title: A prospective study contrasting the psychiatric outcome in drug-resistant epilepsy between patients who underwent surgery and a control group.
abstract: OBJECTIVE
  Psychiatric morbidity in drug-resistant epilepsy is frequent and has a negative influence on quality of life. Surgery is proven to be the best therapeutic alternative for treating seizures. However, it is inconclusive with the current evidence whether surgery, per se, is a risk factor or promotes amelioration of psychiatric disorders. Until now, most studies have been cross-sectional with small or heterogeneous groups. In addition, the few prospective studies did not have an identical control group. The present study aims to clarify the role of surgery in psychopathologic alterations.
  
  
  METHODS
  We analyzed, through a prospective case-control study, the psychopathologic outcomes of patients with drug-resistant epilepsy, comparing those who underwent surgery and those who continued with pharmacologic treatment due to not being suitable for surgery. The assessments were performed during presurgical evaluation and 6 months after surgery. We studied psychiatric changes for each group, compared differences between groups, and also analyzed de novo and remission cases. Finally, we determined associated factors for postsurgical psychiatric disturbances.
  
  
  RESULTS
  The surgical group experienced a significant decrease in psychopathologic alterations in comparison with the control group. In addition, distress perception of surgical patients also improved, whereas it did not decrease in the control group. Patients who underwent surgery presented a decrease in depressive and anxiety symptoms, whereas the nonsurgical group increased its anxiety levels. De novo disturbances that appeared after surgery were less frequent than in nonsurgical patients. We observed significant favorable outcomes considering de novo versus remission cases for anxiety, depression, and total symptoms only in the surgical group. The two main predictors for psychiatric disorders after surgery were presurgical psychiatric functioning and surgery.
  
  
  CONCLUSIONS
  Provides evidence that surgery improves psychiatric functioning in drug-resistant epilepsy through a prospective controlled study.
authors: Can Misses Hospital, Ibiza, Spain. sonia.ramos.12@gmail.com.|University of Barcelona, Barcelona, Spain. sonia.ramos.12@gmail.com.
authors: Sònia
authors: S
authors: Ramos-Perdigués
authors: Department of Experimental and Health Sciences, University Pompeu Fabra, Barcelona, Spain.|Autonomous University of Barcelona, Barcelona, Spain.
authors: Eva
authors: E
authors: Baillés
authors: Institute of Neuropsychiatry and Addictions, Parc de Salut Mar and Foundation IMIM, Barcelona, Spain.|Center for Biomedical Research in Mental Health Network (CIBERSAM), Barcelona, Spain.
authors: Anna
authors: A
authors: Mané
authors: Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain.|Epilepsy Unit, Hospital Clinic of Barcelona, Barcelona, Spain.|Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic of Barcelona, Barcelona, Spain.
authors: Mar
authors: M
authors: Carreño
authors: Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain.|Epilepsy Unit, Hospital Clinic of Barcelona, Barcelona, Spain.|Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic of Barcelona, Barcelona, Spain.
authors: Antonio
authors: A
authors: Donaire
authors: Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain.|Epilepsy Unit, Hospital Clinic of Barcelona, Barcelona, Spain.
authors: Jordi
authors: J
authors: Rumia
authors: Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain.|Epilepsy Unit, Hospital Clinic of Barcelona, Barcelona, Spain.|Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic of Barcelona, Barcelona, Spain.
authors: Nuria
authors: N
authors: Bargalló
authors: Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain.|Epilepsy Unit, Hospital Clinic of Barcelona, Barcelona, Spain.|Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic of Barcelona, Barcelona, Spain.
authors: Teresa
authors: T
authors: Boget
authors: Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain.|Epilepsy Unit, Hospital Clinic of Barcelona, Barcelona, Spain.|Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic of Barcelona, Barcelona, Spain.
authors: Xavier
authors: X
authors: Setoain
authors: Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain.
authors: Manuel
authors: M
authors: Valdes
authors: Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain.|Epilepsy Unit, Hospital Clinic of Barcelona, Barcelona, Spain.|Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clínic of Barcelona, Barcelona, Spain.
authors: Luís
authors: L
authors: Pintor
mesh_terms: D000328:Adult; D000069279:Drug Resistant Epilepsy / Q000000981:diagnostic imaging / Q000601:surgery*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Mental; Operation; Psychopathology; Refractory; Surgical