Hasil untuk "Neurosciences. Biological psychiatry. Neuropsychiatry"

Minghui Lu, Jiajun Wei, Qiang Cai

BackgroundThe optimal timing for tracheostomy in patients with intracerebral hemorrhage extending into the ventricles who require mechanical ventilation remains controversial, and there is a paucity of evidence to guide clinical practice. This study aimed to elucidate the impact of early vs. late tracheostomy on clinical outcomes and complications in this population, utilizing multivariable models to identify risk factors and define the potential beneficiary population.MethodsThis single-center retrospective cohort study consecutively enrolled 157 patients with severe spontaneous intracerebral hemorrhage extending into the ventricles requiring mechanical ventilation (GCS score ≤8) between January 2020 and December 2023. Based on the timing of tracheostomy, patients were classified into an early group (ET, ≤7 days after mechanical ventilation, n = 81) and a late group (LT, >7 days after mechanical ventilation, n = 76). Baseline characteristics, treatment measures, and outcome data were collected. Hematoma volumes in both the brain parenchyma and ventricles on admission CT scans were precisely quantified using 3D Slicer software. The primary outcome was the 6-month modified Rankin Scale (mRS) score. Secondary outcomes included the duration of mechanical ventilation, ICU length of stay (LOS), and the incidence of short-term complications [ventilator-associated pneumonia (VAP), new-onset arrhythmia, shock, and acute kidney injury (AKI)]. Multivariable logistic regression analysis was employed to identify independent risk factors for complications and to assess the protective effect of early tracheostomy.ResultsIn this cohort of 157 mechanically ventilated patients with severe intraventricular hemorrhage, baseline characteristics were well-balanced between Early (ET, n = 81) and Late Tracheostomy (LT, n = 76) groups. While 6-month functional outcomes (mRS) showed no significant difference (P = 0.360), the ET group demonstrated substantially shorter duration of mechanical ventilation (13 vs. 19 days, P < 0.001) and ICU stay (17 vs. 25 days, P < 0.001). ET was associated with significantly lower incidence of ventilator-associated pneumonia (28.40 vs. 48.68%, P = 0.009), new-onset arrhythmia (18.52 vs. 32.89%, P = 0.039), and shock requiring vasopressors (24.7 vs. 40.79%, P = 0.031). Multivariable analysis identified GCS score <6 (OR 3.588, P = 0.008) and Graeb score ≥8 (OR 8.735, P = 0.037) as independent risk factors for complications, while confirming early tracheostomy as an independent protective factor (aOR 0.306, P = 0.019) after adjustment for confounders.ConclusionIn this single-center retrospective cohort study, early tracheostomy was associated with shorter durations of mechanical ventilation and ICU stay, as well as a lower incidence of major complications, and demonstrates a favorable safety profile. Although it does not improve long-term neurological function, early tracheostomy serves as an independent protective factor. When combined with the identification of risk factors such as GCS <6 and Graeb score ≥8, it provides a basis for individualized treatment. These findings suggest an association that warrants further investigation in prospective studies.

Juan Camilo Castro Martínez, Felipe Botero-Rodríguez, Jesús Ramírez-Bermúdez et al.

Neuropsychiatry is a transdisciplinary field at the intersection of neuroscience, psychiatry, neurology, and humanities. Despite this strategic position, a comprehensive framework is still needed to bridge these domains. This review examines the historical evolution of how neurological, mental, and neuropsychiatric symptoms have been conceptualized, from antiquity to contemporary models, using the brain–body dilemma as a guiding thread. This historical analysis provides the epistemological and ontological foundations of neuropsychiatry, which are then connected with current definitions to critically assess the field's persistent tensions. Building on this foundation, a renewed paradigm is proposed where a crosstalk between them is enabled, grounded in deep phenotyping, dimensional research frameworks [e.g., Research Domain Criteria (RDoC), Hierarchical Taxonomy of Psychopathology (HiTOP)], and integrative models linking biological, psychometric, social data, and subjective experience. Special attention is given to a “subjectomic” layer that aims to systematically incorporate lived experience. Finally, reforms in education, clinical practice, and research are advocated to foster this conceptual reorientation, aiming at interdisciplinary collaboration and advancing patient care.

