Abstracts

RATIONALE: This research identifies distinctions between the personality structure and psychosocial adjustment profile of psychogenic seizure patients, left temporal epilepsy patients and right temporal epilepsy patients.
METHODS: We evaluated differences in personality organization and psychosocial adjustment in psychogenic seizure (PS) (N=10), left temporal lobe (LTL) (N=14) and right temporal lobe (RTL) (N=17) seizure patients, utilizing the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Washington Psychosocial Seizure Inventory (WPSI). MMPI-2 high point pairs were identified from standard scores (T-scores). Correlations between MMPI-2 mean sub-scale findings and WPSI mean sub-scale findings were determined by Spearman 2-tailed tests.
RESULTS: PS and LTL groups were found to exhibit distinct MMPI-2 high point pairs (Hypochondriasis-Hysteria and Schizophrenia-Depression) (T: 72.8-70.9 and 66.7-66.6, respectively) with no MMPI-2 mean elevations found for the RTL patient group. Significant correlations between personality traits and adjustment issues were distinct between groups, and minimal for the PS group (Hypochondriasis-Adjustment to Seizures, p[lt].035; Social Introversion-Financial Status, p[lt].049). RTL findings included four distinct correlations constellated around emotional adjustment, while LTL findings included 19 significant correlations across a broad spectrum.
CONCLUSIONS: PS represent the most frequent nonepileptic condition evaluated in epilepsy centers, constitutung approximately 20 percent of referrals (Benbadis et al., 1996). The diagnosis rests primarily on prolonged EEG-video monitoring. In compartive analysis of PS and organic seizure patients, most studies exclude patients with TL abnormalities, due to associated psychological aberrations (Stewart, et al., 1982). However, surgical settings have a particular interest in distinguishing PS from TLE patients. Our findings suggest that PS patients may be distinguished from TLE patients by the unique associations between their personality traits and issues of psychosocial adjustment. Future directions involve participation of our PS patients in a course of dialectic behavioral therapy, considered an efficacious therapeutic approach for psychiatric patients suffering from disorders of personality.
Benbadis, S., Lancman, M., King, L., and Swanson, S. Preictal pseudosleep: A new finding in psychogenic seizures. Neurology, 47, 63-67, 1996.
Stewart, R., Lovitt, R., and Stewart, M. Are hysterical seizures more than hysteria? A research diagnostic criteria, DSM-III, and psychometric analysis. Am J Psychiatry, 139: 7, July, 1982.