Personality functioning in adults with refractory epilepsy and community adults: Implications for health-related quality of life

Personality Traits and Quality of Life Among Older Adults: The Chain Mediating Effects of Perceived Social Support and Positive Coping Styles

The pathways between personality traits and older adults' quality of life (QOL) have been well studied. However, perceived social support and positive coping styles should not be ignored by older adults' QOL. Hence, this study examines the chain mediating role of perceived social support and positive coping styles between personality traits and older adults' QOL. In total, 230 older individuals (Meanage = 69.43, SDage = 7.23, age range from 60 to 93) participated in this study. All older people provided a rating of QOL and perceived social support, the Chinese Big Five personality, and positive coping styles. (1a) the five personality traits of older adults were significantly associated with QOL; (2b) perceived social support mediated the relationship between three personality traits (neuroticism, extraversion, and agreeableness) and QOL; (3c) positive coping styles played a mediator role in the personality traits (neuroticism, extraversion, and agreeableness) and QOL; (4d) perceived social support and positive coping styles had a significant chain mediating effect on the three dimensions of personality traits (neuroticism, extraversion, and agreeableness) and QOL. As mediating influences, social support and positive coping styles can be applied to efforts to promote QOL for older adults who share the personality traits of neuroticism, extraversion, and agreeableness.

Personality traits and quality of life: a cross-sectional study in a middle-aged Iranian general population

INTRODUCTION

Despite considerable research on the association between Personality Traits (PT) and Quality of Life (QoL) in patients and older adults, this association remains poorly understood among the middle-aged general population.This investigation examines how each PT is associated with total QoL and its dimensions.

METHODS

The present investigation utilized data collected from a cross-sectional survey involving 786 families in Isfahan (644 female/wife respondents), Iran. QoL and PT were assessed using the validated WHOQOL-BREF and NEO-FFI questionnaires. Other data including demographic and socioeconomic status (SES) were also collected. Statistical analyses included bivariate correlation and simple and multiple linear and logistic regressions.

RESULTS

Mean value of Psychological health [Mean difference = -4.34, P = 0.003], Physical health [mean difference = -3.93, P = 0.004], and total score of QoL [mean difference = -3.21, P = 0.049] were all significantly lower in women than men. Higher SES score was consistently associated with greater QoL scores (r > 0, P < 0.05). The physical domain and total QoL scores have been negatively correlated with the spouse's age (r < 0, P < 0.05). In crude and adjusted models, higher Neuroticism scores were inversly associated with higher scores of all QoL domains and total QoL (OR < 1, P < 0.05, for all models) while others personality traits except Openness showed a direct association (OR > 1, P < 0.05). Linear regression analysis also confirmed that higher Neuroticism scores were linked to poorer QoL scores (Betacoefficient < 0, P < 0.05), while all other traits, except Openness, showed a positive association (Betacoefficient > 0, P < 0.05).

CONCLUSION

This study provides robust evidence about the significant association of PT with QoL outcomes in middle aged people. This significant association highlights the importance of considering these traits in clinical applications, as tailored interventions based on personality profiles can effectively enhance the well-being of middle-aged individuals.

Personality and Attachment Patterns in Patients with Psychogenic Non-Epileptic Seizures in Saudi Arabia

Background and Objectives: The purpose of this study was to investigate personality and relationship patterns in patients with psychogenic non-epileptic seizures (PNES) and compare them to patients with epilepsy and healthy controls. Materials and Methods: A total of 68 participants were recruited (mean age = 29.8 ± 9.4 years), including 25 (36.2%) with PNES. The assessment was conducted using the Relationship Questionnaire (RQ), Big Five Inventory (BFI), Relationship Assessment Scale (RAS), Satisfaction with Life Scale (SWLS), and Conflict Behavior Scale (CBS). Results: The IQ of patients with PNES (88.8 ± 13.6) was lower compared to healthy controls (103.5 ± 28.0) but higher than epilepsy patients (84.6 ± 12.9). There were no significant differences between PNES patients and either patients with epilepsy or healthy controls in terms of security, fearfulness, preoccupation, or dismissiveness based on RQ subscale scores. PNES patients tended to be less satisfied (RAS total score, p = 0.10), but did not differ on overall life quality (on SWLS) compared to epilepsy patients and healthy individuals. There were no significant differences in the scores for different attachment styles (secure, fearful, preoccupied, dismissive) among the groups (p > 0.05). Significant differences were found in agreeableness (p = 0.017) and openness (p = 0.009) among the groups. The PNES group exhibits higher scores in Negative-Own (p = 0.009), Positive-Own (p = 0.011), Negative-Partner (p = 0.011), and Positive-Partner (p = 0.028) compared to epilepsy and healthy individuals. No significant differences observed in the Abusive-Own and Abusive-Partner scores (p > 0.05). Conclusions: In conclusion, this study highlights distinct personality traits and relationship patterns in patients with psychogenic non-epileptic seizures (PNES) compared to epilepsy patients and healthy controls, emphasizing the need for targeted interventions to address these psychological nuances effectively.