M. Kas, B. W. Penninx, G. Knudsen et al.

The current classification systems for mental disorders provide a uniform symptom-based language to describe and diagnose mental disorders. Clinicians use these classifications to communicate with their patients and colleagues, to treat patients, and when applicable, to request reimbursement from payers. In clinical research and drug development, diagnostic categories are used as enrollment criteria for clinical trials and to inform prescribing information for the appropriate use of therapeutic interventions. However, like other neuropsychiatric diseases, mental disorders arise from the biology of the brain and its bidirectional interaction with the environment. Current classification systems do not reflect this knowledge. With scientific progress in neuroscience, the time has come for global stakeholders to align research efforts to work toward integrating symptomatic, biological, and behavioral information into the definition of mental disorders to advance the development of effective treatments. The European College of Neuropsychopharmacology (ECNP), following the 2024 New Frontiers Meeting, is coordinating a global initiative to design and implement a Precision Psychiatry Roadmap. By mobilizing resources and harmonizing translational methodologies and datasets, the aim is to discuss, design, and implement an iterative framework that incorporates biology-informed evidence into symptom-based syndromes, allowing for more discovery and implementation of mechanism-based effective treatments for mental disorders.

Barbara Franke

In this Genomic Press Interview, Professor Barbara Franke, a trailblazing molecular psychiatrist at Radboud University in Nijmegen, shares her extraordinary scientific journey from an inquisitive child fascinated by nature to becoming one of the world's most influential researchers in biological psychiatry. With over 500 peer-reviewed publications and recognition among the top 1% most cited scientists globally, Franke has helped to revolutionize our understanding of the genetic foundations of neurodevelopmental disorders, particularly ADHD. Bringing together international experts for interdisciplinary research, she founded and leads multiple international research consortia, including the International Multicentre persistent ADHD Collaboration (IMpACT) and the ECNP Network ADHD across the lifespan. Her pioneering work extends beyond gene identification to illuminating the biological pathways from genetic variations to altered behaviour, employing innovative complementary approaches including bioinformatics, brain imaging genetics, and experimental models using fruit flies and human induced pluripotent stem cells. An elected member of the Royal Netherlands Academy of Arts and Sciences, decorated Knight in the Order of the Netherlands Lion, and recipient of numerous prestigious awards, Franke's scientific contributions are matched by her passionate commitment to international collaboration and mentorship of the next generation of researchers. Her recent move into epigenetics research, investigating the interplay between heritable and environmental influences on psychiatric conditions, illustrates her unwavering determination to contribute to a new nosology in psychiatry that will ultimately improve diagnosis, treatment, and management for millions worldwide. Guided by the German proverb “Die Suppe wird nicht so heiß gegessen, wie sie gekocht wird” (“The soup is not eaten as hot as it is cooked”), Franke's balanced approach to life and science continues to inspire groundbreaking advances at the intersection of genetics, neuroscience, and psychiatry.

Omar Alhaj Omar, Stefan T. Gerner, Slava Alikevitch et al.

