Issue 1/2026
Ivanova1, Е., Burgov2, Р.
1 UMHAT „Alexandrovska“, Medical Faculty, Medical University – Sofia
2 VTU „St. Cyril and St. Methodius“, Faculty of Philosophy, Department of Psychology – Veliko Tarnovo
Comorbidity between epilepsy and mental disorders in adolescence represents a significant clinical problem. Adolescence is a particularly vulnerable developmental period, characterized by intensive physiological, psychological, and social changes that increase the risk of depression, anxiety disorders, behavioral disturbances, and suicide attempts. Epidemiological data indicate that between 30% and 50% of adolescents with epilepsy have at least one comorbid mental disorder, with the risk of depression and anxiety being significantly higher than in the general population. Antiepileptic medications play a key role in the control of epileptic seizures; however, they may exert negative effects on mental health, cognitive functioning, endocrine regulation, and metabolic profile, particularly during puberty. Polytherapy and certain antiepileptic drugs are associated with more pronounced adverse effects on cognitive functions and emotional state, as well as with changes in body weight and body image, which further increase the psychological vulnerability of adolescents. The present review highlights the need for a multidisciplinary and individualized approach to the management of adolescents with epilepsy, including regular screening for psychiatric comorbidities, careful selection of antiepileptic medication with consideration of cognitive and metabolic profiles, and systematic follow-up aimed at optimizing long-term prognosis and improving quality of life.
Key words: epilepsy, mental disorders, comorbidity, adolescence.
Address for correspondence:
Assoc. Prof. Dr. E. Ivanova, MD
University Hospital “Aleksandrovska”,
Department of Psychiatry
1, “St. G. Sofiyski”, Blvd.
1431, Sofia
e-mail: helen_aivan@abv.bg