Big Five personality predict epilepsy diagnosis in 7 years

Objective

Recently, there is growing interest in investigating how personality traits could predict a subsequent diagnosis of various diseases. Regarding epilepsy, there is only preliminary evidence based on cross-sectional studies linking personality traits to epilepsy, hence, emphasizing the need for longitudinal studies. The aim of the current study is to assess if the Big Five personality traits can predict the risk of an epilepsy diagnosis.

Methods

The current study analyzed data from 17,789 participants who participated in Understanding Society: the UK Household Longitudinal Study (UKHLS) at Wave 3 (collected between 2011 and 2012) and Wave 10 (collected between 2018 and 2019). The mean age was 47.01 (SD = 16.31) years and were 42.62% male. Two binary logistic regressions were used by including age, monthly income, highest educational qualification, legal marital status, residence, and standardized personality traits scores at Wave 3 as predictors for a clinical diagnosis of epilepsy at Wave 10 for males and females, respectively.

Results

There were 175 participants (0.98%) with epilepsy and 17,614 participants (99.02%) without epilepsy at Wave 10. Results of the binary regression analyses revealed that Neuroticism is positively related to the risk of an epilepsy diagnosis in males (OR = 1.32, p = 0.04, 95% CI [1.01, 1.71]) but not in females 7  years after Wave 3 at Wave 10. However, other personality traits including Agreeableness, Openness, Conscientiousness, and Extraversion were not significant predictors of epilepsy diagnosis.

Conclusion

These findings suggested that personality traits might enhance our understanding of psychophysiological associations in epilepsy. Neuroticism might be a relevant factor that should be taken into account in epilepsy education and treatment. Moreover, sex differences must be taken into account.

Understanding the associations between personality traits and mental health in people with epilepsy and healthy controls

Objectives

The aim of the current study was to test how epilepsy could moderate the associations between Big Five personality traits and mental health.

Methods

This cross-sectional study analyzed data from Understanding Society: UK Household Longitudinal (UKHLS), which relies on a complex multi-stage stratified sampling design. Personality traits were measured by the Big Five inventory whereas mental health where measured by the GHQ-12. A hierarchical regression and two multiple regressions were performed on 334 people with epilepsy with a mean age of 45.14 ± 15.88 years old (41.32% males) and 26,484 healthy controls (42.5% males) with a mean age of 48.71 ± 17.04 years old.

Results

Neuroticism was positively related to worse mental health in both people with epilepsy and healthy controls with a stronger relationship in people with epilepsy, but Conscientiousness was negatively related to worse mental health in both people with epilepsy and healthy controls. Moreover, Openness and Extraversion were negatively related to worse mental health in healthy controls but not in people with epilepsy.

Conclusion

Personality traits are closely related to mental health in both people with epilepsy and healthy controls. Clinicians should use findings from this study to detect people with epilepsy who may be at high risk of poor mental health based on their personality traits.

Clinical relevance of interictal dysphoric disorder and its impact on quality of life in drug-resistant epilepsy

OBJECTIVE

This study aims to assess the prevalence of Interictal Dysphoric Disorder (IDD) in drug-resistant epilepsy (DRE) and to describe its clinical and psychopathological profile, including personality, as well as its impact on quality of life (QOL).