<b>Background/Objectives:</b> Acute ischemic stroke (AIS) remains a major cause of morbidity and mortality worldwide. Although advanced imaging modalities, such as CT perfusion (CTP), are increasingly being used in clinical decision-making, the necessity and added value of perfusion imaging prior to intravenous thrombolysis (IVT) within early time windows remains uncertain. We aim to evaluate the safety and functional outcomes of IVT in AIS patients without perfusion deficits on CTP. We question the requirement of perfusion mismatch for IVT eligibility and hypothesize that IVT is safe and beneficial even in the absence of a perfusion deficit. <b>Methods:</b> A retrospective analysis was conducted using data from the Giessen Stroke Registry, focusing on AIS patients who underwent CTP imaging and received IVT between 01/2018 and 12/2020. Patients who underwent endovascular therapy were excluded. Clinical data, including demographics, National Institutes of Health Stroke Scale (NIHSS) scores, modified Rankin Scale (mRS) scores, and complications, were collected. Patients were dichotomized based on the presence of perfusion lesions and compared in terms of efficacy outcomes (i.e., NIHSS or mRS improvement during the hospital stay) and safety outcomes (i.e., post-thrombolytic hemorrhagic complications). <b>Results:</b> Of the 89 AIS patients with available CTP data who received IVT, 34 (38%) had a perfusion deficit and 55 (62%) did not. There were no significant differences between the groups in terms of hemorrhagic complications or functional outcomes at discharge (NIHSS and mRS). Clinical improvement from admission to discharge was similar in both groups. <b>Conclusions:</b> Our findings suggest that IVT is safe and clinically effective even in AIS patients without detectable perfusion deficits on CTP within the standard therapeutic window. These results support current guideline recommendations that do not mandate perfusion imaging for early presenters. Routine use of CTP in this context may be of limited clinical utility and could unnecessarily delay treatment or introduce additional risks in the first 4.5 h.

Asher Moldwin, Amarda Shehu

This paper surveys foundation models for AI-enabled biological design, focusing on recent developments in applying large-scale, self-supervised models to tasks such as protein engineering, small molecule design, and genomic sequence design. Though this domain is evolving rapidly, this survey presents and discusses a taxonomy of current models and methods. The focus is on challenges and solutions in adapting these models for biological applications, including biological sequence modeling architectures, controllability in generation, and multi-modal integration. The survey concludes with a discussion of open problems and future directions, offering concrete next-steps to improve the quality of biological sequence generation.

Olga A. Vlasova

The article discusses the genesis of antinomianism in the philosophy of psychiatry, analyzes its origins in the philosophical interpretation of mental illness in the 20th century. Antinomianism is the interpretation of methods, concepts, and practices through contradictory but equal categories that set different perspectives for interpretation. The study of antinomianism has a critical orientation, i.e. (implementing Kant’s critical method) is aimed at characterizing the foundations and specifics of the philosophy of psychiatry, the nature of its problematization, its boundaries. The article reveals not only the positive achievements of the philosophy of psychiatry, but also its problem points, its modern situation. The author traces the transformation of antinomianism from the existentialphenomenological tradition in psychiatry to the philosophy of psychiatry. It is emphasized that the history of the field is based on the opposition between traditional psychiatry and a person-centered philosophical approach, within which the research perspective changes from external (objective) to internal (subjective). Based on philosophical problematization and bringing concepts rather than functives to the center of its field, philosophical psychiatry designates the main problem points of the theory with antinomic concepts that capture the non-objectifiable field of experience of a mentally ill person. Existential-phenomenological psychiatry replaces biological (anatomical) theory with phenomenological ontology, and anti-psychiatry develops a social theory (social ontology), on the basis of which it develops deinstitutional practice. The author analyses the antinomianism of the first studies of the philosophy of psychiatry as a problem field and scientific branch, the attempts to overcome it, coupled with the removal of antinomianism in neurophenomenology. The new model of consciousness develops a dialectical philosophical interpretation of mental illness, where the experience of consciousness is consistently explored simultaneously in the causal analysis of neuroscience and the structural analysis of phenomenology. This leads to the construction of a complex (philosophical and neurophysiological) theory of pathological experience. In the study of antinomianism as a platform for the philosophy of psychiatry, the article lays the basis for fundamental and applied studies of its problem field.

Thomas P. Quinn, J. Hess, V. Marshe et al.

Felix Menne, Felix Dörr, Julia Schräder et al.

