Nonpsychotic Psychiatric Disorders in Juvenile Myoclonic Epilepsy

Polina V. Moskaleva, MD; Olga S. Shilkina, MD; Ivan P. Artyukhov, PhD, ScD; Irina G. Strotskaya, MD; Diana V. Dmitrenko, PhD, ScD; Natalia A. Shnayder, PhD, ScD*

V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, The Russian Federation

*Corresponding authorProf. Natalia A. Shnayder, PhD, ScD. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University.  Krasnoyarsk, The Russian Federation.  E-mail:

Published: June 16, 2017.  doi: 10.21103/Article7(2)_RA1


The association of epilepsy with mental illness has been described in recent years. Scientists are trying to relate certain epilepsies, such as juvenile myoclonic epilepsy (JME), with certain personality traits marked by emotional instability. The goal of this review is to evaluate the scientific literature about nonpsychotic psychiatric disorders in JME patients, the most common form of idiopathic generalized epilepsy (IGE). Data in this review were collected through an extensive literature search of available full-text publications in PubMed, Springer, Clinical Keys and eLIBRARY.RU databases. Comorbid personality and nonpsychotic psychiatric disorders are a common and interdisciplinary problem in JME management. The disorders in patients with JME often go undiagnosed and hence untreated. Therefore, this problem requires further and extensive investigation.