METHOD

A retrospective cross-sectional study from an Epilepsy Unit from January 2007 to December 2017. All patients were diagnosed with DRE. Patients underwent a battery of tests (HADS, SCL-90R, PDQ-4+, QOLIE-31) and a psychiatrist assessed the presence of Axis-I disorders and IDD. Statistical procedures were carried out using R-4.0.1 software.

RESULTS

A total of 282 patients were included. A statistically significant association was found between IDD and mood and anxiety disorders (p < 0.001 and p < 0.05 respectively), and between IDD and higher scores in all HADS and SCL-90-R items compared to subjects without IDD (p < 0.001). A statistically significant association was also found between IDD and obsessive-compulsive, borderline and depressive personality disorder (p < 0.05). Scores in all QOLIE-31 items except for 'medication effects' were significantly lower in subjects with IDD compared with subjects without IDD (p < 0.001).

CONCLUSIONS

In DRE, IDD subjects show differences in the psychopathological profile and QOL scores compared to subjects without a diagnosis of IDD. An early diagnosis of IDD could facilitate prompt interventions which might positively impact QOL.

Influence of personality profile in patients with drug-resistant epilepsy on quality of life following surgical treatment: A 1-year follow-up study

The objectives of this study are to determine the influence of personality profile in patients with drug-resistant epilepsy on quality of life (QoL) after surgical treatment and compare the results with a non-surgical control group at the 1-year follow-up. We conducted a prospective, comparative, controlled study, including 70 patients suffering from drug-resistant epilepsy. Demographic, psychiatric, neurological, and psychological data were recorded at the baseline and at the 1-year follow-up. Assessment of personality dimensions was performed using the NEO-FFI-R questionnaire; severity of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS), and QoL was evaluated using the QOLIE-31. At the 1-year follow-up, comparing the control and the surgical groups, we detected differences in scores of most items of QoL, which were higher in those patients who had undergone surgery. High levels of Conscientiousness and Openness to experience at the baseline in patients who underwent surgery predicted better post-surgical outcomes in the QoL scores, whereas high neurotic patients showed worse QoL results. Postoperative changes in QoL in patients were associated with the personality profile at the baseline. QoL measures significantly improved in the surgical group compared with the non-surgical group but were not associated with baseline or postoperative seizure frequency at 1 year.

Temporal Lobectomy: Does It Worsen or Improve Presurgical Psychiatric Disorders?

Temporal lobe epilepsy (TLE) is the type of epilepsy most frequently associated with psychiatric morbidity. Respective surgery for focal epilepsy remains the preferred treatment for medically resistant epilepsy. The aim of this chapter is to review what happens with psychiatric disorders once patients have undergone surgery.Early studies demonstrated a post-surgical increase in the incidence rates of anxiety and depressive disorders, while recent studies found that the prevalence of depression and anxiety decreased 12 months after surgery. In spite of this improvement, de novo anxiety and depressive or psychotic cases can be seen. In particular, de novo psychosis ranges from 1% to 14%, with risk factors including bilateral temporal damage, tumors rather than mesial temporal sclerosis, and seizures emerging after surgery again.Personality changes after temporal lobectomy are yet to be established, but decline in schizotypal behavior and neuroticism is the most replicated so far.In children's studies surgery resolved 16% of the participants' psychiatric problems, while 12% presented a de novo psychiatric diagnosis, but further, more conclusive results are needed.The main limitations of these studies are the inconsistent systematic post-surgical psychiatric evaluations, the small sample sizes of case series, the short follow-up post-surgical periods, and the small number of controlled studies.A psychiatric assessment should be conducted before surgery, and most of all, patients with a psychiatric history should be followed after surgery.

Personality matters: relationship between personality characteristics, spirituality, demoralization, and perceived quality of life in a sample of end-of-life cancer patients

PURPOSE

Personality could be an interesting dimension to explore in end-of-life cancer patients, in order to investigate how personality affects quality of life. Thus, this study aimed to investigate the relationship among personality through the Big Five Inventory (BFI), spirituality, and demoralization and to explore their impact on their quality of life.

