DREAMY STATES AND PSYCHOSES IN TEMPORAL-LOBE EPILEPSY - MEDIATING ROLE OF AFFECT

Among 104 patients with temporal lobe epilepsy treated in our clinic b etween 1992-1995, thirteen patients with repeated dreamy states were e valuated for affective manifestations of dreamy states and their relat ionship with psychotic states. The types of dreamy states were classif ied as deja vu, jamais vu and reminiscence. The affective experiences during dreamy states were evaluated as positive, negative or neutral. As a result, seven patients had deja vu and/or reminiscence: seizure m anifestations in four of these patients were affectively evaluated as positive (familiar and/or pleasurable), and three as neutral. Six case s had experience of jamais vu: five of them were affectively evaluated as negative (mostly fear), and one as neutral. Psychiatrically, only four patients with jamais vu accompanied by feelings of fear had menta l disorders: a chronic paranoid-hallucinatory state in two cases, a ch ronic paranoid state in one case, and obsessive-compulsive symptoms in one case. Other patients who had positive or neutral affect did not d emonstrate psychiatric disturbances. Thus, most patients with jamais v u were accompanied by negative affect of fear, and those patients with jamais vu tended to show more psychotic symptoms than those with remi niscence or deja vu, which were associated with positive or neutral af fects. Based on these results, we discuss the possibility that repeate d negative feelings associated with jamais vu are one of the causes fo r developing epileptic psychoses.