A comparative study of obsessive–compulsive disorder and other psychiatric comorbidities in patients with temporal lobe epilepsy and idiopathic generalized epilepsy Banu Aslantas ß Ertekin a, * , Is ßın Baral Kulaksızog ˘lu a , Erhan Ertekin a , Candan Gürses b , Nerses Bebek b , Ays ßen Gökyig ˘it b , Betül Baykan b a Department of Psychiatry, Istanbul Medical Faculty, Istanbul University, Millet Cad. Capa, Istanbul, Turkey b Department of Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey article info Article history: Received 1 December 2008 Revised 18 January 2009 Accepted 22 January 2009 Available online 14 February 2009 Keywords: Epilepsy Psychiatric comorbidity Obsessive–compulsive disorder Lateralization Temporal lobe epilepsy abstract Our aim was to assess the associations of temporal lobe epilepsy (TLE) and idiopathic generalized epi- lepsy (IGE) with comorbid psychiatric conditions, especially obsessive–compulsive disorder (OCD), in a comparative design. We evaluated 29 patients with TLE, 27 patients with IGE, and 30 healthy controls. The Structured Clinical Interview for DSM-IV (SCID), Yale–Brown Obsessive Compulsive Scale (Y-BOCS) Symptom Checklist, and Beck Depression Inventory (BDI) were administered. Among patients with TLE, 75.9%, and among patients with IGE, 48.1% had at least one Axis I psychiatric disorder. Clinically meaningful obsessive–compulsive symptoms (CM-OCS) were noted in 10 patients with TLE and in 3 patients with IGE, and this difference was statistically significant (P < 0.05). CM-OCS were present in 9 of 18 patients with left-sided TLE, but in only 1 of 11 patients with right-sided TLE. Higher comorbidity in TLE suggests that involvement of the temporal lobe may play a role in the development of specific psy- chopathological syndromes. Ó 2009 Elsevier Inc. All rights reserved. 1. Introduction Epilepsy is one of the most common chronic neurological disor- ders, with a prevalence of 0.4–1% in different studies [1–3]. Be- cause it may have consequences in emotional, behavioral, social, and cognitive domains, psychiatric comorbidity in epilepsy has be- come a major area of interest. There is considerable evidence in the literature suggesting that the risk for psychiatric comorbidity is in- creased in patients with epilepsy. Psychiatric comorbidity occurs in 20–40% of patients with epilepsy, and it is even more frequent in patients with refractory seizures [4]. A study including 60 patients with refractory epilepsy reported that approximately 70% had a comorbid psychiatric disorder [5]. In a recent review, it was re- ported that the prevalence rates of Axis I psychiatric disorders in patients with epilepsy vary between 19% and 80% [6]. Compared with adults without epilepsy, adults with partial/complex partial epilepsy had higher rates of clinically significant mental health symptoms as measured with the Symptom Checklist-90—Revised (SCL-90-R). Eighty-eight percent of adults with partial epilepsy had one or more elevated index or symptom scale scores [7]. Mood disorders are considered the most frequent psychiatric comorbidity in patients with epilepsy [8]. Although most of the attention has been focused on depression, anxiety symptoms are common [9], and anxiety disorders are prevalent comorbidities among people with epilepsy [10]. A population-based study con- ducted in Canada revealed that lifetime prevalences of mood disor- ders and anxiety disorders were quite similar in people with epilepsy (24.4% and 22.8%, respectively) [11]. Swinkels and col- leagues used the Composite International Diagnostic Interview (CIDI) to assess psychiatric comorbidity in patients with different types of epilepsy. They evaluated 209 patients, and the 1-year prevalence of anxiety disorders was 24.9%, whereas the prevalence of mood disorders was 18.7% [12]. It has been suggested that the involvement of different brain structures in different types of epilepsy may play a role in the development of specific psychopathological syndromes [13]. Be- cause the limbic system includes the medial parts of the temporal lobes, more psychiatric disturbances may be expected in patients with an epileptic focus in temporal regions of the brain [6]. Whether patients with temporal lobe epilepsy (TLE) are at in- creased risk of developing psychiatric disorders as compared with patients with other types of epilepsy remains an open question. Perini et al. [14] reported significantly higher psychiatric comor- bidity in patients with TLE (80%) than in patients with juvenile 1525-5050/$ - see front matter Ó 2009 Elsevier Inc. All rights reserved. doi:10.1016/j.yebeh.2009.01.016 * Corresponding author. E-mail address: banu_aslantas@yahoo.com (B.A. Ertekin). Epilepsy & Behavior 14 (2009) 634–639 Contents lists available at ScienceDirect Epilepsy & Behavior journal homepage: www.elsevier.com/locate/yebeh