A case of interictal psychosis characterized by repeated suicidal behavior: Pitfalls in the management of epileptic psychosis by general psychiatrists

Abstract

“Epileptic psychosis” is a generic term comprising several clinical states that have various etiologies and need different treatments, such as postictal psychosis and interictal psychosis. In this paper, we presented a case of interictal psychosis in which the psychotic symptoms showed insidious onset a dozen years after alleviation of epileptic seizures and elicited sudden and repetitive suicidal behavior in the patient. In spite of the involvement of several general psychiatrists in the treatment of this case, several years were required to arrive at an accurate diagnosis and treatment. The number of psychiatrist in Japan specializing in epilepsy has been decreasing. On the other hand, treatments for epileptic psychosis continue to be in demand even in general psychiatric departments. Thus knowledge about epileptic psychoses, a regularly encountered form of organic psychosis, should be shared by more psychiatrists. With this purpose in mind, we summarized the considerations and pitfalls in the treatment of epileptic psychoses.