Abstract Background Psychiatry faces a challenge due to the lack of objective biomarkers, as current assessments are based on subjective evaluations. Automated speech analysis shows promise in detecting symptom severity in depressed patients. This project aimed to identify discriminating speech features between patients with major depressive disorder (MDD) and healthy controls (HCs) by examining associations with symptom severity measures. Methods Forty-four MDD patients from the Psychiatry Department, University Hospital Aachen, Germany and fifty-two HCs were recruited. Participants described positive and negative life events, which were recorded for analysis. The Beck Depression Inventory (BDI-II) and the Hamilton Rating Scale for Depression gauged depression severity. Transcribed audio recordings underwent feature extraction, including acoustics, speech rate, and content. Machine learning models including speech features and neuropsychological assessments, were used to differentiate between the MDD patients and HCs. Results Acoustic variables such as pitch and loudness differed significantly between the MDD patients and HCs (effect sizes 𝜼2 between 0.183 and 0.3, p < 0.001). Furthermore, variables pertaining to temporality, lexical richness, and speech sentiment displayed moderate to high effect sizes (𝜼2 between 0.062 and 0.143, p < 0.02). A support vector machine (SVM) model based on 10 acoustic features showed a high performance (AUC = 0.93) in differentiating between HCs and patients with MDD, comparable to an SVM based on the BDI-II (AUC = 0.99, p = 0.01). Conclusions This study identified robust speech features associated with MDD. A machine learning model based on speech features yielded similar results to an established pen-and-paper depression assessment. In the future, these findings may shape voice-based biomarkers, enhancing clinical diagnosis and MDD monitoring.

Soaad Hossain, James Rasalingam, Arhum Waheed et al.

With the growing interest in using AI and machine learning (ML) in medicine, there is an increasing number of literature covering the application and ethics of using AI and ML in areas of medicine such as clinical psychiatry. The problem is that there is little literature covering the economic aspects associated with using ML in clinical psychiatry. This study addresses this gap by specifically studying the economic implications of using ML in clinical psychiatry. In this paper, we evaluate the economic implications of using ML in clinical psychiatry through using three problem-oriented case studies, literature on economics, socioeconomic and medical AI, and two types of health economic evaluations. In addition, we provide details on fairness, legal, ethics and other considerations for ML in clinical psychiatry.

Michael Timothy Bennett

Are biological self-organising systems more ``intelligent'' than artificial intelligence (AI)? If so, why? I address this question using a mathematical framework that defines intelligence in terms of adaptability. Systems are modelled as stacks of abstraction layers (\emph{Stack Theory}) and compared by how effectively they delegate agentic control down their stacks. I illustrate this using computational, biological, military, governmental, and economic systems. Contemporary AI typically relies on static, human-engineered stacks whose lower layers are fixed during deployment. Put provocatively, such systems resemble inflexible bureaucracies that adapt only top-down. Biological systems are more intelligent because they delegate adaptation. Formally, I prove a theorem (\emph{The Law of the Stack}) showing that adaptability at higher layers is bottlenecked by adaptability at lower layers. I further show that, under standard viability assumptions, maximising adaptability is equivalent to minimising variational free energy, implying that delegation is necessary for free-energy minimisation. Generalising bioelectric accounts of cancer as isolation from collective informational structures, I analyse cancer-like failure modes in non-biological systems when delegation is inadequate. This yields design principles for building robust systems via delegated control, and reframes hybrid agents (e.g. organoids or human--AI systems) as weak boundary-condition design problems in which constraints shape low-level policy spaces while preserving collective identity.

