SCHIZOPHRENIA AND EPILEPSY: WHAT LINKS BETWEEN? ARRAZI HOSPITAL EXPERIENCE ABOUT 56 CASES

Background: Given the higher incidence of psychotic disorders in patients with epilepsy, several neurologists and psychiatrists have attempted to explain this controversial comorbidity. Thus, several hypotheses have been put forward but no link has been established with certainty until today. Objectives: The aim of our work is to draw up a socio-demographic and psychopathological profile of patients with schizophrenia-epilepsy comorbidity as well as to assess the risk of suicide, the management, the reasons for admission and the length of hospitalization. Methodology: we conducted a retrospective cross-sectional study on medical records of patients with schizophrenia and epilepsy who were hospitalized at the Ar-Razi University Psychiatric Hospital in Salé between January 01, 2017 and March 31, 2021. Results: Our study included 56 patients. The average age was 33 + / - 9.83, 55% male. 50% of patients had attempted suicide in the past and 25% had a history of depressive episode, 41.1% had substance use disorder and 26.8% had a family history of psychosis. 85.7% of our patients developed schizophrenia from pre-existing epilepsy the time to onset of schizophrenia compared to epilepsy was 11.08 years +/- 7.71. The mean age of onset of schizophrenia is 23.3 years with a mean duration of progression of 9.18 years, 55.4% of patients were on monotherapy and 8.9% had resistant schizophrenia on clozapine. The average age of onset of epilepsy is 14.73 years, with generalized epilepsy in 84% of cases. The average length of stay is 42 days. The reasons for admission were as follows: hetero-aggression 78.6%, delusional verbalization 85.7% and suicide attempt 23.2%. The majority of our patients have been treated with atypical antipsychotics: Risperidone 30.4%, Amisulpride 21.4% and Aripiprazole 12.5%. Conclusion: The co-occurrence of schizophrenia epilepsy suggests the existence of possible common etiopathogenic factors. The management of this comorbidity requires a multidisciplinary collaboration between neurologist and psychiatrist, in order to confirm the diagnosis, establish a good therapeutic approach and propose a management algorithm taking into account the two pathologies.