title: Risk factors for postoperative depression in 150 subjects treated for drug-resistant focal epilepsy.
abstract: OBJECTIVE
  The primary goal was to identify risk factors for post-surgical depression in subjects operated on for drug-resistant epilepsy. Secondary goals were to confirm the high rate of depression in subjects suffering from epilepsy (prior to surgery) and to look for first post-surgical depressive episode.
  
  
  METHODS
  Case series study of 150 subjects surgically treated for partial epilepsy (side of surgery: 72 right, 78 left; site of surgery: 97 Unilobar Temporal, 17 Unilobar Frontal, 14 Posterior, 22 Multilobar). All subjects routinely had three psychiatric evaluations: before surgery (baseline) and at 6 and 12 months after surgery. Psychiatric diagnoses were made according to DSM-IV-TR criteria. Bivariate (Fisher exact test and Kruskal-Wallis rank sum test) and multivariate (logistic regression model fitting) analyses were performed.
  
  
  RESULTS
  Thirty-three (22%) subjects had post-surgical depressive episodes, 31 of them in the first 6 months. Fourteen out of 33 experienced depression for the first time. Post-surgical depressive episodes are not associated with gender, outcome on seizures, side/site of surgical resection, histological diagnosis, psychiatric diagnoses other than depression. Depressive episodes before surgery and older age at surgery time are risk factors for post-surgical depression (p= 0.0001 and 0.01, respectively, at logistic regression analysis). No protective factors were identified.
  
  
  CONCLUSIONS
  Our data show that lifetime depressive episodes and older age at surgery time are risk factors for postsurgery depression. Moreover, a prospective study could be useful in order to assess whether depression is really a consequence of surgery.
authors.forename: V
authors.initials: V
authors.lastname: Barbieri
authors.forename: F
authors.initials: F
authors.lastname: Cardinale
authors.forename: A
authors.initials: A
authors.lastname: Luoni
authors.forename: G L
authors.initials: GL
authors.lastname: Russo
authors.forename: S
authors.initials: S
authors.lastname: Francione
authors.forename: L
authors.initials: L
authors.lastname: Tassi
authors.forename: I
authors.initials: I
authors.lastname: Sartori
authors.forename: L
authors.initials: L
authors.lastname: Castana
authors.forename: S
authors.initials: S
authors.lastname: Scarone
authors.forename: O
authors.initials: O
authors.lastname: Gambini
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D004828:Epilepsies, Partial / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012008:Recurrence; D012307:Risk Factors