Psychological outcome profiles in childhood-onset temporal lobe epilepsy.
OBJECTIVE
To examine the effect of childhood-onset temporal lobe epilepsy (TLE) on long-term psychological function and to identify outcome profiles related to the natural course and treatment of TLE.


METHODS
Psychological function was studied in a prospective, community-based cohort of childhood-onset TLE, approximately 13 years following seizure onset. Fifty-three patients were assessed using a semi-structured psychosocial interview, supplemented by self-report questionnaires measuring quality-of-life, depression, self-esteem, and anxiety.


RESULTS
Common patterns were observed, giving rise to four distinct patient groups and psychological outcomes: (1) patients who experienced spontaneous remission of their seizures fared best; their psychological profile was characterized by heightened worry about the possibility of seizure recurrence; (2) patients who progressed to surgery and were seizure free reported adjustment difficulties associated with learning to become "well"; (3) patients who progressed to surgery and were not seizure free had the poorest psychological outcomes, with depression featuring prominently; and (4) patients with ongoing intractable epilepsy reported psychological and social features consistent with the effects of their chronic illness.


CONCLUSIONS
Patients with childhood-onset TLE face distinctive long-term psychological challenges. The specific nature of these challenges can be understood in terms of the natural evolution and treatment of their epilepsy.
Micallef
Silvana
S
School of Behavioral Science, University of Melbourne, Vic., Australia. silvana.micallef@austin.org.au
Spooner
Claire G
CG
Harvey
A Simon
AS
Wrennall
Jacquie A
JA
Wilson
Sarah J
SJ
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D018572:Disease-Free Survival; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012649:Self Concept; D012917:Social Adjustment; D011795:Surveys and Questionnaires; D013702:Temporal Lobe / Q000601:surgery; D016896:Treatment Outcome