Behavioural adjustment in seizure-free epilepsy patients on monotherapy.
OBJECTIVE
Risk of depression, anxiety, and reduced quality of life is elevated in epilepsy patients, due to a range of factors including aetiology, structural brain lesions, seizure worry, epilepsy surgery, hereditary factors, psychosocial factors, and possible adverse effects of antiepileptic drugs (AEDs). Studies on the relationships between epilepsy-related variables and behavioural adjustment have been mainly conducted on patients with persisting seizures, whereas the present study investigated behavioural function in epilepsy patients seizure-free for more than 2 years on monotherapy.


METHODS
Adults with epilepsy on AED monotherapy and without epileptic seizures for at least 2 years (n=126) were assessed with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), in addition to MRI and EEG.


RESULTS
Group analysis found mean MMPI-2 scores on all the clinical and content scales to be within the normal range. Abnormally elevated scores on scales measuring aspects of depression, health-related concerns, low self-esteem, negative treatment indicators, and physical complaints were recorded in a higher proportion of patients than would normally be expected. Multiple regression analysis showed that MRI pathology was a significant predictor for an abnormally poor score on the low self-esteem scale, and that epilepsy onset <or=18 years was a significant predictor of abnormally poor score on the work interference scale.


CONCLUSIONS
Although most seizure-free epilepsy patients show normal behavioural adjustment, a higher proportion than expected obtained scores suggesting depression, low self-esteem, and health-related concerns. Both neurobiological and psychosocial factors may explain different aspects of problems with behavioural adjustment.
Hessen
Erik
E
Department of Neurology, Akershus University Hospital, Oslo, Norway. erik.hessen@nevropsykologi.no
Lossius
Morten I
MI
Gjerstad
Leif
L
D000223:Adaptation, Psychological / Q000187:drug effects* / Q000502:physiology; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008950:MMPI / Q000706:statistics & numerical data; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D016896:Treatment Outcome
D000927:Anticonvulsants