A set of related medical disorders that lack a proper classification system and diagnostic criteria is like a society without laws. The result is incoherence at best, chaos at worst. For this reason, the International Classification of Headache Disorders (ICHD) is arguably the single most important breakthrough in headache medicine over the last 50 years. The ICHD identifies and categorizes more than a hundred different kinds of headache in a logical, hierarchal system. Even more important, it has provided explicit diagnostic criteria for all of the headache disorders listed. The ICHD quickly became universally accepted, and criticism of the classification has been minor relative to that directed at other disease classification systems. Over the 20 years following publication of the first edition of the ICHD, headache research has rapidly accelerated despite sparse allocation of resources to that effort. In summary, the ICHD has attained widespread acceptance at the international level and has substantially facilitated both clinical research and clinical care in the field of headache medicine.

International Classification of Headache Disorders

Grit has been presented as a higher order personality trait that is highly predictive of both success and performance and distinct from other traits such as conscientiousness. This paper provides a meta-analytic review of the grit literature with a particular focus on the structure of grit and the relation between grit and performance, retention, conscientiousness, cognitive ability, and demographic variables. Our results based on 584 effect sizes from 88 independent samples representing 66,807 individuals indicate that the higher order structure of grit is not confirmed, that grit is only moderately correlated with performance and retention, and that grit is very strongly correlated with conscientiousness. We also find that the perseverance of effort facet has significantly stronger criterion validities than the consistency of interest facet and that perseverance of effort explains variance in academic performance even after controlling for conscientiousness. In aggregate our results suggest that interventions designed to enhance grit may only have weak effects on performance and success, that the construct validity of grit is in question, and that the primary utility of the grit construct may lie in the perseverance facet. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Much ado about grit: A meta-analytic synthesis of the grit literature.

Several studies have assessed the prevalence of psychiatric disorders in epilepsy. They are characterized by considerable heterogeneity, because of differences in the population setting and type of study. A non-systematic review of the literature allows us to draw some useful, although not definite, conclusions. Six per cent of people with epilepsy in the general population appear to suffer from a psychiatric disorder, while this rises to 10-20% in populations with temporal lobe and/or refractory epilepsy. Mood disorders are the most common culprit (24-74%), particularly depression (30%), followed by anxiety disorders (10-25%), psychoses (2-7%) and personality disorders (1-2%). This comorbidity appears to be related to endogenous and exogenous (including iatrogenic) factors and to the severity and chronicity of epilepsy. Conditions such as schizophrenia-like psychosis of epilepsy and interictal dysphoric disorder are represented only in epilepsy. Adequate recognition and treatment of psychiatric conditions in epilepsy is essential for patient management because of their considerable burden in morbidity and quality of life.

The psychiatric comorbidity of epilepsy

OBJECTIVE: A study was undertaken to determine whether psychiatric disorders associated with suicide are more common in incident epilepsy than in matched controls without epilepsy, before and after epilepsy diagnosis. METHODS: A matched, longitudinal cohort study was conducted in the UK General Practice Research Database. A total of 3,773 cases diagnosed with epilepsy between the ages of 10 and 60 years were compared to 14,025 controls matched by year of birth, sex, general practice, and years of medical records before the index date. We examined first diagnosis of psychosis, depression, anxiety, and suicidality in each of the 3 years before and after the index date and annual prevalence of suicide. Referent diagnoses were eczema and acute surgery. The incidence rate ratio (IRR) was calculated for each year in the study period; the prevalence ratio (PR) was calculated for suicidality. RESULTS: The IRR of psychosis, depression, and anxiety was significantly increased for all years before epilepsy diagnosis (IRR, 1.5-15.7) and after diagnosis (IRR, 2.2-10.9) and for suicidality before epilepsy diagnosis (IRR, 3.1-4.5) and 1 year after diagnosis (IRR, 5.3). The PR was increased for suicide attempt before epilepsy onset (PR, 2.6-5.2) and after onset (PR, 2.4-5.6). Eczema and acute surgery were both associated with epilepsy in the first and third year after diagnosis. INTERPRETATION: Epilepsy is associated with an increased onset of psychiatric disorders and suicide before and after epilepsy diagnosis. These relations suggest common underlying pathophysiological mechanisms that both lower seizure threshold and increase risk for psychiatric disorders and suicide. ANN NEUROL 2012. Language: en

Epilepsy, suicidality, and psychiatric disorders: a bidirectional association.

Although psychological safety research has flourished in recent years, and despite the empirical support for the important role of psychological safety in the workplace, several critical questions remain. In order to address these questions, we aggregate theoretical and empirical works, and draw on 136 independent samples representing over 22,000 individuals and nearly 5,000 groups, to conduct a comprehensive meta-analysis on the antecedents and outcomes of psychological safety. We not only present the nomological network of psychological safety but also extend this research in 4 important ways. First, we compare effect sizes to determine the relative effectiveness of antecedents to psychological safety. Second, we examine the extent to which psychological safety influences both task performance and organizational citizenship behaviors over and beyond related concepts such as positive leader relations and work engagement. Third, we examine whether research design characteristics and national culture alter validities within the nomological network, thus promoting a more accurate and contextualized understanding of psychological safety. Finally, we test the homology assumption by comparing the effect sizes of the antecedents and outcomes of psychological safety across individual and group levels of analysis. We conclude with a discussion of the areas in need of future examination.

