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Several cognitive phenotypes have been identified in TLE, but it is unclear how phenotypes relate to psychiatric comorbidities, such as anxiety and depression. This observational study investigated the relationship between cognitive phenotypes and psychiatric symptomatology in TLE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 826 adults (age\u2009=\u200940.3, 55% female) with pharmacoresistant TLE completed a neuropsychological evaluation that included at least two measures from five cognitive domains to derive International Classification of Cognitive Disorders in Epilepsy (IC\u2010CoDE) cognitive phenotypes (i.e., intact, single\u2010domain impairment, bi\u2010domain impairment, generalized impairment). Participants also completed screening measures for depression and anxiety. Psychiatric history and medication data were extracted from electronic health records. Multivariable proportional odds logistic regression models examined the relationship between IC\u2010CoDE phenotypes and psychiatric variables after controlling for relevant covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with elevated depressive symptoms had a greater odds of demonstrating increasingly worse cognitive phenotypes than patients without significant depressive symptomatology (odds ratio [OR]\u2009=\u20091.123\u20131.993, all corrected <jats:italic>p<\/jats:italic>'s\u2009&lt;\u2009.05). Number of psychotropic (OR\u2009=\u20091.584, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) and anti\u2010seizure medications (OR\u2009=\u20091.507, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), use of anti\u2010seizure medications with mood\u2010worsening effects (OR\u2009=\u20091.748, <jats:italic>p<\/jats:italic>\u2009=\u2009.005), and history of a psychiatric diagnosis (OR\u2009=\u20091.928, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) also increased the odds of a more severe cognitive phenotype, while anxiety symptoms were unrelated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This study demonstrates that psychiatric factors are not only associated with function in specific cognitive domains but also with the <jats:italic>pattern<\/jats:italic> and <jats:italic>extent<\/jats:italic> of deficits across cognitive domains. Results suggest that depressive symptoms and medications are strongly related to cognitive phenotype in adults with TLE and support the inclusion of these factors as diagnostic modifiers for cognitive phenotypes in future work. Longitudinal studies that incorporate neuroimaging findings are warranted to further our understanding of the complex relationships between cognition, mood, and seizures and to determine whether non\u2010pharmacologic treatment of mood symptoms alters cognitive phenotype.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.17795","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T04:30:40Z","timestamp":1696912240000},"page":"3331-3341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["The relationship between mood and anxiety and cognitive phenotypes in adults with pharmacoresistant temporal lobe epilepsy"],"prefix":"10.1111","volume":"64","author":[{"given":"Nolan","family":"Bingaman","sequence":"first","affiliation":[{"name":"Department of Psychology Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Epilepsy Center Neurological Institute, Cleveland Clinic  Ohio Cleveland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Lerner Research Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0625-6990","authenticated-orcid":false,"given":"Anny","family":"Reyes","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine and Applied Sciences and Psychiatry University of California  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie R.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine and Applied Sciences and Psychiatry University of California  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0133-4427","authenticated-orcid":false,"given":"Bruce P.","family":"Hermann","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6482-4795","authenticated-orcid":false,"given":"Kayela","family":"Arrotta","sequence":"additional","affiliation":[{"name":"Epilepsy Center Neurological Institute, Cleveland Clinic  Ohio Cleveland USA"},{"name":"Department of Neurology Neurological Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5442-4912","authenticated-orcid":false,"given":"Robyn M.","family":"Busch","sequence":"additional","affiliation":[{"name":"Epilepsy Center Neurological Institute, Cleveland Clinic  Ohio Cleveland USA"},{"name":"Department of Neurology Neurological Institute, Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,24]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"817","volume-title":"Pre\u2010surgical neuropsychological workup: risk factors for post\u2010surgical deficits. 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