaii J. Focal epilepsy and psychosis symptoms: A case report and review of the literature. Ann Med Surg (Lond). 2022 Nov 16; 84:104862. DOI: 10.1016/j.amsu.2022.104862

              Blumer D. Evidence supporting the temporal lobe epilepsy personality syndrome. Neurology. 1999; 53(5 Suppl 2):S9-12. [Link https://pubmed.ncbi.nlm.nih.gov/10496229/]

              Gold JA, Sher Y, Maldonado JR. Frontal Lobe Epilepsy: A Primer for Psychiatrists and a Systematic Review of Psychiatric Manifestations. Psychosomatics. 2016 Sep-Oct; 57(5):445-64. DOI: 10.1016/j.psym.2016.05.005

              Qiu Z, Guo J, Chen B, Fang J. Psychosis of Epilepsy: An Update on Clinical Classification and Mechanism. Biomolecules. 2025Jan3; 15(1): 56. PMID: 39858450

              Panayiotopoulos CP. Elementary visual hallucinations, blindness, and headache in idiopathic occipital epilepsy: differentiation from migraine. J Neurol Neurosurg Psychiatry. 1999 Apr; 66(4):536-40. DOI: 10.1136/jnnp.66.4.536

              Akiyama O, Kondo A, Akiyama I. Paediatric migraine with visual hallucination auras appearing in the form of a human body. BMJ Case Rep. 2019 Dec 2; 12(12):e232358. DOI: 10.1136/bcr-2019-232358

              Manford M. Simple visual hallucinations and epilepsy. Pract Neurol. 2020 Oct;20(5):345-346. DOI: 10.1136/practneurol-2020-002613

              Barragan M, Laurens KR, Navarro JB, Obiols JE. Psychotic-like experiences and depressive symptoms in a community sample of adolescents. Eur Psychiatry. 2011 Sep; 26(6):396-401. DOI: 10.1016/j.eurpsy.2010.12.007

              Agrawal N, Mula M. Treatment of psychoses in patients with epilepsy: an update. Ther Adv Psychopharmacol. 2019 Jul 10; 9:2045125319862968. DOI: 10.1177/2045125319862968

              Rana M, Khanzode L, Karnik N, Saxena K, Chang K, Steiner H. Divalproex sodium in the treatment of pediatric psychiatric disorders. Expert Rev Neurother. 2005 Mar; 5(2):165-76. DOI:10.1586/14737175.5.2.165

              Berg AT, Langfitt J, Shinnar S, Vickrey BG, Sperling MR, Walczak T, Bazil C, Pacia SV, Spencer SS. How long does it take for partial epilepsy to become intractable? Neurology. 2003 Jan 28; 60(2):186-90. DOI: 10.1212/01.wnl.0000031792.89992.ec

              Kanner AM, Clary HMM. Should neurologists treat common psychiatric comorbidities in patients with epilepsy? Epilepsy Behav Rep. 2024 Oct 29; 28:100725. DOI: 10.1016/j.ebr.2024.100725

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              Published

              02-06-2025

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              Case Report

              How to Cite

              1.
              Epilepsy Versus Psychotic Depression in an Adolescent: A Case Report. Kerala Journal of Psychiatry [Internet]. 2025 Jun. 2 [cited 2026 Aug. 27];38(1):65-9. Available from: https://www.kjponline.com/index.php/kjp/article/view/501

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