Interictal Depression, Anxiety, Personality Traits, and Psychological Dissociation in Patients with Temporal Lobe Epilepsy (TLE) and Extra‐TLE

Abstract

Summary:Purpose: This study was performed to investigate the relation between symptoms of interictal depression, anxiety, personality traits, and psychological dissociation with the localization and lateralization of the epileptogenic zone in patients with partial epilepsy.Methods: All patients were diagnosed according to the localization-related concept of the 1989 International League Against Epilepsy (ILAE) Classification of Epilepsies and Epileptic Syndromes, and the localization and lateralization of the epileptogenic zone was established by using the clinical criteria for noninvasive presurgical evaluation. This resulted in 67 patients with temporal lobe epilepsy (TLE) and 64 patients with extra-TLE. All patients were assessed on the various aspects of psychopathology by using a comprehensive battery of standardized diagnostic instruments. Results:We did not find the hypothesized excess of psychiatric symptoms in patients with (mesial) TLE in comparison with patients with extra-TLE. We also found no differences between patients with the lateralization of epilepsy in the left versus the right hemisphere.Conclusions: TLE per se cannot be considered a risk factor in developing more or more severe symptoms of psychopathology in patients with partial epilepsy. Concomitant factors, such as the duration of epilepsy, seizure frequency, and frontal lobe dysfunction may play an additional role. Our findings support the hypothesis of a multifactorial explanation for the psychiatric symptoms in patients with epilepsy.

Anxiety disorders in people with epilepsy

“…A clear lateralization could not be demonstrated for psychopathology (including anxiety) in epilepsy patients by several studies (Altshuler et al, 1990, Sperli et al, 2009) nor could a clear localization (temporal lobe versus extract temporal lobe epilepsy) be shown (Swinkels et al, 2006).…”

Third International Congress on Epilepsy, Brain, and Mind: Part 2

“…Of course, there are true personality traits that set persons with epilepsy, as a group, apart from the population at large, predominantly DSM-IV Cluster C traits such as Avoidance, Dependency and Obsessive Compulsive Behavior [53]. But at the time that Kraepelin made his observations, even the main (University) hospitals were largely staffed with religiously motivated nurses, and all the institutions, actually rather asylums, that were founded at the end of the 19th century or early 20th century, and which followed the example of Friedrich von Bodelschwing d.Ä (1831-1919) in Bielefeld with the specific purpose to take care of the "epileptics" and other derelict subjects, were run by religious organizations.…”

Neurobiological Factors Linking Personality Traits and Major Depression

“…In contrast, however, there is little evidence that patients with temporal lobe epilepsy have greater levels of psychiatric symptoms or personality dysregulation, despite anecdotal evidence for a behavioural phenotype associated with temporal lobe seizures. 64 Another region implicated in MDD is the ACC (see Caetano 65 ), a region that is crucial for emotional processing and the integration of emotional, cognitive, and physiological stimuli. 66 An interesting and novel study recently suggested that personality traits and the ACC may be related by studying iris characteristics and their relation to scores on the NEO Personality Inventory.…”