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November 1996

Schizophrenia and Temporal Lobe Epilepsy-reply

Arch Gen Psychiatry. 1996;53(11):1063. doi:10.1001/archpsyc.1996.01830110101018

The Study by Gold et al1 of the neuropsychological performance of patients with severe chronic SCZ in comparison with patients with unilateral TLE is a thoughtful approach to understanding the cognitive dysfunction in SCZ. Unfortunately, several problems with their study are important to document. The authors stress the analogy of these 2 disorders for their early developmental origin. However, examination of the epilepsy cohorts reveals a mean age of onset of 11.1 years (left temporal lobe) and 13.8 years (right temporal lobe) with a broad SD. A recent study by Roberts et al2 demonstrated that the psychopathogic comparison of TLE and psychotic disorder was of maximal validity when the first seizure occurred before 6 years of age. Considering the group with SCZ, Gold et al present few data regarding the histories of the patients, although they acknowledge a bias toward poor prognosis. Calculation reveals a mean schizophrenic illness duration of 12