Epilepsia, 47(12):2086–2091, 2006 Blackwell Publishing, Inc. C  2006 International League Against Epilepsy Psychiatric Comorbidity in Juvenile Myoclonic Epilepsy ∗ Eugen Trinka, †Gudrun Kienpointner, ∗ Iris Unterberger, ∗ Gerhard Luef, ∗ Gerhard Bauer, ∗ Lisa Bartha Doering, and ‡Stephan Doering Departments of ∗ Neurology and †Psychiatry, Innsbruck Medical University, Innsbruck, Austria; ‡Departments of Prosthodontics and Psychosomatics and Psychotherapy, University of Muenster, Germany; Clinical Department of Medical Psychology and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria Summary: Objective: To assess the prevalence of psychiatric disturbances among patients with juvenile myoclonic epilepsy (JME). Methods: Forty-three patients with JME (22 female, 21 male, mean age 32.4 ± 13, range 15–63) were assessed by means of the Structured Clinical Interviews for DSM-IV (SCID-I and SCID- II). Current and lifetime psychiatric diagnoses were assigned. Results: Thirty-five percent of the JME patients suffered from one or more psychiatric disorders (Axis I and Axis II). Personal- ity disorders were present in 23% and Axis I disorders in 19%. Altogether, 47% had a psychiatric disorder at any time of their life. Conclusions: Psychiatric diagnoses are slightly higher than in representative community samples. The substantially in- creased number of personality disorders in JME patients might be attributed to frontal lobe deficits. Key Words: Juvenile myoclonic epilepsy—Psychiatric disorders—Comorbidity— Personality disorders. Juvenile myoclonic epilepsy (JME) is an age-related idiopathic generalized epilepsy characterized by an aver- age onset around puberty, normal neurological and intel- lectual abilities, and a strong genetic predisposition. The predominating seizure-type are massive myoclonic jerks, often with generalized tonic–clonic seizures on awakening and less often with absences as additional seizure types. Seizures are often precipitated by sleep deprivation, alco- hol intake, fatigue, and stress. Interictal EEGs show gen- eralized rapid spike-waves and polyspike-waves without close correlation between EEG spikes and jerks (Janz, 1969; Wolf, 1992; Janz and Durner, 1997; Genton et al., 2000; Thomas et al., 2002). There is general agreement that JME does not represent a severe progressive epilep- tic condition and is controlled with valproate (VPA) or other appropriate drugs in 76–88% (Delgado-Escueta and Enrile-Bacsal, 1984; Panayiotopoulos et al., 1994; Gelisse et al., 2001b; Trinka et al., 2004). In patients with JME, mild but characteristic person- ality problems have been initially described by Janz and Christian, (1957) and have later been reported by other authors ( Lund et al., 1976; Reintoft et al., 1976; Tsuboi, 1977; Janz and Durner, 1997). These patients were seen Accepted April 12, 2006. Address correspondence and requests to Dr. Eugen Trinka, Depart- ment of Neurology, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck, Austria. E-mail: eugen.trinka@uklibk.ac.at doi: 10.1111/j.1528-1167.2006.00828.x as “attractive but emotionally labile, switching between comradeship and distrust—rather immature, childlike be- havior that can lead to difficulties in social adjustment,” they show a “denying attitude towards the disease,” and “often have character neurotic traits” (Janz and Durner, 1997, P. 2395). To our knowledge so far only three studies empirically assessed psychiatric diagnoses in patients with JME. Gelisse et al. (2001a) found psychiatric diagnoses in 26.5% of their JME patients, while Perini et al. (1996) reported a psychiatric diagnosis in 22%. Lund et al. (1976) investigated the personality of JME patients and diagnosed 36.4% as “character neurotic” (i.e., with personality disor- ders). Unfortunately, these investigations suffer from con- siderable methodological shortcomings: diagnoses were assigned without any clinical interview or psychometric assessment (Gelisse et al., 2001a) or were not properly de- fined (Lund et a., 1976), and very small sample sizes were assessed (Perini et al., 1996). The present study aims to overcome the shortcomings of the three previous studies by assessing a larger group of JME patients with a high standard diagnostic procedure, the Structured Clinical In- terview for DSM-IV (First et al., 1997a, 1997b). METHODS Study design Cross-sectional. From a large database (n = 4,794) of the outpatient unit for epilepsy patients of the Department 2086