antiepileptic drugs ● juvenile myoclonic epilepsy ● nonpsychotic psychiatric disorders ● personality disorders
  1. O’Muircheartaigh J, Vollmar C, Barker GJ, Kumari V, Symms MR, Thompson P, et al. Abnormal thalamocortical structural and functional connectivity in juvenile myoclonic epilepsy. Brain. 2012;135 (Pt 12):3635-44. doi: 10.1093/ brain/aws296.
  2. Wandschneider B, Thompson PJ, Vollmar C, Koepp MJ. Frontal lobe function and structure in juvenile myoclonic epilepsy: a comprehensive review of neuropsychological and imaging data. Epilepsia. 2012;53(12):2091-8. doi: 10.1111/epi.12003.
  3. Janz D. Juvenile myoclonic epilepsy. Epilepsy with impulsive petit mal. Cleve Clin J Med. 1989;56 Suppl Pt 1:S23-33; discussion S40-2
  4. Janz D, Christian W. Impulsive petit-mal. Deutsche Zeitschrift f¨ur Nervenheilkunde 176:346–386. (English translation by Genton P. 1994). In: Malafosse A, Genton P, Hirsch E, Marescaux C, Broglin D, Bernasconi M. (eds.) 1994;1957:229–251.
  5. Walsh J, Thomas RH, Church C, Rees MI, Marson AG, Baker GA. Executive functions and psychiatric symptoms in drug-refractory juvenile myoclonic epilepsy. Epilepsy Behav. 2014;35:72-7. doi: 10.1016/j.yebeh.2014.03.026.
  6. Moschetta S, Fiore LA, Fuentes D, Gois J, Valente KD. Personality traits in patients with juvenile myoclonic epilepsy. Epilepsy Behav. 2011;21(4):473-7. doi: 10.1016/j.yebeh.2011.03.036
  7. Lee JM, Kim SY, Hwang YH, Lee HW, Suh CK, Park SP. Longitudinal Assessment of Cognitive Function in Patients with Juvenile Myoclonic Epilepsy. J Korean Epilepsy Soc. 2008; 12(2):85-91.
  8. Proposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia. 1989;30(4):389-99.
  9. Shilkina O, Artyukhov I, Moskaleva P, Strotskaya I, Shnayder N. Cognitive disorders in juvenile myoclonic epilepsy. International Journal of Biomedicine. 2017;7(1):9-14
  10. de Araújo Filho GM, Lin K, Lin J, Peruchi MM, Caboclo LO, Guaranha MS, et al. Are personality traits of juvenile myoclonic epilepsy related to frontal lobe dysfunctions? A proton MRS study. Epilepsia. 2009;50(5):1201-9. doi: 10.1111/j.1528-1167.2009.02021.x.
  11. Moschetta S, Valente KD. Impulsivity and seizure frequency, but not cognitive deficits, impact social adjustment in patients with juvenile myoclonic epilepsy. Epilepsia. 2013;54(5):866-70. doi: 10.1111/epi.12116.
  12. de Araujo Filho GM, Yacubian EM. Juvenile myoclonic epilepsy: psychiatric comorbidity and impact on outcome. Epilepsy Behav. 2013;28 Suppl 1:S74-80. doi: 10.1016/j.yebeh.2013.03.026.
  13. Martínez-Domínguez S, Labrada-Abella J, Pedrós-Roselló A, López-Gomáriz E, Tenías-Burillo JM. [Mental illness, personality traits and quality of life in epilepsy: control study of patients with juvenile myoclonic epilepsy and other epilepsies]. Rev Neurol. 2013;56(12):608-14. [Article in Spanish].
  14. Somayajula S, Vooturi S, Jayalakshmi S. Psychiatric disorders among 165 patients with juvenile myoclonic epilepsy in India and association with clinical and sociodemographic variables. Epilepsy Behav. 2015;53:37-42. doi:10.1016/j.yebeh.2015.09.024.
  15. Conrad R, Schilling G, Bausch C, Nadstawek J, Wartenberg HC, Wegener I, et al. Temperament and character personality profiles and personality disorders in chronic pain patients. Pain. 2007;133(1-3):197-209.
  16. Pierò A. Personality correlates of impulsivity in subjects with generalized anxiety disorders. Compr Psychiatry. 2010;51(5):538-45. doi:10.1016/j.comppsych.2010.02.003.
  17. Rzezak P, Moschetta SP, Lima E, Castro CX, Vincentiis S, Coan AC, et al. Distinct domains of impulsivity are impaired in juvenile myoclonic epilepsy but not in temporal lobe epilepsy. Epilepsy Behav. 2015;45:44-8. doi: 10.1016/j.yebeh.2015.02.028.
  18. Cloninger CR. A practical way to diagnosis personality disorder: a proposal. J Pers Disord. 2000;14(2):99-108.
  19. Congdon E, Canli T. A neurogenetic approach to impulsivity. J Pers. 2008;76(6):1447-84. doi: 10.1111/j.1467-6494.2008.00528.x. Review.
  20. Wandschneider B, Centeno M, Vollmar C, Stretton J, O'Muircheartaigh J, Thompson PJ, et al. Risk-taking behavior in juvenile myoclonic epilepsy. Epilepsia. 2013;54(12):2158-65. doi: 10.1111/epi.12413.
