The COVID-19 pandemic poses practical and ethical challenges that put the medical community through their paces daily. Under these circumstances, Kuroda and colleagues  remind us of a critical aspect, the mental health burden for people with epilepsy (PwE). In their letter (classed as purple in the EAN rainbow classification scheme), they outline reasons for mental stress that PWE may already bear and examine possible additional stressors stemming from the pandemic. Such factors include anxiety about COVID-19, refraining from usual activities, the impact of COVID-19 on epilepsy management, economic insecurity, and caregiver stress.
Hao et al.  (blue classification) report that the severity of psychological distress among PWE during the pandemic is comparable to evacuees from the Fukushima Daichii nuclear power plant accident. Increased time spent paying attention to COVID-19 and a diagnosis of drug-resistant epilepsy constitute independent predictors for severe psychological distress.
Aledo-Serrano et al.  (blue classification) sought the perspective of people who care for individuals with genetic developmental and epileptic encephalopathies. They describe an increase in seizure frequency associated with age, as well as difficulties with access to antiseizure medication. Behavioural deterioration was associated with type of epilepsy, living in a home without outside space and caregiver anxiety.
The COVID-19 pandemic requires that we pay particular attention to the mental well-being of our patients and their caregivers.
• The COVID-19 pandemic carries additional risks of severe mental stress for people with epilepsy (PwE).
• Time spent paying attention to COVID-19 and a diagnosis of drug-resistant epilepsy are independent predictors for psychological distress.
• The mental well-being of caregivers may have direct effects on the seizure control and behaviour of individuals with genetic developmental and epileptic encephalopathies
Kuroda, N. (2020) ‘Mental health considerations for patients with epilepsy during COVID-19 crisis’, Epilepsy and Behavior, 111. doi: 10.1016/j.yebeh.2020.107198.
Hao, X. et al. (2020) ‘Severe psychological distress among patients with epilepsy during the COVID-19 outbreak in southwest China.’, Epilepsia. doi: 10.1111/epi.16544.
Aledo-Serrano, Á. et al. (2020) ‘Genetic epilepsies and COVID-19 pandemic: Lessons from the caregiver perspective.’, Epilepsia. 61(6), pp. 1312–1314. doi: 10.1111/epi.16537.