METHODS

A sample of 210 end-of-life Italian cancer patients were assessed with the BFI, the Demoralization Scale (DS), the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-SP-12), the Functional Assessment of Cancer Therapy Scale-General Measure (FACT-G), and the Karnofsky performance status.

RESULTS

Correlational analysis highlighted a significantly negative relationship between extraversion and agreeableness traits and all the demoralization dimensions. On the other side, neuroticism trait was significantly and positively correlated with the Demoralization Scale (p < 0.01). To understand the impact of these variables on quality of life (FACT-G), we performed a hierarchical multiple regression: in the final model, demoralization remained the strongest contributing factor (β =  - 0.509, p < 0.001), followed by neuroticism (β =  - 0.175, p < 0.001), spirituality (β = 0.163, p = 0.015), and Karnofsky index (β = 0.115, p = 0.012).

CONCLUSION

Our data underlined how both the neuroticism trait and demoralization are correlated with a worst health status in terminal cancer patients, whereas spirituality is a protective factor. The study of personality may allow to better understand the inner patient's experience and improve communication between patient and healthcare staff in order to build and apply better-tailored psychological treatment.

Neuroticism and extraversion affect health-related quality of life of persons with epilepsy independently from depression and anxiety symptoms

PURPOSE

We determined whether neuroticism and extraversion are associated with health-related quality of life (HRQoL) independently from other psychological factors in persons with epilepsy.

METHODS

This was a cross-sectional study of 357 adults with epilepsy. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31), short form of the Eysenck Personality Questionnaire-Revised, Hospital Anxiety Depression Scale, Rosenberg Self-esteem Scale, and Stigma Scale for Epilepsy were used. A hierarchical linear regression analysis and Sobel test were performed.

RESULTS

The final model explained 64.2% of the variance in the QOLIE-31. Demographic factors, entered in step 1 of the hierarchical linear regression, explained <1% of the variance. Social factors entered in step 2 and epilepsy-related factors in step 3 explained an additional 9.3% and 9.6% of the variance, respectively. Psychological factors, entered in the final step, explained 44.7% of the variance. Except for extraversion, all psychological factors assessed were independently associated with QOLIE-31 scores. When entered in step 1 of the regression analysis, neuroticism explained 36.1% of the variance, following only depression (49.0%) and anxiety (44.9%) according to the Hospital Anxiety Depression Scale. Both neuroticism (B = -0.264, p = 0.001) and extraversion (B = 0.189, p = 0.009) had indirect effects on QOLIE-31 scores mediated by depressive symptoms.

CONCLUSIONS

Neuroticism is the third most important factor for HRQoL of persons with epilepsy, following depressive symptoms and anxiety. Both neuroticism and extraversion indirectly affect HRQoL through depressive symptoms.

Personality changes in patients with refractory epilepsy after surgical treatment: A systematic review

PURPOSE

We aimed to conduct a systematic review to evaluate the personality changes in adult patients with drug-resistant epilepsy following surgical treatment.

METHODS

A systematic review was conducted using the Preferred Reporting Items of Systematic Reviews and MetaAnalyses (PRISMA) statement. We searched PubMed, Medline databases, and the Cochrane Controlled Trials Register, with search terms 'personality', 'epilepsy', and 'surgery'.

RESULTS

Eleven studies were selected. In 7 out of 11 studies, personality changes were more adaptive, with patients experiencing decreased neuroticism, impulsivity, hypochondriasis, psychasthenia. One study showed increased emotional lability. The remainder of the studies showed no changes in personality dimensions. Changes in personality differed according to the localization of the epileptogenic area, depended on seizure status after treatment and duration of follow-up. Seizure freedom as an outcome of surgical treatment influenced the existence of personality changes, and their severity. Adaptive personality changes could be seen from early follow-up assessments even in patients who were not seizure-free, though further follow-ups showed that improvements after 1-2 years were specific to seizure-free patients.

LIMITATIONS

The main limitation of our research is the heterogeneity of approaches used to evaluate personality in the included studies. Furthermore, the included studies also had different sample sizes and comparison groups, different designs, and different follow-up durations. We only included studies that were written in English.

CONCLUSIONS

The majority of studies reported changes in personality dimensions in patients suffering from refractory epilepsy.