Subjective memory and mood of Hong Kong Chinese adults with epilepsy Alma Au a, * , Patrick Leung b , Amy Kwok c , Patrick Li d , Colin Lui d , John Chan d a Department of Applied Social Science, Hong Kong Polytechnic University, Hong Kong, China b Psychology Department, The Chinese University of Hong Kong, Hong Kong, China c Department of Clinical Psychology, New Territories East Cluster, Hong Kong, China d Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China Received 23 November 2005; revised 30 March 2006; accepted 2 April 2006 Available online 11 May 2006 Abstract Clinicians are often confronted with the self-report of memory difficulties by patients. This study explored the possible correlates of subjective memory in 67 adult Chinese patients with epilepsy in Hong Kong. These correlates include epilepsy-related factors, mood state, and actual performance on neuropsychological tests. Results suggested that there exists no significant systematic relationship between subjective and illness-related factors such as seizure frequency, age at onset, and medication. Instead, stepwise regression anal- ysis revealed that mood (anxiety) explained about 17% of the variance of subjective memory difficulties, whereas performance on a mem- ory test accounted for only 8% of the variance. Findings are discussed in the light of the need to attend to the anxiety of patients with epilepsy in the process of rehabilitation. Ó 2006 Elsevier Inc. All rights reserved. Keywords: Epilepsy; Subjective memory; Mood; Anxiety; Neuropsychological tests 1. Introduction Whether and how subjective memory complaints are related to actual memory performance on neuropsycho- logical tests represent important issues in assessment of and intervention in patients with epilepsy. However, though clinicians are often confronted with the self-report of memory difficulties by patients, the clinical utility of subjective memory complaints in predicting neuropsycho- logical functioning has not really been established. A number of factors have been proposed to account for sub- jective memory. These include epilepsy-related factors, mood state, and actual performance on neuropsychologi- cal tests [1]. Both subjective perception and objective measures of memory functioning have been found to relate to epilep- sy-related factors. However, these studies often included patients with a wide range of etiologies, seizure frequen- cies, and different levels of social and occupational func- tioning. For instance, neuropsychological testing of patients with refractory epilepsy showed that diminished cognitive outcomes were associated with earlier age at onset, longer duration of epilepsy, drug treatment, as well as localization of the epileptogenic zone in the temporal lobe [2–4]. Similarly, there have been subjective reports of low cognitive functioning in localization-related epilep- sy [5]. On the other hand, for patients with well-controlled epilepsy, age at onset, duration, seizure type, and fre- quency were not found to be strongly associated with cognitive impairment. However, although the relatively well-controlled seizures did not interfere with actual functioning, these patients still tended to report more cognitive complaints than healthy controls [6]. The lack of a strong association between subjective memory com- plaints and actual test performance has also been docu- mented in older adults with or without dementia. The www.elsevier.com/locate/yebeh Epilepsy & Behavior 9 (2006) 68–72 1525-5050/$ - see front matter Ó 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.yebeh.2006.04.004 * Corresponding author. Fax: +852 2773 6546. E-mail address: ssalma@inet.polyu.edu.hk (A. Au).