Study of Psychopathology in Patients with Chronic Non-Lesional Epilepsy: A Minnesota Multiphasic Personality Inventory Profile Controlled Study

Abstract

Objective: Psychiatric morbidity and psychopathology have been widely assessed in patients with epilepsy. However, the issue of whether people with epilepsy are at increased risk for psychopathology remains highly controversial. These disorders are not evaluated in a systematic manner in patients with non-lesional epilepsy, so they could be underestimated. The objective is to evaluate personality disorders in patients with non-lesional epilepsy. Methods: In this study, we investigated the presence of personality disorders in 63 patients with chronic non-lesional (idiopathic and cryptogenic) epilepsy and in 40 unrelated and randomly selected controls by means of Minnesota Multiphasic Personality Inventory (MMPI) and DSM-IV criteria for the different personality disorders. Results: The overall scores were significantly higher in the patients in the subscales of schizophrenia, depression, hysteria, mania, paranoia, psychasthenia and psychopathic deviate. However, the differences in the proportion of patients with clinically significant scores occurred only for schizophrenia (57 vs. 20%), depression (55 vs. 15%), psychasthenia (28 vs. 10%) and paranoia (14 vs. 0%). According to DSM-IV criteria, only 11 patients met the criteria of schizotypal personality. We found excellent concordance for paranoid personality and depression between the two instruments of diagnosis. However, we did not find cases with either antisocial or avoidant personality. We also found a significant link between poor control of epilepsy and high scores in both paranoia and psychopathic deviate. Conclusions: In comparison with the DSM-IV criteria for such personality disorders, the MMPI was oversensitive in detecting schizotypal features. However, the MMPI correctly classified the remaining personality disorders, especially depression and paranoid personality. On the basis of these results, we conclude that psychopathology is overrepresented in patients with chronic non-lesional epilepsy and that, in determined variables, this is due to the severity of the condition rather than to the type and duration of epilepsy. The approach to patients with chronic epilepsy should include neurobehavioural scales.

Behavioural adjustment in seizure-free epilepsy patients on monotherapy

“…Dikmen et al 25 however, found that MMPI is sensitive to behavioural abnormalities in patients with different seizure categories. A study by Modrego et al 26 also supports the validity of MMPI for detection of abnormal behaviour in patients with chronic non-lesional epilepsy. Compared with the Diagnostic and Statistical Manual of Mental Disorders-Version Four (DSM-IV) criteria, the MMPI correctly identified personality disorders, especially depression and paranoid personality.…”

Focal epilepsies in adult patients attending two epilepsy centers: Classification of drug‐resistance, assessment of risk factors, and usefulness of “new” antiepileptic drugs

“…Among the “probably symptomatic” subjects, the positive relationship between AED resistance and psychiatric pathologies can be interpreted as a reactive condition in patients whose seizures are constraining in the absence of any significant neurologic or cognitive defects (Beghi et al., 2002; Modrego et al., 2002).…”

Disease duration and arcuate fasciculus abnormalities correlate with psychoticism in patients with epilepsy

“…5 Modergo et al noticed a high prevalence of schizophrenia traits (57%) compared to other personality changes in non-lesional epilepsy patients. 6 The schizophrenia traits, paranoid disorder and aggressive behavior lead to many psychosocial problems, such as social maladjustment, poor self-esteem, depressive feelings, reduced attention control, impaired cognitive function and difficulties in reversal learning, [7][8][9] which significantly compromise patients' quality of life.…”