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The comorbidity of epilepsy and psychosis is an important area for continued research
  1. Gail S Bell,
  2. Mark R Keezer
  1. NIHR University College London Hospitals Biomedical Research Centre, Department of Clinical & Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
  1. Correspondence to Gail S Bell, gail.bell{at}

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What is already known on this topic?

Postictal psychosis is a well-recognised epileptic phenomenon, while there is also mounting evidence of increased prevalence of interictal psychosis and schizophrenia in people with epilepsy.1 The co-occurrence of these two disease states raises important questions about potentially shared pathological mechanisms and creates important challenges in their medical management.2

What does this paper add?

  • First systematic review and meta-analysis examining the prevalence of psychosis in people with epilepsy.

  • Pooled prevalence (a combination of lifetime, period and possibly point prevalence) of psychosis in those with epilepsy (including postictal psychosis, interictal psychosis and schizophrenia; 18 studies are included whose definition of psychosis is presumably unknown) alongside the odds of psychosis relative to those without epilepsy were reported.


  • The study authors comment on ‘substantial’ heterogeneity between included primary studies (I2>70%), and proceed with the meta-analysis using a random effects model to help accommodate this heterogeneity. Importantly, however, …

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  • Competing interests None.