Depression and anxiety before and after temporal lobe epilepsy surgery.
OBJECTIVE
To examine the course of depression and anxiety in patients with temporal lobe epilepsy (TLE) treated with epilepsy surgery (and anticonvulsant drugs) or medical means alone.


METHODS
Of 94 TLE patients evaluated for epilepsy surgery, 76 underwent a resective procedure, 18 continued on medical treatment alone. Depression (Beck Depression Inventory (BDI)) and anxiety scores (Self-Rating Anxiety Scale (SRAS)) were examined during presurgical evaluation (T1) and after a mean of 16 months (T2), or 12 months after surgery. Depression and anxiety scores were related to type of intervention, underlying epileptogenic lesion, change of seizure control and anticonvulsant therapy.


RESULTS
At T1, depression and anxiety scores were higher in patients with TLE than scores in published normal populations. At T2, depression but not anxiety scores were significantly lower than at T1. Change of depression scores interacted with improvements of seizure control.


CONCLUSIONS
Evidence of depression and anxiety is commonly found in patients with TLE. Depression improves not because of epilepsy surgery per se, but because of improved seizure control. This is more commonly achieved by surgery than medical treatment. The results are consistent with the hypothesis that depression in TLE is caused by pathological epileptic activity rather than a fixed structural defect.
Reuber
Markus
M
University Hospital of Epileptology, Sigmund-Freud Str. 25, 53105 Bonn, Germany.
Andersen
Björn
B
Elger
Christian E
CE
Helmstaedter
Christoph
C
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology; D003131:Combined Modality Therapy; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D004833:Epilepsy, Temporal Lobe / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011182:Postoperative Care; D011300:Preoperative Care; D012044:Regression Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors
D000927:Anticonvulsants