Social and psychological aspects of aggression in epilepsy

Even though our studies concentrated on research into the neurobiological basis of aggressive behaviour in patients with epilepsy, there is no question about the critical role of social and psychological intervening variables for the development of aggressive behaviour in general, be it in the context of epilepsy or not. Social disadvantage, prejudice, poor housing, poverty, poor communication skills, all are factors that make hyperarousal states and states of discontentment and anger more likely and thus might increase the probability of aggressive behaviour. On the other hand a precise and correct diagnosis always is the first step in managing difficult behaviour, and sociological, psychological and neurobiological views of the same problem are not necessarily contradictory.

For example, we were able to demonstrate a close link between episodic dyscon-trol, reduced IQ, depression and anxiety. Even though disentangling the complex interaction between these different psychobiological elements is very difficult, it nevertheless may suggest a possible way of treatment, irrespective of which of these elements is the most important one from an aetiological point of view.

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