Psychobiology

Commission Members

Bettina Schmitz, Chair - Germany
Michael Trimble - U.K.
Steffi Koch-Stöcker - Germany
Cesare Cornaggia - Italy
John Gates - USA
Kousuke Kanemoto - Japan
E.S. Krishnamoorthy - India
John Moriarty - U.K.
F. Besag - U.K.

I have appointed four new commission members: K. Kanemoto, E.S. Krishnamoorthy, J. Moriarty and F. Besag.

A second commission meeting was held in association with the Bethel-Cleveland meeting in Bielefeld in May 2003, and a third meeting is scheduled at the ILAE meeting in Lisbon, October 2003.

The following subcommissions have continued their work:

• Epilepsy surgery
• Dissociative seizures
• Learning disabilities
• Periictal disorders
• Affective disorders
• New commission: Behavioural side effects of anticonvulsants (F. Besag).

Meetings

1. There are advance plans for a meeting in Italy: The subcommission on learning disabilities has planned a two-day meeting on cognitive profiles of epileptic syndromes, which was supposed to be held in Bologna, 19-20 September 2003. Unfortunately, financial support for this meeting could not be covered by drug companies, due to recent changes in Italian sponsorship regulations. The meeting has therefore been postponed, and we hope that the meeting will take place next year, since all invited speakers were highly enthusiastic about the topic. With help from the ILAE, proceedings from this meeting shall be published as a supplement of Epilepsia and a request for financial support for this is submitted to the ILAE.
   
2. Lisbon: The commission has submitted two symposia: 1. Transcultural aspects of pseudoseizures (Gates). 2. Affective disorders (Schmitz and Trimble). Both symposia have been accepted.
   
3. There is a plan for a roundtable discussion organised by the subcommission on affective disorders (organisers: Trimble and Schmitz) bringing together psychiatrists working with anti-epileptic drugs in bipolar disorder and epileptologists with a special interest in affective complications. This meeting will take place in spring in Berlin. The topic will be links between affective disorders and antiepileptic drugs in epilepsy. We hope that this meeting will be sponsored by GlaxoSmithKline and have asked for a sponsorship. The proceedings of this meeting are planned to be published as a supplement of Epilepsia and the publication shall be supported by the ILAE.

Following is a list of speakers and topics for this roundtable meeting:

• Introduction to Anti-epileptic Drugs, Dieter Schmidt - Germany
• Neurochemical Underpinnings of Bipolar Disorders and Epilepsy, Benedikt Aman - Germany
• Mood Disorders in Patients with Epilepsy, B. Schmitz - Germany
• Towards a Clinical Understanding of Bipolar Disorders: Classification and Presentations, J. Cookson - U.K.
• Studies of the Neurobiology of Bipolar Disorder
• Neurochemistry and neuropsychology, G. Goodwin - U.K.
• Imaging Studies, Stefanio Bruno - U.K.
• On the Use of Anti-epileptic Drugs in Epilepsy - Quality of Life Studies, C. Selai - U.K.
• Anti-epileptic Drugs In Epilepsy - Effects On Mood and Cognition, M. Trimble - U.K.
• Anti-epileptic Drugs in the Control of Mood Disordered Patients, H. Grunze - Germany
• Studies With Lamotrigine, J. Calabrese - USA.

4. There is a main session on psychiatric aspects of epilepsy (psychiatric side effects of epilepsy treatments) at the next European League meeting in Vienna 2004. Psychiatry is one of the main topics (Schmitz).
   
5. There are plans for a parallel session at the next ILAE meeting in Paris:
   Depression and Interictal Dysphoric Disorder of Epilepsy. Tentative topics and speakers include:
   • Discovery and Definition of IDD, Blumer - USA
   • Phenotypes of Disturbed Affect in Epilepsy and Psychiatry, Krishnamoorthy - India
   • Regulation of Mood, Biological Foundations - The Lessons from Epilepsy, M.R. Trimble - U.K.
   • Treatments for Mood Disorders in Epilepsy, B. Schmitz - Germany.

Publications
Two papers from the commission have been submitted for publication:

• Classification (Krishnamoorthy et al.),
• Learning disabilities and mental handicap (Cornaggia et al.).

Subcommission Reports

Subcommission on epilepsy surgery (Koch-Stöcker):
The survey on neuropsychiatric care in epilepsy surgery centres is being analysed by Koch-Stöcker and Krishnamoorthy. Results will be published as a commission report together with recommendations for psychiatric standards. The manuscript will be discussed with the commission on epilepsy surgery (submission planned for Epilepsia autumn 2003).

Subcommission on affective disorders (Trimble):
Meetings (see above)

• Roundtable discussion in Berlin spring 2004 on affective disorders in epilepsy, anticonvulsants, bipolar disorders. From this meeting should come a commission report to be published in Epilepsia in 2004.
• Workshop on affective disorders in Lisbon 2003.
• Proposal for the Paris meeting in 2005: A workshop on the "Blumer syndrome."

Research project: A multicenter study on the Blumer syndrome. A study protocol is being developed, and a grant application for financial support from the ILAE will be prepared.

Subcommission on transcultural affairs (Krishnamoorthy):
Will meet next year in conjunction with a meeting organised by Krishnamoorthy in India. The members and contact addresses will be mailed to the commission members.

Subcommission on dissociative disorders (Nonepileptic Seizure Subcommission) (Gates):
The following members have been appointed:
Luciano DePaolo, Parana University, Curitiba, Brazil
Chi Wan Laia, Taipei, Taiwan
Naji Riachi, Rizk Hospital, Beirut, Lebanon
John R. Gates, Minnesota Epilepsy Group, United and Children's Hospital, St. Paul, Minnesota, USA (Chair)

The committee has conducted one conference call in which the ILAE program proposed for Lisbon was discussed. In addition, the committee is working on the development of a standardized survey tool for the program in Lisbon on what will be the common clinical features of nonepileptic seizures, to emphasize multicultural variations.

A formal meeting of the committee is planned for Lisbon, with further teleconferences between now and then to formalize the program and standardize the data collection.

John R. Gates has approached Steven Schachter regarding this program, and a preliminary agreement has been reached for a possible article in Epilepsy & Behavior as a consequence of the neurobiology nonepileptic seizure subcommission effort summarizing the Lisbon program.

Subcommission on learning disabilities: see Cornaggia meeting above.

Subcommission on postictal psychosis (Kanemoto): Goals to be defined.

Subcommission on psychiatric adverse events of AED (Besag): The task of this commission is a report on psychiatric side effects of old and new anti-epileptic drugs and a recommendation for appropriate instruments to evaluate these effects.

Main Commission ongoing research project: "Attitudes toward psychiatric complications and the role of psychiatrists in epilepsy centres worldwide." We have planned a survey on psychiatric care in epilepsy centres worldwide. A standardized questionnaire is being developed and will be sent to all sections of the ILAE with the request that this questionnaire be forwarded to the most significant national epilepsy centres (numbers according to size [= members] of sections). The questionnaire is adapted from the questionnaire used in the epilepsy surgery survey and will focus on questions on estimates of psychiatric complications (frequency, type, severity), use of psychiatric treatments (medical or psychotherapeutic), and availability of psychiatric services or cooperation with psychiatrists (Schmitz).

Date: 1 July 2003
Report by: Bettina Schmitz