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

<b>Objective:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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 (<i>p</i> = .043). The ‘after’ group showed significantly more general psychiatric symptoms (<i>p</i> = .026), as well as more postictal mood and anxiety symptoms (<i>p</i> = .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 (<i>p</i> = .028) and fewer febrile seizures (<i>p</i> = .030) were significant predictors for the ‘before’ group. <b>Significance:</b> 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. The timing of potentially psychologically traumatic experiences (PPTE) may influence patients’ psychiatric and neurological profiles.Patients with a history of PPTE tend to have higher rates of psychiatric comorbidities.Early exposure to PPTE may impact the temporal localization of epilepsy. The timing of potentially psychologically traumatic experiences (PPTE) may influence patients’ psychiatric and neurological profiles. Patients with a history of PPTE tend to have higher rates of psychiatric comorbidities. Early exposure to PPTE may impact the temporal localization of epilepsy.

**研究目标：** 尽管癫痫患者（People with Epilepsy，以下简称PWE）的心理创伤是一项亟待解决的重要问题，但针对此类创伤与癫痫之间相互作用的研究仍较为匮乏。因此，本研究的首要目标是阐明与癫痫起病相关的潜在心理创伤性经历（Potentially Psychologically Traumatic Experiences，以下简称PPTE）的类型与发生时机；次要目标则是评估PPTE的发生时机对患者精神与神经学特征的影响。
**研究方法：** 本研究为观察性研究，共纳入182名PWE患者，排除共病功能性/分离性发作的受试者。所有参与者均接受全面精神评估，通过半结构化临床访谈与标准化量表收集其人口学、神经学、精神学及创伤相关数据。本研究将受试者分为三组：无PPTE病史组、癫痫起病前发生PPTE组，以及癫痫起病后发生PPTE组，并对比三组患者的神经学与精神学特征。
**研究结果：** 共有61名患者（33.5%）报告在癫痫起病前经历过PPTE，65名患者（35.7%）报告在癫痫起病后经历过PPTE，另有56名患者（30.8%）在癫痫起病前后均无PPTE病史。“起病前”组的颞叶源性癫痫患病率显著更高（p=0.043）。“起病后”组的一般性精神症状（p=0.026）以及发作后心境与焦虑症状（p=0.014）均显著更多。此外，“起病前”组报告的既往创伤性经历数量更多，且儿童期创伤性经历的患病率更高。基于多项逻辑回归模型，颞叶定位更高（p=0.028）与更少的热性惊厥史（p=0.030）是“起病前”组的显著预测因素。
**研究意义：** 本研究阐明了PPTE发生时机对患者精神与神经学特征的潜在影响，强调了对PWE患者进行系统性精神与创伤后共病评估的重要性。创伤在颞叶癫痫中的作用仍需进一步研究。PPTE的发生时机可能影响患者的精神与神经学特征，有PPTE病史的患者精神共病患病率往往更高，早期暴露于PPTE可能影响癫痫的颞叶定位。PPTE的发生时机可能影响患者的精神与神经学特征，有PPTE病史的患者精神共病患病率往往更高，早期暴露于PPTE可能影响癫痫的颞叶定位。