Interictal mood and personality disorders in temporal lobe epilepsy and juvenile myoclonic epilepsy

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 61; no. 6; pp. 601 - 605
• Main Authors: Perini, G I, Tosin, C, Carraro, C, Bernasconi, G, Canevini, M P, Canger, R, Pellegrini, A, Testa, G
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01-12-1996; BMJ; BMJ Publishing Group LTD
• Subjects: Adult; Affective Disorders, Psychotic - physiopathology; Biological and medical sciences; Electroencephalography; Epilepsies, Myoclonic - physiopathology; Epilepsy, Temporal Lobe - physiopathology; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Personality Disorders - physiopathology; Human; Mood disorder; Nervous system diseases; Complex partial epilepsy; Interictus; Progressive myoclonus epilepsy; Epidemiology; Personality disorder; Cerebral disorder; Symptomatology; Central nervous system disease; Temporal lobe epilepsy; Degenerative disease; Psychopathology; Comparative study
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.61.6.601

BACKGROUND: Mood disorders have been described as the commonest psychiatric disorders in patients with temporal lobe epilepsy. Secondary depression in temporal lobe epilepsy could be interpreted either as an adjustment reaction to a chronic disease or as a limbic dysfunction. To clarify this issue, a controlled study of psychiatric disorders was conducted in different forms of epileptic and non-epileptic chronic conditions. METHODS: Twenty outpatients with temporal lobe epilepsy, 18 outpatients with juvenile myoclonic epilepsy--a primary generalised seizure disorder--20 matched type I diabetic patients, and 20 matched normal controls were assessed by a structured interview (SADS) and by self rating scales (Beck depression inventory (BDI) and the state and trait anxiety scales STAIX1 and STAIX2). RESULTS: Sixteen (80%) patients with temporal lobe epilepsy fulfilled the criteria for a psychiatric diagnosis at the SADS interview with a significantly higher frequency than patients with juvenile myoclonic epilepsy (22%) and diabetic patients (10%) (P < 0.0001). The most frequent disorder in temporal lobe epilepsy was a mood disorder: 11 (55%) patients with temporal lobe epilepsy had depression compared with three patients with juvenile myoclonic epilepsy and two diabetic patients (P < 0.001). Eight patients with temporal lobe epilepsy with an affective disorder also had a comorbid personality or anxiety disorder. Patients with temporal lobe epilepsy scored significantly higher on BDI, STAIX1, and STAIX2 than the three control groups (P < 0.001, P < 0.01, P < 0.001). CONCLUSIONS: Patients with temporal lobe epilepsy have a higher incidence of affective and personality disorders, often in comorbidity, than patients with juvenile myoclonic epilepsy and diabetic patients suggesting that these psychiatric disorders are not an adjustment reaction to a chronic disease but rather reflect a limbic dysfunction.