Psychiatric morbidity in refractory epilepsy is frequent and has a negative influence on quality of life. Treatment-refractory epileptic patients are at higher risk of developing psychiatric disturbances. The interictal dysphoric disorder (IDD) has been described as a pleomorphic pattern of symptoms claimed to be typical of patients with epilepsy. It is characterized by 3/8 symptoms: depressive mood, anergia, pain, insomnia, fear, anxiety, irritability, and euphoric mood.

To provide evidence that psychiatric morbidity is high in refractory epilepsy and to describe associations to IDD.

The present study aims to show that there are typical psychiatric conditions in epilepsy that can be unnoticed.

We cross-sectional analyzed the psychopathologic outcomes of patients with refractory epilepsy. The assessments methods included SCID for DSM-IV and clinical interview for epileptic specific psychiatric conditions.

The sample consists of 153 patients, with a mean age of 37. A total of 42.5% were males. One or more Axis I diagnoses was seen in 38% of the patients. The most common condition was IDD (27.1%), followed by affective and anxiety disorders (22 and 15.3% respectively). Considering patients with IDD, we found differences in locus (P = 0.001) (present in 34.3% of non-stablished locus, 8.6% of extra-temporal locus and 57.1% of temporal locus) but not with hemisphere, sex, type of crises, treatment. We neither found correlation with age, number of crisis or number of treatments.

Psychiatric comorbidities as IDD do not appear in the DSM-IV but are prevalent and could be related with temporal locus.

The authors have not supplied their declaration of competing interest.