Devinsky O, Barr W B, Vickrey B G, Berg A T, Bazil C W, Pacia S V, Langfitt J T, Walczak T S, Sperling M R, Shinnar S, Spencer S S
New York University School of Medicine, New York, NY, USA.
Neurology. 2005 Dec 13;65(11):1744-9. doi: 10.1212/01.wnl.0000187114.71524.c3.
To determine changes in depression and anxiety after resective surgery.
Data from subjects enrolled in a prospective multicenter study of resective epilepsy surgery were reviewed with the Beck Psychiatric Symptoms Scales (Beck Depression Inventory [BDI] and Beck Anxiety Inventory [BAI]) and Composite International Diagnostic Interview (CIDI) up to a 24-month period. chi2 analyses were used to correlate proportions.
A total of 358 presurgical BDI and 360 BAI results were reviewed. Moderate and severe levels of depression were reported in 22.1% of patients, and similar levels of anxiety were reported by 24.7%. Postoperative rates of depression and anxiety declined at the 3-, 12-, and 24-month follow-up periods. At the 24-month follow-up, moderate to severe levels of depression symptoms were reported in 17.6 and 14.7% of the patients who continued to have postoperative seizures. Moderate to severe depression and anxiety were found in 8.2% of those who were seizure-free. There was no relationship, prior to surgery, between the presence or absence of depression and anxiety and the laterality or location of the seizure onset. There were no significant relationships between depression or anxiety at 24-month follow-up and the laterality or location of the surgery.
Depression and anxiety in patients with refractory epilepsy significantly improve after epilepsy surgery, especially in those who are seizure-free. Neither the lateralization nor the localization of the seizure focus or surgery was associated with the risk of affective symptoms at baseline or after surgery.
确定切除性手术后抑郁和焦虑的变化情况。
对参加前瞻性多中心切除性癫痫手术研究的受试者数据进行回顾，使用贝克精神病症状量表（贝克抑郁量表[BDI]和贝克焦虑量表[BAI]）以及复合国际诊断访谈（CIDI），随访期长达24个月。采用卡方分析来关联比例。
共回顾了358份术前BDI结果和360份BAI结果。22.1%的患者报告有中度和重度抑郁，24.7%的患者报告有类似程度的焦虑。在3个月、12个月和24个月的随访期，抑郁和焦虑的术后发生率下降。在24个月随访时，仍有术后癫痫发作的患者中，17.6%和14.7%报告有中度至重度抑郁症状。在无癫痫发作的患者中，8.2%存在中度至重度抑郁和焦虑。术前抑郁和焦虑的有无与癫痫发作起始的侧别或部位之间没有关系。24个月随访时的抑郁或焦虑与手术的侧别或部位之间没有显著关系。
难治性癫痫患者的抑郁和焦虑在癫痫手术后显著改善，尤其是在无癫痫发作的患者中。癫痫病灶或手术的侧别及定位在基线或术后均与情感症状风险无关。
