Depression and suicide in epilepsy: Fact or artefact?

There is evidence that depression is the most frequent comorbid psychiatric disorder in epilepsy and a history of depression is associated with a 4- to 6-fold greater risk of developing epilepsy. Epilepsy, on the other hand, as a chronic and stressful disease, represents a risk factor for developing depression. These data suggest either a possible “bi-directional” relationship between these two disorders or the presence of common pathogenic mechanisms that facilitate the occurrence of one in the presence of the other [10]. So the question is: Is the association between depression and suicide in epilepsy a fact or an artefact?We do not yet knowwhether a bi-directional relationship exists between depression and epilepsy, and we need to identify common mechanisms that facilitate depression associated with epilepsy and epilepsy associated with depression. We found no difference across the depression and temporal lobe epilepsy groups in the depression inventories and risk for suicide. Further research is needed to clarify the impact of depressive symptoms in people with epilepsy, such as the presence of suicidal risk factors, suicidal ideation and suicide attempts in these patients as correlates of depression or as psychopathological features directly associated to epileptic disease.