9 Psychological, neurobehavioural, cognitive and developmental comorbidities in epilepsy

9 Psychological, neurobehavioural, cognitive and developmental comorbidities in epilepsy

9.1 Providing coordinated care

9.1.1 Be aware that there is a higher prevalence of mental health difficulties, learning disabilities, neurodevelopmental comorbidities (for example, attention deficit hyperactivity disorder and autism spectrum disorder) and dementia, and a higher risk of suicide in people with epilepsy compared with the general population.

9.1.2 Provide coordinated care for people with epilepsy who have a mental health condition or learning disability using a multidisciplinary team approach.

9.1.3 Be aware that children and young people with a complex childhood epilepsy syndrome can have developmental difficulties and cognitive impairment, and may need additional support from a multidisciplinary team.

9.1.4 Ensure effective communication and liaison between healthcare professionals across the relevant services involved in the care of people with epilepsy and a mental health condition to agree and plan care across services.

9.1.5 For people with epilepsy who have a learning disability, a mental health problem or challenging behaviour, or who have dementia, follow the recommendations on coordinating care in NICE's guidelines on mental health problems in people with learning disabilities, challenging behaviour and learning disabilities and dementia.

9.2 Support and treatment

9.2.1 Recognise that a diagnosis of epilepsy can have a significant adverse impact on a person's mental health and that people with epilepsy may feel socially excluded and stigmatised.

9.2.2 Review neurodevelopment, cognitive function, mental health, social and emotional wellbeing, and learning disabilities as part of the routine management for people with epilepsy.

9.2.3 Offer assessment and provide mental health support and treatment for people with epilepsy and depression in line with NICE's guidelines on depression in adults with a chronic physical health problem and depression in children and young people.

9.2.4 Be alert to anxiety, other mental health difficulties and the risk of suicide in people diagnosed with epilepsy. If mental health difficulties are suspected, consider referral and follow the recommendations in NICE's guidelines on:

For a short explanation of why the committee made these recommendations and how they might affect practice, see the rationale and impact section on psychological, neurobehavioural, cognitive and developmental comorbidities in epilepsy.

Full details of the evidence and the committee's discussion are in:

  • National Institute for Health and Care Excellence (NICE)