Brain with flowers and thorns, symbolizing epilepsy and mood disorders

Beyond the Blues: Understanding and Addressing Interictal Dysphoric Disorder (IDD) in Epilepsy

Lena Voss in Health & Wellness December 2025 • 4 min read.

"A translated and culturally adapted inventory offers new hope for identifying and managing mood disturbances in epilepsy patients."

Living with epilepsy involves more than just managing seizures; many individuals experience significant mood and behavioral changes. The complex relationship between epilepsy and psychiatric disorders is increasingly recognized, highlighting the need for better understanding and treatment strategies.

One such challenge is Interictal Dysphoric Disorder (IDD), a condition characterized by intermittent emotional and physical symptoms that occur between seizures. These symptoms, which can include depression, irritability, anxiety, and atypical pain, often fall outside the diagnostic criteria for standard mood disorders, making IDD difficult to identify and treat.

To address this gap, researchers have developed the Interictal Dysphoric Disorder Inventory (IDDI), a tool specifically designed to screen for IDD in epilepsy patients. A team in Brazil has translated and culturally adapted the IDDI, making it more accessible for Portuguese-speaking populations. This article explores the significance of this adaptation and how it can improve the lives of individuals with epilepsy.

What is Interictal Dysphoric Disorder (IDD)?

Brain with flowers and thorns, symbolizing epilepsy and mood disorders

Interictal Dysphoric Disorder (IDD) is a neuropsychiatric condition recognized in individuals with epilepsy, distinct from typical mood disorders. It is marked by a constellation of symptoms that occur in the time between seizures (the interictal period). These symptoms, while disruptive, often don't meet the strict diagnostic criteria for disorders like major depression or generalized anxiety, making IDD a unique challenge.

Symptoms are divided into three dimensions:

Depressive Symptoms: Characterized by low mood, lack of energy (anergia), physical pain, and insomnia.
Affective Symptoms: Primarily involve feelings of anxiety and fear/panic.
Specific Symptoms: Include paroxysmal irritability and episodes of elevated mood (euphoria).

Diagnosis of IDD requires the presence of at least three of these symptoms causing notable disruption to daily life and function. The IDDI helps clinicians evaluate these factors systematically.

The Future is Brighter: How the IDDI Can Help

The translation and cultural adaptation of the IDDI for the Brazilian population represents a significant step forward in addressing the often-overlooked mental health challenges faced by individuals with epilepsy. By providing a culturally relevant and easily administered tool, this research empowers clinicians to more effectively identify and manage IDD.

This can lead to better treatment strategies, improved quality of life, and a greater sense of well-being for those living with epilepsy. Further validation of the IDDI's psychometric properties will solidify its utility in clinical practice and research settings.

Ultimately, by recognizing and addressing the emotional and behavioral complexities of epilepsy, we can provide more holistic and effective care for those affected, helping them to live fuller, more meaningful lives.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1590/s1676-26492010000400007, Alternate LINK

Title: Tradução E Adaptação Transcultural Do Interictal Dysphoric Disorder Inventory (Iddi) Para O Brasil

Subject: Physiology (medical)

Journal: Journal of Epilepsy and Clinical Neurophysiology

Publisher: FapUNIFESP (SciELO)

Authors: Gerardo Maria De Araujo Filho, Guilherme Nogueira M. De Oliveira, Carlos Henrique Oliva, Lenon Mazetto, Arthur M. Kummer, Neide Barreira Alonso, Antônio Lucio Teixeira, Elza Marcia Targas Yacubian

Published: 2010-01-01

Everything You Need To Know

What exactly is Interictal Dysphoric Disorder (IDD)?

Interictal Dysphoric Disorder (IDD) is a neuropsychiatric condition found in people with epilepsy. It involves mood and behavioral symptoms that happen in between seizures, not during them. These symptoms are varied and can include depression, anxiety, irritability, and even physical pain. It's different from other mood disorders because it often doesn't fit their specific diagnostic criteria, making it a unique challenge to identify and treat.

What is the Interictal Dysphoric Disorder Inventory (IDDI) and what does it do?

The Interictal Dysphoric Disorder Inventory (IDDI) is a tool designed to help identify IDD in people with epilepsy. This inventory helps clinicians screen for the presence of IDD symptoms. It is a key step because IDD symptoms can often be overlooked or mistaken for other mood disorders, making it hard to get the right treatment. The IDDI gives clinicians a structured way to assess the presence and impact of IDD symptoms, leading to more accurate diagnoses and more effective care.

What are the main symptoms of Interictal Dysphoric Disorder (IDD)?

The symptoms of Interictal Dysphoric Disorder (IDD) are divided into three main areas. The first is depressive symptoms, which include low mood, a lack of energy, physical pain, and trouble sleeping. The second is affective symptoms, primarily involving feelings of anxiety, and sometimes fear or panic. The third is specific symptoms, such as irritability that comes and goes, and occasionally, periods of elevated mood, also known as euphoria. A diagnosis of IDD requires experiencing at least three of these symptoms, which must significantly disrupt daily life.

Why is the Interictal Dysphoric Disorder Inventory (IDDI) so important?

The Interictal Dysphoric Disorder Inventory (IDDI) is important because it enables earlier and more accurate identification of IDD in individuals with epilepsy. Early identification is crucial because it allows for timely intervention and management of the symptoms. Without a tool like the IDDI, symptoms of IDD may be misdiagnosed or untreated, negatively affecting a person's quality of life. The use of the IDDI helps to bridge this gap by providing a way to systematically assess and address the mental health needs of people with epilepsy.

Why is it important to have a culturally adapted Interictal Dysphoric Disorder Inventory (IDDI)?

The translation and cultural adaptation of the Interictal Dysphoric Disorder Inventory (IDDI) for specific populations, like the Brazilian Portuguese-speaking community, is vital for making sure the tool is accessible and useful. Cultural adaptation considers language, cultural nuances, and healthcare practices to ensure the questions and scoring are understood and correctly interpreted. This ensures that clinicians in these communities can effectively use the IDDI to accurately identify IDD, leading to improved diagnoses and better management of the condition for a wider range of individuals.