title: Different attachment styles correlate with mood disorders in adults with epilepsy or migraine.
abstract: OBJECTIVE
  Interpersonal relationships are viewed as important contexts within which psychopathology emerges and persists or desists. Attachment theory describes the dynamics of long-term relationships between humans especially in families and lifelong friendships. The present study was aimed at investigating attachment styles in adult patients with epilepsy as compared to subjects with migraine and their potential correlates with a history of mood disorders.
  
  
  METHODS
  A consecutive sample of 219 adult outpatients with epilepsy (117) or migraine (102) was assessed with the Attachment Style Questionnaire (ASQ).
  
  
  RESULTS
  Patients with epilepsy and a lifetime history of mood disorders presented elevated scores for Need for approval (p<0.001) and Preoccupation with relationships (p<0.001). Age correlated with the Relationships as secondary (r=0.322; p<0.001) and Need for approval (r=0.217; p=0.019) subscales while age at onset correlated only with Relationships as secondary (r=0.225; p=0.015). Seizure-free patients presented lower scores for Need for approval (p=0.003). Patients with migraine and a lifetime history of mood disorders presented lower scores in Confidence (p=0.002) and higher scores in Discomfort with closeness (p=0.026).
  
  
  CONCLUSIONS
  An anxious-preoccupied attachment correlated with mood disorders in epilepsy while it was an avoidant pattern in migraine. Our results bring further data on the role of psychological variables in mood disorders in epilepsy. Further studies will allow early identification of patients at risk and the development of preventive strategies.
authors.affiliation: Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals NHS Foundation Trust, London, UK; Institute of Medical and Biomedical Sciences, St. George's University of London, UK. Electronic address: mmula@sgul.ac.uk.
authors.forename: Marco
authors.initials: M
authors.lastname: Mula
authors.affiliation: Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals NHS Foundation Trust, London, UK.
authors.forename: Davies
authors.initials: D
authors.lastname: Danquah-Boateng
authors.affiliation: Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals NHS Foundation Trust, London, UK; Institute of Medical and Biomedical Sciences, St. George's University of London, UK.
authors.forename: Hannah R
authors.initials: HR
authors.lastname: Cock
authors.affiliation: Institute of Medical and Biomedical Sciences, St. George's University of London, UK; Headache Group, Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals NHS Foundation Trust, London, UK.
authors.forename: Usman
authors.initials: U
authors.lastname: Khan
authors.affiliation: Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals NHS Foundation Trust, London, UK; Institute of Medical and Biomedical Sciences, St. George's University of London, UK.
authors.forename: Dora A
authors.initials: DA
authors.lastname: Lozsadi
authors.affiliation: Institute of Medical and Biomedical Sciences, St. George's University of London, UK; Headache Group, Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals NHS Foundation Trust, London, UK.
authors.forename: Niranjanan
authors.initials: N
authors.lastname: Nirmalananthan
mesh_terms: D000328:Adult; D015897:Comorbidity; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D009769:Object Attachment; D011795:Surveys and Questionnaires
keywords: Attachment; Comorbidity; Depression; Epilepsy; Migraine; Personality