CLINICAL AND PSYCHOLOGICAL ASPECTS OF DRUG-RESISTANT EPILEPSY

Abstract

Drug-resistant epilepsy is determined by both clinical and subjective factors that are realized through psychological, behavioral and social mechanisms leading to low compliance, behaviors that help maintain a certain frequency of seizures, deformation of the motivational and emotional spheres of patients. The purpose of the study is to analyze the clinical, psychological characteristics of patients with drug-resistant epilepsy, to identify significant correlations between clinical and psychometric characteristics in patients with different course of epilepsy. The study included 60 patients diagnosed with epilepsy, divided into 2 groups: 30 patients with drug-resistant epilepsy and 30 patients with seizure remission. Patients underwent psychometric tests. Statistical differences were assessed using non-parametric statistics, Spearman's coefficient was used for correlation analysis, data at p < 0.05 were considered reliable. Clinical predictors of drug-resistant epilepsy were consistent with those described earlier in the literature: early onset of seizures, long duration of the disease and frequency of seizures, the prevalence of focal seizures, symptomatic structural variant of epilepsy. Negative correlations have been found between seizure frequency and levels of neuroticism and self-destructive behavior. Thus, high anxiety caused a more responsible attitude of patients to the treatment process, increasing their compliance. In patients with drug-resistant epilepsy, negative personality characteristics correlated with insufficiency of the inhibition process. The influence of neuroticism, alexithymia extended to a greater number of personality traits and behavior, indicating their systemic impact on the behavior of patients. The construction of models of behavior in conflict by patients with drug-resistant epilepsy reflected a tendency to compensate for personality traits through ineffective avoidance behavior, to demonstrate a lack of flexibility. Drug-resistant epilepsy is an important medical and social problem. The relationship of the disease with psychological and behavioral characteristics is close and complex, so such patients need clinical and psychological support to optimize the treatment process.