Psychopathological studies on the so-called epileptic personality change

Abstract

Psychopathological abnormalities have at all times contributed to a uniform concept of epilepsy. However, frequency, conditions, structure and specificity of epileptic personality change have been regarded in very different ways. 140 chronic epileptic patients were all assessed by indirect anamnesis, by psychiatrists and by psychological tests. The findings were correlated with neurological criteria, such as type, severity and conditions of attacks or fits. Whereas 74% of the patients showed psychological changes, 21% appeared severely disturbed, and in 53% changes in some personality traits could be found. There were positive correlations with the severity, with the psychomotoric and generalised diffuse type of fits. Neither the often-described epileptic, nor the likewise previously observed pseudopsychopathic type, but rather a mixture of both, determined the psychopathological picture, which was characterised by increased irritability, hidden aggressiveness, good orderliness, good general mood, good ability to make contacts, a positive self-image, and, furthermore, by a tendency towards a certain rigidity and inflexibility of thought as well as memory and concentration malfunctions. Persistent inhibition of impulse could not be demonstrated; one-third of the patients showed instability of emotion. The severity or chronic nature of the fits corresponded to an epileptic-low impulse pattern of behaviour, possibly depending on the amount of cortical damage. In patients with minor fits, the element of suggestibility was more predominant. Hence, specific psychosyndromes of nocturnal or rising fits could not be proved. In general, the findings did not differ from the common picture of an organic psychosyndrome.