U. Anyeji, O. Alli-Balogun

Introduction Meningiomas are the most frequent primary brain tumor. Although most Meningiomas are benign, their location in the central nervous system can predict symptomatology which could result in significant morbidity and mortality. However, due to the slow-growing nature, meningiomas are usually asymptomatic, and diagnosis is often made incidentally on neuroimaging or at an autopsy. The incidence rate is 1.2-fold higher in Black Americans than White Americans. Neuropsychiatry manifestation might be only initial presentation; thus, psychiatrists are often the first to see these patients, and the correct diagnosis may be made only when the tumor has grown to a considerable size and begun to displace the brain. Objectives The aim of this study is to understand the biological basis of psychiatry symptoms in patients with Frontal Lobe meningiomas. Methods A review of literature and individual patient data analysis was conducted. The literature review was conducted on PubMed, Medline, MeSH, Google Scholar, and mount Sinai’s levy Library using the key words; meningioma, meningioma with psychiatric symptoms, psychosis, depression, neuropsychiatry manifestation of meningiomas. Results The review revealed that 88% of brain tumors and psychiatric symptoms are located in the frontal region. Meningiomas accounts for 13%-26% of intracranial tumors. There is a reported low incidence due to its slow growing nature and are usually asymptomatic. Incidence of meningiomas is predominant in females, and is attributed to hormonal factors, this is associated with estrogen and progestogen cycles. Reports shows that smoking has been linked to increase risk of meningiomas in men. Frontal lobe meningiomas may present with only psychological symptoms that resemble depression, anxiety states, hypomania and schizophrenia. Personality and mental status changes are also noted in Frontal lobe tumors. Left sided lesions are associated with inhibition of motor activity, impairment in motor and initiative aspect of speech, diminished generalization ability and general inertia of mental process. Conclusions Given the absence of frank neurological symptoms, to help localize the lesion, most meningiomas are missed due to diagnostic overshadowing of the primary psychiatric illness. Peritumoral edema indicates the underlying mechanism and location of the lesion predicts symptomatology. Like our patient who is an 81-year-old male with no past psychiatry history, presenting to our comprehensive psychiatry emergency program with psychiatric manifestation as the initial presentation and subsequently with MRI suggestive of Right Frontal extra-axial meningioma. This study shows that primitive frontal lobe tumors are likely to be misdiagnosed as patients with such tumors are often referred first to psychiatrist. High index of suspicious is needed. Disclosure of Interest None Declared

In-Young Yoon

A. Javanbakht, L. Grasser

Conflict and climate change continue to displace millions of people who experience unique trauma and stressors as they resettle in host countries. Both children and adults who are forcibly displaced, or choose to migrate, experience posttraumatic stress disorder, anxiety, depression, and other mental health conditions at higher rates than the general population. This may be attributed to severe, cumulative stress and trauma (largely interpersonal traumas), discrimination and harassment in host countries, and structural barriers to accessing and addressing mental health concerns, including clinician availability, language barriers, cultural differences, geographic accessibility, health care access, and stigma. Despite high exposure to and clinical impact of such experiences, and despite representing 1% of the world population, forcibly displaced people are underrepresented in neuroscientific research. Availability of such literature and research findings is significant in understanding unique genetic and cultural aspects of trauma and stress-related mental health, advocacy, reducing stigma, informing prevention, and treatment. The present work aimed to explore how the field of neuroscience can address mental health equity for individuals who have been uprooted in relation to land, with a focus on refugee populations. We offer practical suggestions on how to improve research in this area and narrow the gap in knowledge.

