Comparison of neurological and psychiatric profiles of people with epilepsy based on the presence and timing of potentially psychologically traumatic experiences.

Abstract

Objective: While psychological trauma in people with epilepsy (PWE) is a major issue, there is limited research on the interactions between such trauma and epilepsy. Therefore, our primary aim is to describe types and timing of potentially psychologically traumatic experiences (PPTE) in relation to epilepsy onset. Our secondary objective is to evaluate the impact of the timing of the PPTE on patients' psychiatric and neurological profiles.Methods: We conducted an observational study involving 182 PWE, excluding patients with comorbid functional/dissociative seizures. All participants underwent a comprehensive psychiatric evaluation, including biographical, neurological, psychiatric, and traumatic data collection through a semi-structured clinical interview and standardized scales. We compared the neurological and psychiatric characteristics of three groups of patients: those without PPTE, those with PPTE occurring before the onset of epilepsy, and those with PPTE occurring after the onset of their epilepsy.Results: Sixty-one patients (33.5%) reported having experienced PPTE before the onset of epilepsy, 65 patients (35.7%) reported having experienced PPTE after the onset of their epilepsy, and 56 patients (30.8%) had no history of PPTE neither before nor after the onset of epilepsy. The 'before' group had a significantly higher prevalence of epilepsy localized in the temporal lobe (p = .043). The 'after' group showed significantly more general psychiatric symptoms (p = .026), as well as more postictal mood and anxiety symptoms (p = .014). Additionally, the 'before' group reported a higher number of past traumatic experiences, with childhood traumatic experiences being more prevalent. According to our multinomial logistic regression model, higher temporal localization (p = .028) and fewer febrile seizures (p = .030) were significant predictors for the 'before' group.Significance: This study highlights the potential impact of the timing of PPTE on patients' psychiatric and neurological profiles. It underscores the importance of systematically assessing psychiatric and posttraumatic comorbidities in PWE. The role of trauma in temporal epilepsy requires further investigation.