  21. de Araujo Filho GM, de Araujo TB, Sato JR, Silva Id, Lin K, Júnior HC, et al. Personality traits in juvenile myoclonic epilepsy: evidence of cortical abnormalities from a surface morphometry study. Epilepsy Behav. 2013;27(2):385-92. doi: 10.1016/j.yebeh.2013.02.004.
  22. Coppola A, Caccavale C, Santulli L, Balestrini S, Cagnetti C, Licchetta L, et al. Psychiatric comorbidities in patients from seven families with autosomal dominant cortical tremor, myoclonus, and epilepsy. Epilepsy Behav. 2016;56:38-43. doi: 10.1016/j.yebeh.2015.12.038.
  23. Ertem DH, Dirican AC, Aydın A, Baybas S, Sözmen V, Ozturk M, et al. Exploring psychiatric comorbidities and their effects on quality of life in patients with temporal lobe epilepsy and juvenile myoclonic epilepsy. Psychiatry Clin Neurosci. 2017;71(4):280-288. doi: 10.1111/pcn.12499.
  24. Mosby’s Medical Dictionary, 9th edition. Elsevier; 2009.
  25. Thomas RH, Walsh J, Church C, Sills GJ, Marson AG, Baker GA, et al. A comprehensive neuropsychological description of cognition in drug-refractory juvenile myoclonic epilepsy. Epilepsy Behav. 2014;36:124-9. doi:10.1016/j.yebeh.2014.04.027.
  26. Lin JJ, Mula M, Hermann BP. Uncovering the neurobehavioural comorbidities of epilepsy over the lifespan. Lancet. 2012 Sep 29;380(9848):1180-92. doi:10.1016/S0140-6736(12)61455-X.
  27. Camfield CS, Camfield PR. Juvenile myoclonic epilepsy 25 years after seizure onset: a population-based study. Neurology. 2009;73(13):1041-5. doi: 10.1212/WNL.0b013e3181b9c86f.
  28. Caplan R, Siddarth P, Gurbani S, Hanson R, Sankar R, Shields WD. Depression and anxiety disorders in pediatric epilepsy. Epilepsia. 2005;46(5):720-30.
  29. Miller JM, Kustra RP, Vuong A, Hammer AE, Messenheimer JA. Depressive symptoms in epilepsy: prevalence, impact, aetiology, biological correlates and effect of treatment with antiepileptic drugs. Drugs. 2008;68(11):1493-509.
  30. Beyenburg S, Schmidt D. [Patients with epilepsy and anxiety disorders. Diagnosis and treatment]. Nervenarzt. 2005;76(9):1077-8, 1081-2, 1084-6 passim. doi: 10.1007/s00115-004-1867-4. [Article in German].
  31. Kar SK, Tekkalaki B, Mohapatra S, Saha R. Mental Health Perspectives of Epilepsy: Focus on Anxiety Disorders. Delhi Psychiatry Journal 2015; 8(1):7-15.
  32. Chachua T, Goletiani C, Maglakelidze G, Sidyelyeva G, Daniel M, Morris E, et al. Sex-specific behavioral traits in the Brd2 mouse model of juvenile myoclonic epilepsy. Genes Brain Behav. 2014;13(7):702-12. doi: 10.1111/gbb.12160.
  33. Harden C. Juvenile myoclonic epilepsy-what does the future look like? Epilepsy Curr. 2014;14(3):150-1. doi: 10.5698/1535-7597-14.3.150.
  34. Shnayder NA, Shilkina OS, Petrov KV, Chernykh IA, Diuzhakova AV. [Clinical and genetic heterogenity of juvenile myoclonic epilepsy]. Epilepsy and Paroxyzmal Conditions. 2016;8(2):20-36. doi:10.17749/2077-8333.2016.8.2.020-036. [Article in Russian]
  35. Bell GS, Mula M, Sander JW. Suicidality in people taking antiepileptic drugs: What is the evidence? CNS Drugs 2009;23(4):281-92.
  36. Kotov AS. [Anxiety in epileptic patients]. Zh Nevrol Psikhiatr Im SS Korsakova 2013;113(4 Pt 2):41-4.[Article in Russian]
  37. Johnson EK, Jones JE, Seidenberg M, Hermann BP. The relative impact of anxiety, depression, and clinical seizure features on health-related quality of life in epilepsy. Epilepsia 2004;45(5):544-50.
  38. Nur U, Tyrer P, Merson S, Johnson T. Relationship between clinical symptoms, personality disturbance, and social function: a statistical enquiry. Irish Journal of Psychological Medicine. 2004;21:19–22.
  39. Pellock JM. Defining the problem: psychiatric and behavioral comorbidity in children and adolescents with epilepsy. Epilepsy Behav. 2004;5 Suppl 3:S3-9.
  40. Pascalicchio TF, de Araujo Filho GM, da Silva Noffs MH, Lin K, Caboclo LO, Vidal-Dourado M, et al. Neuropsychological profile of patients with juvenile myoclonic epilepsy: a controlled study of 50 patients. Epilepsy Behav. 2007;10(2):263-7.
  41. Asadi-Pooya AA, Schilling CA, Glosser D, Tracy JI, Sperling MR. Health locus of control in patients with epilepsy and its relationship to anxiety, depression, and seizure control. Epilepsy Behav. 2007;11(3):347-50. 

The fully formatted PDF version is available.
Download Article
International Journal of Biomedicine. 2017;7(2):85-90. ©2017 International Medical Research and Development Corporation. All rights reserved.