European Journal of Cardiovascular Medicine

Epilepsy affects over 50 million people globally, with 6–8 million cases in India1. Beyond seizures, PWE face cognitive deficits and psychiatric disorders, contributing to poor quality of life (QOL). CI in epilepsy arises from factors like seizure frequency, anti-epileptic drugs (AEDs), and disease duration. Psychiatric comorbidities, particularly depression and anxiety, occur in 20–50% of PWE. Despite their prevalence, these comorbidities often remain undiagnosed. This study evaluates cognitive performance, psychiatric morbidity, and their interplay in PWE.

Study Design and Participants

A cross-sectional study of 100 PWE (aged 18–55 years) was conducted at Osmania General Hospital, Hyderabad, India. Exclusion criteria included intellectual disability, substance use, and neurological comorbidities.

Ethical Approval: Obtained from Osmania Medical College (IRB No. OMC/2020/45). Submitted: February 23, 2025

Conflicts of Interest: None declared.

Assessments

1. Cognitive Function:

• MoCA: Scores <26 indicated CI.
• ACE-III: Scores <83 indicated CI.

2. Psychiatric Morbidity: Diagnosed using MINI modules (DSM-V criteria).

Statistical Analysis

Data were analyzed using SPSS v29. Chi-square tests assessed associations between variables (p<0.05 significant).

Sociodemographic and Clinical Characteristics

Table 1: Sociodemographic Profile (N=100)

Table 2: Clinical Characteristics

Cognitive Impairment

Table 3: Cognitive Performance (N=100)

• ACE-III Domains: Verbal fluency (84% impaired) and memory (71%) were most affected.
• Psychiatric Morbidity

Table 4: Psychiatric Comorbidities (N=17)

Associations

• CI correlated with lower education (p<0.001), unemployment (p=0.001), and polytherapy (p=0.03).
• No significant link between CI and psychiatric morbidity (p=0.12).

Cognitive Impairment

This study identified CI in 66–90% of PWE, aligning with global data. Low education and unemployment exacerbated CI, likely due to limited cognitive reserve and socioeconomic stress. Polytherapy’s role in CI underscores AED neurotoxicity risks.

Psychiatric Comorbidity

Depression dominated psychiatric comorbidities (64.7%), consistent with prior studies. Despite CI prevalence in psychiatric cases (82.4%), the lack of statistical significance suggests multifactorial etiology, including stigma and diagnostic limitations.

LIMITATIONS

Small sample size and reliance on cross-sectional data limit causal inferences. Future studies should include longitudinal designs and neuroimaging.

Cognitive and psychiatric comorbidities are pervasive in PWE, necessitating routine screening. Interventions should address modifiable factors (e.g., AED regimens, education access). Multidisciplinary care models integrating neurology and psychiatry are recommended.

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