/pdf/psychological-safety-a-meta-analytic-review-and-extension-4epuhr7i5l.pdf

Psychological Safety: A Meta-Analytic Review and Extension

Revised NEO Personality Inventory（NEO-PI-R）を用いたてんかん患者におけるパーソナリティ傾向に関する検討

Migraine-like features sometimes characterize the headache that follows epileptic seizure (postictal headache, PIH). We compared patients with different types of epilepsy to investigate the association between migraine-like PIH and seizure type. Subjects comprised 364 patients with partial epilepsy. Epilepsy types were temporal lobe epilepsy (TLE, n = 177), frontal lobe epilepsy (FLE, n = 116), and occipital lobe epilepsy (OLE, n = 71). Patients participated in a structured interview pertaining to PIH as well as interictal headache and family history of migraine. Headaches were classified according to the International Headache Society criteria, which was modified for this study. Forty percent had PIH and 26% of these patients had migraine-like PIH. Migraine-like PIH occurred significantly more often in cases of TLE and OLE than in cases of FLE. In addition, the incidence of interictal migraine headache was significantly higher in patients with migraine-like PIH. These results suggest that migraine-like PIH is related to particular regions of epileptogenic focus and that susceptibility to migraine headache predisposes to migraine-like PIH.

Characteristics of Postictal Headache in Patients with Partial Epilepsy

Summary:  Purpose: To evaluate further the relevance of designating psychotic episodes as either postictal or interictal, we compared several biologic variables between epilepsy patients with and without psychosis.



Methods: The study subjects comprised 282 patients with psychosis (36 with postictal psychosis, 224 with interictal psychosis, and 22 with both postictal and interictal psychoses, i.e., bimodal psychosis), and 658 epilepsy patients without psychosis. The clinical characteristics of these patients were reviewed retrospectively by experienced neuropsychiatrists. Factors predicting the development of each type of psychosis were determined by serial multivariate logistic regression analyses.



Results: Factors that were comparable between postictal and interictal psychoses were intellectual function, family history of psychosis, epilepsy type, and the presence of complex partial seizures. In contrast, age at the onset of epilepsy and at the onset of psychosis and the presence of generalized tonic–clonic seizures differed for the three types of psychosis. Patients with bimodal psychosis showed characteristics associated with both postictal and interictal psychoses.



Conclusions: This study documented conditions, including both general factors and epilepsy-related factors, common to epilepsy patients with psychosis, regardless of chronologic distinctions. Certain epileptic processes appear to have equal influence on postictal and interictal psychoses. However, some differences between postictal and interictal psychoses suggest that these chronologic descriptors are valid. Our findings confirmed that psychosis associated with epilepsy should not be defined as a single, simple condition but rather as a complex condition with several possible subcategories.

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1528-1157.2002.22402.x

Psychoses and epilepsy: are interictal and postictal psychoses distinct clinical entities?

We report the findings of single photon emission computed tomography using 123I-IMP and magnetic resonance image studies of five patients with Charles Bonnet syndrome (CBS) while they were having visual hallucinations. All patients developed complex visual hallucinations after suffering from eye disease. The mean age at onset of CBS was 71.6 years. Single photon emission computed tomography studies in all patients disclosed hyperperfusion areas with some asymmetrical appearances in the lateral temporal cortex, striatum and thalamus. These results suggest that when elderly people suffer from eye disease, subsequent excessive cortical compensation in the lateral temporal cortex, striatum and thalamus may precipitate the development of visual hallucinations.

Hyperperfusion in the lateral temporal cortex, the striatum and the thalamus during complex visual hallucinations: single photon emission computed tomography findings in patients with Charles Bonnet syndrome.

Summary: Purpose: Status epilepticus (SE) appears to cause cognitive dysfunction as well as other serious neurologic sequelae. To confirm whether SE produces a subsequent intellectual decline, we evaluated intellectual function prospectively in adult epilepsy patients with and without SE.



Methods: Of 1,685 patients with epilepsy who underwent comprehensive neuropsychological testing in two national hospitals in Japan, 15 patients experienced an episode of SE afterward and underwent the second neuropsychological examination after the SE episode. Forty clinically matched patients with epilepsy, but without an episode of SE since their initial neuropsychological examination, were also reevaluated. We compared IQs and subscores from the Wechsler Adult Intelligence Scale–Revised between the two groups by repeated measures analysis of variance. In the patients who experienced an SE episode, SE-related variables (i.e., age at the SE episode and type and duration of SE) and epilepsy-related variables such as epilepsy type, lateralization of EEG abnormalities, the presence of mesial temporal sclerosis, and previous history of SE, were evaluated in relation to intellectual outcome.



Results: Patients with SE, in comparison to those without SE, failed to show any significant post-SE intellectual decline. Furthermore, neither the SE-related variables nor the clinical characteristics were correlated with intellectual outcome.



Conclusions: Our findings suggest that SE does not lead to a significant intellectual decline in adult patients receiving treatment for epilepsy.

Naoto Adachi

Papers

Revised NEO Personality Inventory（NEO-PI-R）を用いたてんかん患者におけるパーソナリティ傾向に関する検討

Characteristics of Postictal Headache in Patients with Partial Epilepsy

Psychoses and epilepsy: are interictal and postictal psychoses distinct clinical entities?

Hyperperfusion in the lateral temporal cortex, the striatum and the thalamus during complex visual hallucinations: single photon emission computed tomography findings in patients with Charles Bonnet syndrome.

Intellectual prognosis of status epilepticus in adult epilepsy patients: analysis with Wechsler Adult Intelligence Scale-revised.