Psychiatric disorders in temporal lobe epilepsy patients over the first year after surgical treatment.
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 disorders' 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 lower postsurgical rate of psychiatric disorders than those with psychiatric history (X(2)=9.87, gl=1, p< or =0.001), with psychiatric disorders in the presurgical evaluation (X(2)=12.02, gl=1, p< or =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.
Pintor
Luis
L
Department of Psychiatry, Neuroscience Institut, Hospital Clínico, Barcelona, Spain. lpintor@clinic.ub.es
Bailles
Eva
E
Fernández-Egea
Emili
E
Sánchez-Gistau
Vanessa
V
Torres
Xavier
X
Carreño
Mar
M
Rumia
Jordi
J
Matrai
Silvia
S
Boget
Teresa
T
Raspall
Toni
T
Donaire
Antonio
A
Bargalló
Nuria
N
Setoain
Xavier
X
D000328:Adult; D004833:Epilepsy, Temporal Lobe / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome