title: Psychosocial factors associated with in postsurgical prognosis of temporal lobe epilepsy related to hippocampal sclerosis.
abstract: We examined the long-term psychosocial trajectory in a consecutive and homogeneous series of 120 patients followed up for five years after corticoamygdalohippocampectomy (CAH). Evaluation of psychosocial variables at baseline and at five-year follow-up were compared. After five years of CAH, a significant improvement in educational level (p=0.004) and employment status (p<0.001) was observed, although retirement (p<0.001) and divorce (p=0.021) rates increased. In a long-term follow-up, a tendency to have similar QOL profile was observed between Engel classes IA and IB (p>0.05). A more favorable surgical outcome (Engel IA) was related to better psychiatric status (p=0.012). Poor psychosocial adjustment before surgery was the most important predictor of QOL outcome (p<0.05). Patients' trajectory after surgical treatment showed positive effects mainly in those with better seizure outcome. Our results emphasized the influence regarding baseline psychosocial functioning on postoperative psychosocial adjustment. Furthermore, many psychosocial gains and difficulties after surgery may be similar in developing and developed countries.
authors.affiliation: Department of Neurology, Escola Paulista de Medicina/UNIFESP, São Paulo, Brazil. Electronic address: neide.bal@uol.com.br.
authors.forename: Neide Barreira
authors.initials: NB
authors.lastname: Alonso
authors.affiliation: Department of Neurology, Escola Paulista de Medicina/UNIFESP, São Paulo, Brazil.
authors.forename: Lenon
authors.initials: L
authors.lastname: Mazetto
authors.affiliation: Department of Psychiatry, Escola Paulista de Medicina/UNIFESP, São Paulo, Brazil.
authors.forename: Gerardo Maria
authors.initials: GM
authors.lastname: de Araújo Filho
authors.affiliation: Department of Neurology, Escola Paulista de Medicina/UNIFESP, São Paulo, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Vidal-Dourado
authors.affiliation: Department of Neurology, Escola Paulista de Medicina/UNIFESP, São Paulo, Brazil.
authors.forename: Elza Márcia Targas
authors.initials: EM
authors.lastname: Yacubian
authors.affiliation: Department of Neurosurgery, Escola Paulista de Medicina/UNIFESP, São Paulo, Brazil.
authors.forename: Ricardo Silva
authors.initials: RS
authors.lastname: Centeno
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D004651:Employment; D004833:Epilepsy, Temporal Lobe / Q000523:psychology / Q000601:surgery*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D011379:Prognosis; D011593:Psychology, Social; D011788:Quality of Life; D012598:Sclerosis / Q000473:pathology*; D012640:Seizures / Q000523:psychology; D013702:Temporal Lobe / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adjustment; Epilepsy surgery; Psychosocial follow-up; Quality of life