Abstracts

Rationale: There is growing evidence on the occurrence of poor psychosocial adjustment in patients with JME. In an earlier study (Moschetta & Valente 2013), we performed a formal assessment of social adjustment (SA) using a validated instrument developed and standardized for this purpose in patients with JME. Patients with JME had worse social adjustment in two relevant aspects: work and familiar relationship. In this series of patients with JME, higher seizure frequency and impulsive traits, but not cognitive performance, were correlated with worse social adjustment. However, the relevance of mood disorders was neglected. We aimed to verify which aspects of social adjustment are impaired by depressive symptoms and anxiety traits. Methods: We prospectively evaluated 50 patients with an unequivocal diagnosis of JME and 44 controls. Social Adjustment was evaluated by The Self-Report Social Adjustment Scale (SAS) that evaluated performance in: work; social and leisure activities; relationship with extended family; marital role; parental role; membership in the family unit; and economic adequacy. Patients had a formal psychiatric interview using SCID. Depressive symptoms were assessed using Beck Depression Inventory (BDI) Current level of anxiety was assessed using State-Trait Anxiety Inventory (STAI). The impact of epilepsy-related variables (age of onset, duration, seizure frequency and type) as well as patients-related factors (gender and age) on SAS was analyzed. Results: Patients with JME had worse score on Global SAS than controls (p = 0.001), especially on Work (p = 0.032) and Extended Family (p = 0.005). Considering patient's factors, age had an impact the subdomain work. Patients with JME scored significantly higher on depression (P=0.001), state anxiety (P=0.007), and trait anxiety (P=0.001) scales. Higher scores on depression inventory were correlated with worse scores on Work (p= 0.01). Higher scores on state and trait anxiety scale were not correlated with any aspects of Social Adjustment Scale. Higher seizure frequency - myoclonic (p=0.005) and GTC (p=0.035) - were correlated with higher scores on factor Work of SAS. Conclusions: Patients with JME have worse social adjustment, especially those with inadequate seizure control. Higher scores on depressive symptoms predicted worse social functioning. As already documented in patients with refractory epilepsy, depression leads to maladaptive behaviors and predicts greater difficulty in distinct areas of social functioning.