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Psychiatric Symptoms in Refractory Epilepsy During the First Year After Surgery

  • Sònia Ramos-Perdigués
  • Eva Baillés
  • Anna Mané
  • Mar Carreño
  • Antonio Donaire
  • Jordi Rumià
  • Nuria Bargalló
  • Teresa Boget
  • Xavier Setoain
  • Manuel Valdés
  • Luís Pintor
Original Article
  • 23 Downloads

Abstract

Psychiatric morbidity in drug-resistant epilepsy is frequent. Surgery is the best therapeutic alternative for treating seizures, but the current evidence concerning the effects of surgery on psychiatric disorders (PDs) is inconclusive. We aim to clarify surgery’s role in long-term PDs. Using a prospective controlled study, we analyzed the psychopathologic outcomes of patients with drug-resistant epilepsy, comparing those who underwent surgery to those who did not due to not being suitable. Surgical candidates were paired (n = 84) with the immediately following nonsurgical candidates (n = 68). Both groups continued their usual medical treatment. We studied psychiatric changes for each group and analyzed de novo and remission cases. The assessments were made during the presurgical evaluation, and at 6 months (6-M) and 12 months (12-M) after surgery. Finally, we determined associated factors for postsurgical PDs. At 12 months, using the Hospital Anxiety and Depression Scale (HADS), anxiety improved in both groups (p = 0.000), while depression improved only in the surgical group (p = 0.016). Moreover, all symptom dimensions on the Symptom Checklist-90-R (SCL-90), as well as severity, distress, and total symptoms, decreased only in the surgical group. These ameliorations reached not only statistical significance but also clinical significance for depression (HADS) (p = 0.014) and the interictal dysphoric disorder (p = 0.013). The main predictors for PDs after surgery were as follows: the presurgical and 6-month psychiatric symptoms, the absence of surgery, seizure outcomes, and some antiepileptic and psychiatric drugs. This study provides evidence that surgery for epilepsy could have a role in improving some symptoms of psychiatric disorders 12-M after the surgery.

Key Words

Neuropsychiatry Psychopathology Epilepsy comorbidity Consultation liaison psychiatry Neurosurgery. 

Notes

Acknowledgments

This study was supported by the Fondo de Investigación Sanitaria PI040418 (Spain).

Compliance with Ethical Standards

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Disclosures

None of the authors has any conflict of interest to disclose.

Supplementary material

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Copyright information

© The American Society for Experimental NeuroTherapeutics, Inc. 2018

Authors and Affiliations

  • Sònia Ramos-Perdigués
    • 1
    • 2
  • Eva Baillés
    • 3
    • 4
  • Anna Mané
    • 5
    • 6
  • Mar Carreño
    • 7
    • 8
    • 9
  • Antonio Donaire
    • 7
    • 8
    • 9
  • Jordi Rumià
    • 7
    • 8
  • Nuria Bargalló
    • 7
    • 8
    • 9
  • Teresa Boget
    • 7
    • 8
    • 9
  • Xavier Setoain
    • 7
    • 8
    • 9
  • Manuel Valdés
    • 7
  • Luís Pintor
    • 7
    • 8
    • 9
  1. 1.Sant Joan de Déu Terres de Lleida HospitalLleidaSpain
  2. 2.Nostra Senyora de Meritxell HospitalEscaldes-EngordanyAndorra
  3. 3.Department of Experimental and Health SciencesUniversity Pompeu FabraBarcelonaSpain
  4. 4.Autonomous University of BarcelonaBarcelonaSpain
  5. 5.Institute of Neuropsychiatry and AddictionsParc de Salut Mar and Foundation IMIMBarcelonaSpain
  6. 6.Center for Biomedical Research in Mental Health Network (CIBERSAM)MadridSpain
  7. 7.Clinical Institute of NeurosciencesHospital Clinic of BarcelonaBarcelonaSpain
  8. 8.Epilepsy UnitHospital Clínic de BarcelonaBarcelonaSpain
  9. 9.Hospital Clinic of BarcelonaBiomedical Research Institute August Pi i Sunyer (IDIBAPS)BarcelonaSpain

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