Study of psychopathology in patients with chronic non-lesional epilepsy: a Minnesota multiphasic personality...

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.

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.

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.

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.