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Annals of Neurology: Post-epilepsy psychosis is caused by a combination of epilepsy and psychosis genetic susceptibility

 Last Update: 2021-08-04
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Mental disorders inEpilepsy is very common and affects up to 50% of patients; the prevalence of focal epilepsy is higher than that of idiopathic generalized epilepsy, especially epilepsy involving the temporal lobe
.

The broad-spectrum mental spectrum of epilepsy includes affective disorders (most commonly depression), anxiety disorders, attention deficit hyperactivity disorder, and mental disorders

About 6% of epilepsy patients suffer from psychosis ; compared with the general population, the risk of epilepsy patients suffering from psychosis has increased almost 8 times

Braatz V and others described the characteristics of psychosis after seizures, and determined the clinical and genetic characteristics related to psychosis after seizures

The study is a case-control cohort study.
The subjects of the study were patients with psychosis after epileptic seizures were confirmed by psychiatric evaluation
.

Available data on epilepsy, treatment, psychiatric history, psychosis profile and results were collected .

The study is a case-control cohort study.

After screening 3288 patients with epilepsy , 83 cases were found to have psychosis and 49 cases were post-seizure psychosis
.

The control group consisted of 98 adults, age matched with the epilepsy group, and no history of mental illness

After screening 3288 patients with epilepsy , 83 cases were found to have psychosis and 49 cases were post-seizure psychosis

Bar graphs fitted to the polygenic risk score (PRS) model for schizophrenia under different thresholds of P value
.

Genome-wide schizophrenia (SCZ) polygenic risk score (PRS)
.

(A) The PRS of schizophrenia in patients with psychosis after a single episode is compared with the PRS in patients with recurrent episodes and patients who continue to develop chronic psychosis
.

(B) PRS in post-onset psychotic patients with or without a family history of psychosis

(A) The PRS of schizophrenia in patients with psychosis after a single episode is compared with the PRS in patients with recurrent episodes and patients who continue to develop chronic psychosis

The patient group was more likely to have cluster seizures (OR 7.
59, P<0.
001), threatened seizures (OR 2.
49, P=0.
013), and family history of psychosis (OR 5.
17, P=0.
022)
.
Epileptiform discharges in the right temporal area accounted for the majority (OR 4.
87, P=0.
007)
.
There was no difference between the case group and the control group in terms of epilepsy duration, neuroimaging findings or anti-epileptic treatment
.
In an enlarged cohort of patients with post-seizure psychosis (58), the polygenic risk score of schizophrenia was significantly higher than that of the 1366 epilepsy control group (R ² =3%, P=6×10 ^-3 ), but compared with 945 There was no significant difference in independent patients with schizophrenia (R ² =0.
1%, P=0.
775)
.
²^-3²

Post-seizure psychosis is an important neuropsychiatric manifestation of patients with epilepsy
.
The study of Braatz V et al.
showed that there are clinical factors related to the occurrence of psychosis after the onset
.
The emergence of certain phenomena in chronic diseases (here, post-seizure psychosis) may be due to the genetic susceptibility of these phenomena (here, the increased PRS of schizophrenia) and the consequence of the chronic disease itself (here, epileptic seizure group) Combined
.
If supported by empirical data, the model will further support the value of obtaining comprehensive individual genetic information in the diagnosis of each patient with epilepsy
.

Post-seizure psychosis is an important neuropsychiatric manifestation of patients with epilepsy
.
The study of Braatz V et al.
showed that there are clinical factors related to the occurrence of psychosis after the onset
.
The emergence of certain phenomena in chronic diseases (here, post-seizure psychosis) may be due to the genetic susceptibility of these phenomena (here, the increased PRS of schizophrenia) and the consequence of the chronic disease itself (here, epileptic seizure group) Combined
.
The emergence of certain phenomena in chronic diseases (here, post-seizure psychosis) may be due to the genetic susceptibility of these phenomena (here, the increased PRS of schizophrenia) and the consequence of the chronic disease itself (here, epileptic seizure group) Combined
.
If supported by empirical data, the model will further support the value of obtaining comprehensive individual genetic information in the diagnosis of each patient with epilepsy
.
diagnosis

Post-seizure psychosis occurs in epilepsy patients with high genetic susceptibility under special circumstances, indicating that in a common disease, the interaction between disease biology (seizures) and trait susceptibility (schizophrenia) produces specific results ( Post-onset psychosis)
.
Post-seizure psychosis occurs in epilepsy patients with high genetic susceptibility under special circumstances, indicating that in a common disease, the interaction between disease biology (seizures) and trait susceptibility (schizophrenia) produces specific results ( Post-onset psychosis)
.

Original source

Braatz V, Martins Custodio H, Leu C, et al.
Post-ictal psychosis in epilepsy: A clinico-genetic study [published online ahead of print, 2021 Jul 20].
Ann Neurol.
2021;10.
1002/ana.
26174.
doi: 10.
1002/ana.
26174

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