R. Joober

In this editorial I use the advances in genetic studies of psychiatric disorders as a fulcrum to propose that there might be limitations on what we can achieve in biological psychiatry research; i.e., an epistemic horizon. I propose that more “digging” in biology might not solve the lack of biological validators of psychiatric disorders; rather we need a change in our conceptual framework of diagnosing and treating mental disorders. I propose that all that is needed to practise psychiatry and advance research in this field is to focus on “surface” phenotypes and their optimal treatment, using all the rich and diversified tools at our disposal. I believe this framework positions psychiatry as the flagship of personalized and precision medicine. Since I started as co-editor in chief of the Journal of Psychiatry and Neuroscience (JPN) in 2010, working with Dr. Patricia Boksa and then Dr. Paul Albert until passing on this responsibility to Dr. Lena Palaniyappan, I have authored or co-authored 14 editorials, and I am grateful to all the editorial board members who reviewed, and often moderated, my views about practice and research in psychiatry. I also thank Dr. Albert for giving me the opportunity to write this “exit” editorial. Using Google Scholar Citations as a metric to evaluate the impact of these editorials, 3 of the 14 stood out, with their number of citations surpassing 3 digits. These are the 3 editorials, by order of citations: 1. Publication bias: What are the challenges and can they be overcome?1 (282 citations since 2012) 2. “Mental illness is like any other medical illness”: a critical examination of the statement and its impact on patient care and society2 (149 citations since 2015) 3. Mental wellness in Canada’s Aboriginal communities: striving toward reconciliation3 (113 citations since 2015) Notably, these 3 editorials addressed major controversies and problems in the field, namely the replicability crisis in behavioural sciences4–6 (and in biomedical sciences in general7), the difficulties our field faces in defining8 and treating9 mental illnesses, and the inequalities in service delivery in our societies and how these inequalities impact people with different ethnicities, genders and sexual orientations, geographical locations, socioeconomic status10–14 and others. In the present editor ial I update my views on the first 2 controversies and show how they may be connected. In addition, many of the 11 other editorials I contributed to JPN discussed some aspects of these 2 controversies. Notwithstanding the importance of the third one, and because of limited space and personal expertise in this field, I am not going to comment on it here. Many commentators in the literature invoke a status of crisis in our discipline — a crisis based mostly on a few observations. First, except for the major psychotropic drugs that were discovered mostly by serendipity, few innovations have come from the billions of dollars spent on academic and pharmaceutical research.15–17 Second, despite thousands of publications in the field of biological psychiatry, not a single biomarker has been validated to help diagnose major mental illness, and our nosology is still based on authoritative approaches more or less guided by the literature.18 Third is the so-called treatment–prevalence paradox; i.e., the persistence of a high prevalence of mental disorders in the general population despite major efforts to reduce that prevalence.19,20 The crisis is reflected in the opening sentences of our grant applications, in the introduction sections of our manuscripts, and in our presentations where we tend to convey the idea that nothing or very little is known about psychiatric disorders and that everything needs to be invented. The student of medicine is often left with the impression that psychiatry is at the stage of development where cardiology was before the

Rajeev Sharma, Ashish Bindra, Kapil Dev Soni

Nasal bridge is a common site suffering personal protective equipment-induced skin damages over face among first-line health care workers in this coronavirus disease 2019 pandemic. We hereby report folliculitis as a complication following regular use of N95 respirator and goggles, unreported in literature till now.

Rumeysa Eda Kanık Tezcan, Özden Yalçınkaya Alkar

Fibromyalgia is a musculoskeletal pain syndrome characterized with the presence of sensitive points and widespread chronic pain and restricts one's daily life activities and decreases the quality of life. The etiology of fibromyalgia is unclear, but there are numerous hypotheses regarding the emergence and progression of the disease. Among these, the biopsychosocial model offers a holistic framework in which biological, psychological and social mechanisms play a role in the development of fibromyalgia. Since the etiology of the disease is not yet understood, effective methods for its treatment have not been found, thus, interventions aim to reduce the effect of fibromyalgia and increase psychological and physiological functionality. This article aims to examine the psyhcological intervention areas and methods for fibromyalgia patients. In the literature, it is concluded that pain avoidance beliefs and behaviors, self-efficacy, physical activity, sleep quality, self-compassion, emotional skills, coping strategies, personality, comorbid psychopathology are the factors related with the emergence of the disease, severity of pain, and adherence to treatment in fibromyalgia patients. In this context, Cognitive-Behavioral Therapy (CBT), physical exercises, sleep management Acceptance and Commitment Therapy (ACT), compassion focused psychotherapies, mindfulness based psychotherapies, emotion expression and emotion regulation techniques, and biofeedback are recommended as effective methods which can be included in the treatment plans of fibromyalgia patients. Moreover, considering the psychosocial factors in the assessment processes was essential to establish individualized treatment plans. In addition, the importance of multidisciplinary approaches in the treatment processes of fibromyalgia has been discussed within the framework of the biopsychosocial model.

