Étude des tempéraments affectifs chez des patients épileptiques en Tunisie

Abstract

PurposeEpilepsy is a chronic neurological disorder that is associated with an increased risk for psychopathology. Depression is the most common comorbid psychiatric condition in epilepsy, with often atypical clinical manifestations, including symptoms of irritability and anxiety. Temperament refers to biologically based characteristic patterns of emotional reactivity and self-regulation. In early studies, specific temperamental factors have been shown to be risk factors for depression symptoms in adult epilepsy patients. Thus, determining the affective temperament profile of epilepsy patients has important clinical implications especially in identifying those patients most at risk of developing mood disorders. However, very few studies of temperament in epilepsy patients have yet been published. The purpose of this study was to measure depression symptoms and severity, and to assess temperament in adult epilepsy patients, in comparison with control subjects; and to evaluate among the group of epilepsy patients the relationships between affective temperament types, sociodemographic profiles, clinical characteristics, and symptoms of depression. MethodParticipants were recruited from the Neurology Outpatient Department of National Institute of Neurology in Tunis, Tunisia. The study sample comprised 53 epilepsy outpatients (males=33, females=20) over the age of 16years with a confident diagnosis of epilepsy. Matched controls (based on sex and age) included 52 healthy individuals. The Hamilton Rating Scale for Depression (HRSD) and the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A) was used in their Arabic versions to measure depression and temperament respectively. The questionnaires were administered individually. Data were analyzed using SPSS software, version 18. ResultsFindings indicated that patients with epilepsy had higher scores on depression and temperament scales than healthy controls. With respect to temperaments, hyperthymic temperament had the highest score in patients and controls, followed by anxious, cyclothymic, and depressive temperaments. Irritable temperament had the lowest average score. No significant associations were found between sociodemographic profile, illness characteristics and temperament scores in patients with epilepsy. An extremely strong association was found between depressive, cyclothymic, irritable and anxious temperament scores and the HRSD scale among epilepsy patients. These findings confirm literature data about affective temperament profile in epilepsy patients that put them at greater risk for mood disorders. ConclusionResults underscore the importance of assessment of affective temperaments among epilepsy patients, which could play a key role in defining the sub-group at high risk for developing mood disorders and improving, consequently, diagnostic and therapeutic approaches to patients suffering from both epilepsy and depression. More extended studies may help validate the concepts of profile temperaments in epilepsy and their relation to depressive vulnerability.