{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:58:11Z","timestamp":1777946291466,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to conduct an umbrella review to summarize the existing evidence regarding the prevalence of peri\u2010ictal psychiatric manifestations (PM) in people with epilepsy (PWE) including pre\u2010ictal, ictal, and postictal stages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<jats:bold>s<\/jats:bold><\/jats:title><jats:p>Databases were searched up to June 2023 for systematic reviews (SR) of observational studies that included patients with epilepsy peri\u2010ictal PM. Data selection, data extraction, and risk of bias assessment (with the AMSTAR\u20102 instrument) were performed by two independent reviewers. We performed a narrative synthesis using previous guidelines. We used a self\u2010developed decision table according to the GRADE system adapted for narrative outcomes if the certainty of outcomes was not determined by systematic review authors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four SRs were included comprising 66 primary studies (<jats:italic>n<\/jats:italic>\u2009=\u200910\u2009217). Three SRs evaluated one period (pre\u2010ictal, ictal, and postictal), and one did not determine it. During the pre\u2010ictal period, the more prevalent symptom was confusion, although with a low certainty (due to the heterogeneity and serious risk of bias). One systematic review that only included case reports evaluated the ictal period, finding mood\/anxiety disorders, psychosis, and personality changes. The postictal period included the most PM (anxiety: 45.0% and depressive symptoms: 43.0%), with very low certainty, due to risk of bias, potential publication bias, heterogeneity, and failure to report the confidence intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>With very low certainty, epileptic periods are characterized by a wide spectrum of PM, being postictal symptoms the most prevalent, predominantly anxiety, and depressive symptoms. Further understanding of these PM of epilepsy could improve the attention of the people with epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>In this review of reviews, we summarize the frequency in which psychiatric manifestations occur in relation to an epileptic seizure. A total of 10\u2009217 patients were reported in the reviews. The most common manifestations included symptoms of anxiety and depression, as well as changes in the normal behavior of the patient. These manifestations occurred most frequently right after the seizure finished.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12949","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:40:51Z","timestamp":1717116051000},"page":"1166-1175","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Peri\u2010ictal psychiatric manifestations in people with epilepsy: An umbrella review"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3584-7298","authenticated-orcid":false,"given":"Carlos","family":"Alva\u2010Diaz","sequence":"first","affiliation":[{"name":"Grupo de Investigaci\u00f3n Neurociencia, Efectividad Cl\u00ednica y Salud P\u00fablica Universidad Cient\u00edfica del Sur  Lima Peru"},{"name":"Servicio de Neurolog\u00eda, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigaci\u00f3n (OADI) Hospital Daniel Alcides Carri\u00f3n  Callao Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9976-0530","authenticated-orcid":false,"given":"Miguel","family":"Cabanillas\u2010Lazo","sequence":"additional","affiliation":[{"name":"Universidad de Hu\u00e1nuco  Hu\u00e1nuco Per\u00fa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alba","family":"Navarro\u2010Flores","sequence":"additional","affiliation":[{"name":"International Max Planck Research School for Translational Psychiatry (IMPRS\u2010TP)  Munich Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raisa N.","family":"Martinez\u2010Rivera","sequence":"additional","affiliation":[{"name":"Red de Eficacia Clinica y Sanitaria (REDECS)  Lima Peru"},{"name":"Universidad Nacional de Piura  Piura Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Valdeiglesias\u2010Abarca","sequence":"additional","affiliation":[{"name":"Servicio de Neurolog\u00eda, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigaci\u00f3n (OADI) Hospital Daniel Alcides Carri\u00f3n  Callao Peru"},{"name":"Universidad Ricardo Palma  Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krystel","family":"Acevedo\u2010Marino","sequence":"additional","affiliation":[{"name":"Servicio de Neurolog\u00eda, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigaci\u00f3n (OADI) Hospital Daniel Alcides Carri\u00f3n  Callao Peru"},{"name":"Universidad Ricardo Palma  Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7166-2816","authenticated-orcid":false,"given":"Kevin","family":"Pacheco\u2010Barrios","sequence":"additional","affiliation":[{"name":"Neuromodulation Center and Center for Clinical Research Learning Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Vicerrectorado de Investigaci\u00f3n, Unidad de Investigaci\u00f3n Para la Generaci\u00f3n y S\u00edntesis de Evidencias en Salud Universidad San Ignacio de Loyola  Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramiro","family":"Ruiz\u2010Garcia","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry National Institute of Neurology and Neurosurgery  Mexico City Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Burneo","sequence":"additional","affiliation":[{"name":"Epilepsy Program and Neuroepidemiology Unit, Department of Clinical Neurological Sciences, Schulich School of Medicine Western University  London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,30]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"World Health Organization.Epilepsy: a public health imperative. 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