Psychiatric comorbidities in patients from seven families with autosomal dominant cortical tremor, myoclonus, and epilepsy

Description

Objective: The objective of this report was to assess the psychiatric comorbidity in a group of patients affected by autosomal dominant cortical tremor, myoclonus, and epilepsy (ADCME). Methods: Reliable and validated psychodiagnostic scales including the BDI (Beck Depression Inventory), STAI-Y1 and 2 (State-Trait Anxiety Inventory - Y; 1 and 2), MMPI-2 (Minnesota Multiphasic Personality Inventory - 2), and QoLIE-31 (Quality of Life in Epilepsy Inventory - 31) were administered to 20 patients with ADCME, 20 patients with juvenile myoclonic epilepsy (JME), and 20 healthy controls. Results: There was a higher prevalence of mood disorders in patients with ADCME compared to patients with JME and healthy controls, particularly depression (p = 0.035 and p = 0.017, respectively) and state anxiety (p = 0.024 and p = 0.019, respectively). Trait anxiety was not different from JME (p = 0.102) but higher than healthy controls (p = 0.017). The myoclonus score positively correlated with both state (rho: 0.58, p = 0.042) and trait anxiety (rho: 0.65, p = 0.011). These psychiatric features were also often associated with pathological traits of personality: paranoid (OR: 25.7, p = 0.003), psychasthenia (OR: 7.0, p = 0.023), schizophrenia (OR: 8.5, p = 0.011), and hypomania (OR: 5.5, p = 0.022). Finally, in patients with ADCME, decreased quality of life correlated with these psychiatric symptoms. Significance: Patients with ADCME show a significant psychiatric burden that impairs their quality of life. A comprehensive psychiatric evaluation should be offered at the time of diagnosis to detect these comorbidities and to treat them.

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