Background: In the Sfax area and the south of Tunisia, epileptics are not all followed by neurologist. Some are addressed to psychiatrist. This fact raises the question of the motivations of such an orientation. The objectives of our survey were to point out the socio-cultural, clinical and psycho(patho)logical profile of the epileptic consulting in adult psychiatry, in Sfax teaching hospital, and to confront it to literature data coming from the studies dealing with the epileptic treated in neurological wards.
Methods: It was a retrospective survey assesing the epileptic whose first consultation occurred from the 1st January 1999 to 31st December 2003.
Results: The studied sample included 197 cases. The sex-ratio (male/female) was 2.18. The rate of generalised seizures was 84.4%. The aetiology was known or presumed to be genetic in 48.2%. Sixty-nine per cent of the epileptics had mental disorders Our results and literature data showed that, compared with the epileptic treated in neurological wards, the consultants in psychiatry had epilepsy treated in a more classical way, more difficult to stabilise and frequently associated with mental disorders. By another way, we point out that in the area of our survey, although a department of neurology does exist, some epileptics without mental disorder are still addressed to psychiatrist, at least up to the period of the survey.
Conclusion: Anyway, what seems to be more important is that the treatment should have realistic objectives. Psychotherapeutic support is fundamental to help epileptics to lead a decent life.