“…Circumstantiality and obsessionalism are characteristics observed in some patients without epilepsy in a mood disorders clinic [28], and we could hypothesize that bidirectional mechanisms increase the vulnerability to mood disorders and viscosity, especially in TLE. Some of these symptoms may be better described by standard psychiatric evaluation, including assessment with instruments as the BDI, Brief Psychiatric Rating Scale, or even specific mood instruments such as the Interictal Dysphoric Disorder Inventory [29][30][31] or the Neurological Disorders Depression Inventory for Epilepsy [32,33]. Thus, an alternative explanation for so many traits in BFI and NBI is that some of these traits are 'artifacts' of underecognized and undertreated depression and anxiety in TLE.…”