Editing Epilepsy (section)

===Psychosocial===
Epilepsy can have substantial effects on psychological and social well-being. People with the condition may experience social isolation, stigma, or functional disability, which can contribute to lower educational attainment and reduced employment opportunities. These challenges often extend to family members, who may also encounter stigma and increased caregiving burden.<ref name="National Clinical Guideline 21_28" />

Several psychiatric and neurodevelopmental disorders are more common in individuals with epilepsy. These include [[major depressive disorder|depression]], [[anxiety disorder|anxiety]], [[obsessive–compulsive disorder]] (OCD),<ref>{{cite journal |vauthors=Kaplan PW |date=November 2011 |title=Obsessive-compulsive disorder in chronic epilepsy |journal=Epilepsy & Behavior |volume=22 |issue=3 |pages=428–432 |doi=10.1016/j.yebeh.2011.07.029 |pmid=21889913}}</ref> and [[migraine]].<ref>{{cite book |url=https://books.google.com/books?id=K-1UqhH2BtoC&pg=PA471 |title=Epilepsy Part I: Basic Principles and Diagnosis E-Book: Handbook of Clinical Neurology |vauthors=Stefan H |publisher=Newnes |year=2012 |isbn=978-0-444-53505-4 |edition=Volume 107 of Handbook of Clinical Neurology |page=471}}</ref> [[Attention deficit hyperactivity disorder]] (ADHD) is particularly prevalent among [[Epilepsy in children|children with epilepsy]], occurring three to five times more often than in the general population. ADHD and epilepsy together can markedly affect behavior, learning, and social development.<ref>{{cite journal |vauthors=Reilly CJ |date=May–June 2011 |title=Attention deficit hyperactivity disorder (ADHD) in childhood epilepsy |journal=Research in Developmental Disabilities |volume=32 |issue=3 |pages=883–893 |doi=10.1016/j.ridd.2011.01.019 |pmid=21310586}}</ref> Epilepsy is also more common in children with [[Autism|autism spectrum disorder]].<ref>{{cite journal |vauthors=Levisohn PM |year=2007 |title=The autism-epilepsy connection |journal=Epilepsia |volume=48 |issue=Suppl 9 |pages=33–35 |doi=10.1111/j.1528-1167.2007.01399.x |pmid=18047599 |doi-access=free}}</ref>

Approximately, one-in-three people with epilepsy have a lifetime history of a psychiatric disorder.<ref>{{cite journal | vauthors = Lin JJ, Mula M, Hermann BP | title = Uncovering the neurobehavioural comorbidities of epilepsy over the lifespan | journal = Lancet | volume = 380 | issue = 9848 | pages = 1180–1192 | date = September 2012 | pmid = 23021287 | pmc = 3838617 | doi = 10.1016/s0140-6736(12)61455-x }}</ref> This association is thought to reflect a combination of shared neurobiological mechanisms and the psychosocial impact of living with a chronic neurological condition.<ref>{{cite journal | vauthors = Kanner AM, Schachter SC, Barry JJ, Hesdorffer DC, Mula M, Trimble M, Hermann B, Ettinger AE, Dunn D, Caplan R, Ryvlin P, Gilliam F, LaFrance WC | title = Depression and epilepsy: epidemiologic and neurobiologic perspectives that may explain their high comorbid occurrence | journal = Epilepsy & Behavior | volume = 24 | issue = 2 | pages = 156–168 | date = June 2012 | pmid = 22632406 | doi = 10.1016/j.yebeh.2012.01.007 }}</ref> Some research also suggests that psychiatric conditions such as depression may precede the onset of epilepsy in certain individuals, particularly those with focal epilepsy. However, the nature of this association remains under investigation and may involve shared pathways, diagnostic overlap, or other confounding factors.<ref>{{cite journal |vauthors=Adelöw C, Andersson T, Ahlbom A, Tomson T |date=February 2012 |title=Hospitalization for psychiatric disorders before and after onset of unprovoked seizures/epilepsy |journal=Neurology |volume=78 |issue=6 |pages=396–401 |doi=10.1212/wnl.0b013e318245f461 |pmid=22282649}}</ref>

Comorbid depression and anxiety are associated with poorer quality of life,<ref>{{cite journal |vauthors=Taylor RS, Sander JW, Taylor RJ, Baker GA |date=December 2011 |title=Predictors of health-related quality of life and costs in adults with epilepsy: a systematic review |journal=Epilepsia |volume=52 |issue=12 |pages=2168–2180 |doi=10.1111/j.1528-1167.2011.03213.x |pmid=21883177 |doi-access=free}}</ref> increased healthcare utilization, reduced treatment response (including to surgery), and higher mortality.<ref>{{cite journal |vauthors=Lacey CJ, Salzberg MR, Roberts H, Trauer T, D'Souza WJ |date=August 2009 |title=Psychiatric comorbidity and impact on health service utilization in a community sample of patients with epilepsy |journal=Epilepsia |volume=50 |issue=8 |pages=1991–1994 |doi=10.1111/j.1528-1167.2009.02165.x |pmid=19490049 |doi-access=free}}</ref> Some studies suggest that these psychiatric conditions may influence quality of life more than seizure type or frequency.<ref>{{cite journal |vauthors=Boylan LS, Flint LA, Labovitz DL, Jackson SC, Starner K, Devinsky O |date=January 2004 |title=Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy |journal=Neurology |volume=62 |issue=2 |pages=258–261 |doi=10.1212/01.wnl.0000103282.62353.85 |pmid=14745064}}</ref> Despite their clinical importance, depression and anxiety often go underdiagnosed and undertreated in people with epilepsy.<ref>{{cite journal |vauthors=Munger Clary HM, Croxton RD, Allan J, Lovato J, Brenes G, Snively BM, Wan M, Kimball J, Wong MH, O'Donovan CA, Conner K, Jones V, Duncan P |date=March 2020 |title=Who is willing to participate in research? A screening model for an anxiety and depression trial in the epilepsy clinic |journal=Epilepsy & Behavior |volume=104 |issue=Pt A |pages=106907 |doi=10.1016/j.yebeh.2020.106907 |pmc=7282472 |pmid=32000099}}</ref>