4.3 Article

Psychiatric disorders in temporal lobe epilepsy patients over the first year after surgical treatment

Journal

SEIZURE-EUROPEAN JOURNAL OF EPILEPSY
Volume 16, Issue 3, Pages 218-225

Publisher

W B SAUNDERS CO LTD
DOI: 10.1016/j.seizure.2006.12.004

Keywords

epilepsy; psychiatric disorders; surgery; depression

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Objective: To evaluate the psychiatric disorders over a 1-year period in. a group of TLE patients who underwent surgery. Methods: Prospective, open study in a sample of 70 TLE patients. Psychiatric disordprs' assessment was made before surgery, and at 1, 6 and 12 months after surgery, with the structured clinical diagnostic interview for DSM-IV axis I diagnoses (SCID). Presurgical psychiatric and neurological variables were compared with the outcomes of surgery and the course of psychiatric pathology over the follow-up through parametric and non-parametric tests. Results: Depression decreased from 17.2% before surgery to 4.3% at 12 months after surgery (chi(2) = 5.41, d.f. = 1, p = 0.071), anxiety disorders decreased from 21.5% before surgery to 14.2% at 12 months after surgery (chi(2) = 10.309, d.f. = 1, p < 0.005). Patients with no presurgical psychiatric condition had tower postsurgical rate of psychiatric disorders than those with. psychiatric history (X-2 = 9.87, gl = 1, p <= 0.001), with psychiatric disorders in the presurgical evaluation (X-2 = 12.02, gl = 1, p <= 0.001), or with both conditions (chi(2) = 15.28, d.f. = 1, p < 0.001). No association was found between psychiatric disorders and the outcomes after surgery. No association was found between the course of psychiatric disorders before and after surgery and neurological or neurosurgical variables. Conclusions: Surgery in TLE patients does not worsen the global psychopathological status. Presurgical psychiatric morbidity was found to be related to the presence of psychiatric disorders after surgery. Specific psychiatric assessment should be made before and after surgery. (c) 2006 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

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