title: Awareness, overestimation, and underestimation of cognitive functions in epilepsy.
abstract: This study estimated cognitive awareness and the predictors of self-rating in patients with epilepsy (PWE). The Multiple Ability Self-Report Questionnaire (MASQ), State-Trait Anxiety Inventory, and Beck Depression Inventory were used for self-evaluation. Neuropsychological assessment yielded five single-domain scores (Long-Term Memory, Mental Speed, Working Memory, Set Shifting, and Visuospatial Matching) and a total composite score. Awareness was computed as the concordance between the neuropsychological and MASQ scores. In 37 patients with full awareness, self-ratings were predicted by Long-Term Memory, Working Memory, and Mental Speed. In 58 patients with incomplete or no awareness, self-ratings related to depression and seizure frequency. Compared with overestimation, underestimation was associated with higher test scores, better education, and younger age. Brain lesion and the type of epilepsy showed no effect. Therefore, PWE may appear unaware of their cognitive abilities due to negative affect and clinical burden. Understanding patients' awareness of their cognitive deficits can help clarify the clinical pattern provoked by epilepsy, as well as patients' compliance with treatment for seizures or cognitive difficulties.
authors.affiliation: Laboratory of Cognitive Neurology and Rehabilitation, Neurology and Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milano, Italy. r.giovagnoli@istituto-besta.it
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Giovagnoli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D001364:Awareness; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D004827:Epilepsy / Q000150:complications* / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012647:Self-Assessment; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D055815:Young Adult