{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T20:35:00Z","timestamp":1758054900824,"version":"3.44.0"},"reference-count":17,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec id=\"S2056472425108363_as1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Epilepsy is frequently accompanied by psychiatric symptoms, including mood disturbances such as depression, irritability and euphoria. Interictal dysphoric disorder (IDD), characterised by depressive and affective symptoms, is typically managed with psychiatric treatment. However, persistent symptoms, despite adequate psychiatric intervention, may indicate an underlying epileptogenic mechanism.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108363_as2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>To highlight the importance of recognising epileptogenic contributions to persistent psychiatric symptoms, even in patients with apparently well-controlled epilepsy.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108363_as3\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>We present a case report of a Japanese woman in her 40s with well-controlled epilepsy; however, she developed enduring psychiatric symptoms. Clinical features, psychiatric treatments, neurological evaluation and therapeutic outcomes are described.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108363_as4\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>The patient experienced anxiety, depression, irritability and fear, leading to an initial diagnosis of IDD. Treatment with escitalopram and olanzapine achieved only partial symptom relief. Residual symptoms prompted further investigation, which revealed symptoms suggestive of temporal lobe epilepsy auras. Adjustment of anti-seizure therapy with lacosamide resulted in complete resolution of psychiatric symptoms, marked functional recovery and a reduction in her Hamilton Depression Rating Scale (HAMD-17) score improved from 23 to 6.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472425108363_as5\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>This case highlights that even in apparently well-controlled epilepsy persistent psychiatric symptoms may indicate an underlying epileptogenic mechanism rather than a primary psychiatric disorder. Careful evaluation and appropriate optimisation of anti-seizure medication can yield substantial psychiatric and functional improvements, underscoring the importance of multidisciplinary assessment in such presentations.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2025.10836","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T06:38:43Z","timestamp":1757918323000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Persistent psychiatric symptoms in apparently well-controlled epilepsy: case report"],"prefix":"10.1192","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3837-1504","authenticated-orcid":false,"given":"Masahiro","family":"Hata","sequence":"first","affiliation":[{"name":"Osaka University Graduate School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rei","family":"Sakagami","sequence":"additional","affiliation":[{"name":"Osaka University Graduate School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9049-4694","authenticated-orcid":false,"given":"Shun","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Osaka University Graduate School of Medicine"},{"name":"Graduate School of Rehabilitation Science, Osaka Metropolitan University"},{"name":"Asakayama General Hospital"},{"name":"Wakayama Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manabu","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Osaka University Graduate School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"S2056472425108363_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2019.03.036"},{"key":"S2056472425108363_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2012.01.007"},{"key":"S2056472425108363_ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-014-0194-z"},{"key":"S2056472425108363_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2023.109231"},{"key":"S2056472425108363_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebr.2024.100673"},{"key":"S2056472425108363_ref16","doi-asserted-by":"publisher","DOI":"10.1038\/46286"},{"key":"S2056472425108363_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-013-0355-2"},{"key":"S2056472425108363_ref17","doi-asserted-by":"publisher","DOI":"10.1111\/pcn.12784"},{"key":"S2056472425108363_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2010.06.017"},{"key":"S2056472425108363_ref5","unstructured":"5 Kraepelin, E. 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e213"}}