Memory complaints in epilepsy: correlations with cognitive performance and neuroticism

Subjective memory functioning was assessed by a questionnaire in 102 patients with epilepsy. Factor analysis of their responses yielded five factors: (1) Absentmindedness, (2) Retrieval, (3) Memory for Semantic Structures, (4) Childhood Memories and (5) Rote Memory. Scales representing the factors were constructed. On all scales, patients (n = 71) who had been specifically referred for an evaluation of subjective memory problems showed moderate to large differences from normal Controls (n = 111) in complaint scores, indicating adequate sensitivity of the scales to clinically significant complaint levels. By contrast, candidates for epilepsy surgery (n = 31) resembled the Controls in their perceived memory status, showing a moderately elevated complaint level on only one of the factor based scales. Relationships of subjective memory difficulties to performance on objective tests of memory and other relevant cognitive functions as well as neuroticism were examined. The two epilepsy groups were fairly similar in their test performance, but differed markedly in their subjective memory problems. Also, correlational analysis revealed only a single weak correlation between cognitive tests and subjective memory ratings. The present findings indicate that there is no simple relationship between subjective evaluations of memory and test performance. Patients' memory complaints do not accurately predict disturbances that can be measured on standard neuropsychological tests. Such complaints may be related more to neuroticism. Also, psychosocial difficulties which may accompany chronic disorders in general may have to be invoked to account for memory complaints in people with epilepsy. The epilepsy itself does not appear to be a critical factor in producing memory complaints.