Abstracts

RATIONALE: Specific personality traits have been associated with Juvenile Myoclonic Epilepsy (JME), such as emotional lability, immaturity, poor social adjustment, denial, and non-compliance with therapy. However this pattern could be a reflection of an underlying affective disorder and not an inherent personality pattern. We examined prospectively the degree of depression and anxiety in JME versus a matched group of Grand Mal on Awakening (GMA) patients. METHODS: 16 JME and 20 GMA patients completed the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the SOS questionaire on quality of life. Patient groups didn't differ in regards to age, years of education, gender, age of seizure onset, and seizure control. AEDs in the JME group were limited to valproate or lamotrigine; a wider spectrum of AEDs was used in GMA. RESULTS: Data showed a consistent pattern of greater psychopathology in the JME group. JME patients endorse significantly higher levels of depression. BDI-II mean score for JME was 14.5 (mild to moderate range) vs. 5.1 (normal) for the GMA group (p<0.0001). Similar findings emerged when comparing the degree of anxiety. BAI mean score for JME was 11.4 (mild) vs. 4.1 (normal) for the GMA group (p<0.002). Quality of life scores per SOS were slightly higher in the GMA group (51.8 vs 47.6, p<0.02 borderline significance following Bonferroni correction) CONCLUSIONS: "Personality traits" in JME could be a manifestation of a mild to moderate depression. It is unlikely to be reactive in nature given that both groups have similar seizure control. Although AEDs may be playing a role, valproate and lamotrigine have positive psychotropic effects in mood modulation. Our data corroborates the clinical observation of lack of insight and denial in JME patients, given the disproportionate elevated depression-anxiety scores compared with quality of life results. These findings have implications in the management of affective and conduct disorders in JME.