Patients with epilepsy have a significantly higher prevalence of psychiatric comorbid disorders involving depression, anxiety, psychotic, and attention deficit disorders. Accordingly, one would expect that psychiatrists would be actively involved in the evaluation and management of these patients. This, however, is hardly the case. Patients who undergo temporal lobectomies, for example, are known to experience postsurgical depression and occasionally psychotic disorders. Yet, most epilepsy centers in North America do not include a psychiatric evaluation as part of the presurgical work-up. Collaboration between epileptologists and psychiatrists is often sparse, despite the intimate relationship between psychiatric comorbidities and epilepsy. The purpose of this paper is to highlight this bizarre phenomenon and to identify some of the reasons behind it. © 2003 Elsevier Inc. All rights reserved.
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