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Led by researchers from the Oxford Precision Psychiatry Lab at the University of Oxford Department of Psychiatry and supported by the NIHR Oxford Health Biomedical Research Centre (OH BRC), the study brought together international experts in neurology, psychiatry, and people with lived experience to identify key challenges and propose practical solutions for improving mental health outcomes in epilepsy. The paper was published in the British Journal of Psychiatry.
By bringing together a group of experts to agree on the best approach, the team reviewed current evidence and engaged in multidisciplinary discussions to define priorities for clinical practice and research. They found that despite epilepsy affecting around 50 million people worldwide, psychiatric disorders such as depression, anxiety, psychosis, and suicidality remain under-recognised and undertreated. Current epilepsy care still focuses primarily on seizure control, while many patients’ quality of life is shaped by broader psychological and social factors.
The group calls for a shift from a seizure-centric to a patient-centred model of care, advocating for routine mental health screening, stronger collaboration between neurologists and psychiatrists, and improved access to psychiatric services. They also recommend expanding neuropsychiatry services, embedding lived-experience involvement in service design, and developing decision-support tools (including artificial intelligence-based screening) to help clinicians identify patients most in need of integrated support.
Dr Riccardo De Giorgi, Clinical Lecturer in Psychiatry at the University of Oxford and lead author of the paper, said:
People with epilepsy face a double burden of illness that includes psychiatric comorbidity, yet the two are too often treated in isolation. Our work shows that bridging the gap between neurology and psychiatry is both possible and indeed essential. A collaborative, biopsychosocial model of care can transform outcomes and quality of life for millions worldwide.”
The authors emphasise that addressing the mental health needs of people with epilepsy requires systemic change, investment in interdisciplinary research, and innovative service models. Such efforts could not only reduce premature mortality and suicide but also help redefine brain health as an integrated field shared by psychiatry and neurology.
Professor Andrea Cipriani, Professor of Psychiatry at the University of Oxford and senior author of the paper, said:
There is an urgent need for greater research at the intersection of mental health and neurology to deepen our understanding of the mechanisms underlying disorders that span both fields, across the brain and the whole body. Addressing these knowledge gaps can ultimately improve patient care. Recent advances in our biological understanding of the neuropsychiatric aspects of epilepsy, including cognitive impairment and functional dissociative seizures, offer new insights into potential therapeutic avenues.”