Anna-Sophia Wahl, Anna-Sophia Wahl, Adam Q. Bauer et al.

Sharon Jessica Fandy

Parkinson’s disease (PD) is the most common neurological disease globally, only second to Alzheimer’s disease. One of the emerging treatments for PD is nutraceuticals. Grape seed extract (GSE) has a high concentration of polyphenolic compounds possessing antioxidant and neuroprotective capacity that may be valuable for neurodegenerative diseases. So far, there is no review summarizing the neuroprotective effect of GSE on PD, even though it is crucial to provide an insight into GSE as a potential natural treatment for PD. This systematic review aims to summarize the neuroprotective effect of grape seed extract (GSE) in Parkinson’s Disease in vivo and in vitro and their mechanism. The author performed a literature search using PubMed, Science Direct, Scopus, Sinta, and Garuda databases with keywords comprising “Neuroprotective”, “Grape Seed,” and “Parkinson’s disease.” Out of 1611 studies retrieved, 20 articles fit the inclusion criteria and became the basis for this review. The author analyzed and extracted the records regarding the neuroprotective effect and potential anti-PD properties from the studies. The analysis summarized that GSE could significantly improve the biological hallmarks of PD with numerous mechanisms, including antioxidant, anti-inflammation, protection of dopaminergic neurons, anti-amyloid effect, anti-apoptotic, neurogenesis, and synaptogenesis. Although the precise mechanism underlying PD is still elusive, treatment should target not only a single cause of PD but instead several pathways that could lead to the disease. In conclusion, GSE should be considered a potential nutraceutical in clinical trials to prevent and alleviate Parkinson’s disease by multiple mechanisms.

Sisi Shen, Zaiquan Dong, Qi Zhang et al.

Background: Emotional disorder is an important indicator for assessing the quality of life (QOL) of people with epilepsy (PWE). Depression, somatic symptom disorder (SSD) and anxiety are among the most frequently occurring mental disorders and overlap with each other. Objectives: This study examines the overlap of these three emotional disorders and their effects separately and in combination on the QOL of PWE. Design: Cross-sectional study. Data Sources and Methods: Adults attending our epilepsy clinic between 1 July 2020 and 1 May 2022 were consecutively enrolled. They were screened for depression, SSD, and anxiety by structured interviews, and demographic, epilepsy-related and QOL indicators were collected. Multivariate analysis, propensity score matching (PSM) and stratified analysis were used to explore the effects of their respective and combined effects on QOL. Results: Among the 749 patients, 189 patients (25%) were diagnosed with depression, 183 patients (24%) were diagnosed with SSD, and 157 patients (21%) were diagnosed with anxiety. The frequency of occurrence of each emotional disorder together with other emotional disorders was higher than the frequency of occurrence of an emotional disorder alone. Depression, SSD, and anxiety all had an independent effect on QOL of PWE ( p  < 0.001). Depression had the greatest effect, followed by SSD, and then anxiety ( β : multivariate analysis, −11.0 versus –7.8 versus –6.5; PSM, −14.7 versus –9.4 versus –6.8). The QOL of PWE decreased more significantly with the increasing number of comorbid emotional disorders ( β : –12.1 versus –20.7 versus –23.0). Conclusion: It is necessary to screen for three emotional disorders, that is, depression, SSD, and anxiety, in PWE. Attention should be paid to people with multiple comorbid emotional disorders.