Psychiatric disorders in juvenile myoclonic epilepsy.

Mild personality problems have been described in patients with juvenile myo clonic epilepsy (JME), but clinical practice shows that JME can be diagnose d in patients with more or less severe psychiatric disorders (PD). The pres ence in JME patients of personality disorders has been described repeatedly , but never quantified. We thus decided to evaluate, using the DSM IV, the current prevalence and types of PD in a large series of consecutive, newly referred patients with JME. Among 170 consecutive JME cases referred to two departments of epileptology (Marseilles and Nice) between 1981 and 1998 (6 6 males, 104 females; aged 11.7-70; mean+/-SD 32.4+/-10.4 follow-up 12.7+/- 10 [0.5-52]), we found 45 patients (26.5p.100) with PD. According to the DS M IV, they could be classified as severe mental retardation (main diagnosis ) (one case); pervasive developmental disorders (2 cases); tic disorder (1 case); enuresis (1 case); psychotic disorders (5 cases, including schizophr enia paranoid type (1 case), disorganized type (1 case), delusional disorde r (1 case), unspecified (2 cases)); depressive disorders (3 cases); general ized anxiety (6 cases); anorexia nervosa (2 cases); personality disorders ( 24 cases, including borderline personality (11 cases), dependent personalit y (5 cases), histrionic personality (2 cases), obsessive-compulsive persona lity (1 case), not specified (5 cases)). Sudden unexplained death occurred in 2 cases (borderline personality and pervasive developmental disorder not otherwise specified respectively) and death due to pneumonia in 1 cases (a norexia) Although uncommonly severe cases of JME may have been selected in our referral centers, it appears that JME may be associated with PD. Compar atively mild personality disorders are the most common finding, and may be part of the clinical picture to some extent, while severe PD are less commo n, and probably coincidental. The presence of PD does not exclude the diagn osis of JME, and PD may represent a further challenge in the comprehensive care of these patients.