Subjective memory complaints in adults with epilepsy reflect affective and attentional processes rather than...

Memory complaints are common in individuals with epilepsy and often occur despite preserved performance on standard neuropsychological tests, indicating that subjective memory complaints (SMCs) may be influenced by cognitive and affective factors beyond objective memory impairment. We examined the associations between subjective memory appraisal, defined as patients' self-evaluative judgment of their memory function, and psychiatric, neurodevelopmental, and clinical variables, to identify factors linked to low subjective memory evaluation, a construct conceptually related to SMCs.

Subjective memory was assessed in 184 adults with epilepsy using a self-report questionnaire to evaluate overall quality of life, global memory function and common memory experiences. The items were rated on an 11-point Likert scale (0-10). Associations between subjective ratings and objective neuropsychological performance, psychiatric measures, neurodevelopmental traits, and clinical variables were examined.

Exploratory factor analysis identified a single dominant factor accounting for 53.5 % of the variance, reflecting the global subjective memory appraisal (GSMA). GSMA showed a moderate negative correlation with depressive symptoms (Beck Depression Inventory-II [BDI-II]: r =  - 0.412, p < 0.001) and was associated with attention-deficit/hyperactivity disorder (ADHD)-related traits, particularly inattention (Conners' Adult ADHD Rating Scale [CAARS-A]: r =  - 0.536, p < 0.001). Associations with objective memory performance were weak. The core epilepsy-related variables showed little or no association with subjective memory perception.

SMCs in epilepsy appear more closely tied to affective and attentional processes than to objective memory impairment or epilepsy severity. Incorporation of psychiatric and neurodevelopmental perspectives into clinical assessment may improve evaluation and management.