Smith Jason A D, Armacost Michelle, Ensign Emily, Shaw Susan, Jimenez Nora, Millett David, Liu Charles, Heck Christianne N
Rancho Los Amigos National Rehabilitation Center, 7601 Imperial Hwy, Downey, CA 90242, USA; University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., CS6.104, Dallas, TX 75390-9055, USA.
Rancho Los Amigos National Rehabilitation Center, 7601 Imperial Hwy, Downey, CA 90242, USA; Los Angeles County - University of California Medical Center, 2051 Marengo Street, Los Angeles, CA 90033, USA; University of Southern California, Department of Neurology, 1540 Alcazar Street, Suite 215, Los Angeles, CA 90033, USA.
Epilepsy Behav. 2018 Jun;83:1-6. doi: 10.1016/j.yebeh.2018.03.015. Epub 2018 Apr 7.
The objective of this study was to investigate the effect of epilepsy surgery on depression, anxiety, and quality of life (QOL) in a Hispanic, primarily immigrant, Spanish-speaking population with intractable epilepsy (IE).
Patients with IE from a comprehensive epilepsy treatment center in an urban, public healthcare setting who underwent resective brain surgery between 2008 and 2014 (N=47) and completed presurgical and postsurgical neuropsychological evaluation were retrospectively identified. Presurgical and 1-year postsurgical Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and QOLIE-31 ratings were analyzed as postsurgical outcome measures. One-tailed paired sample t-tests were used to evaluate whether scores improved postoperatively. Established severity level classifications of depression and anxiety (i.e., minimal, mild, moderate, or severe) were used to analyze changes in occurrence of depression and anxiety.
Medium to large improvements on the BDI-II and most QOLIE-31 subscales, with a smaller effect on the BAI and remaining QOLIE-31 subscales, were noted 1-year postsurgery. Levels of depression and anxiety were significantly reduced 1-year postsurgery. Depression, anxiety, and QOL improvements were robust and unaffected by gender, levels of education, or hemisphere of surgery.
This study supports the positive benefits of epilepsy surgery on depression, anxiety, and QOL in Hispanic, primarily undocumented immigrant, Spanish-speaking people with epilepsy (PWE) in the US. These results are useful for educating this particular population about the possible benefits of surgery for IE and can enhance presurgical counseling.
本研究的目的是调查癫痫手术对以西班牙语为母语、主要为移民的西班牙裔顽固性癫痫（IE）患者的抑郁、焦虑和生活质量（QOL）的影响。
回顾性确定2008年至2014年期间在城市公共医疗环境中的一家综合癫痫治疗中心接受切除性脑手术并完成术前和术后神经心理学评估的IE患者（N = 47）。将术前和术后1年的贝克抑郁量表第二版（BDI-II）、贝克焦虑量表（BAI）和癫痫生活质量量表-31（QOLIE-31）评分作为术后结果指标进行分析。采用单尾配对样本t检验评估术后评分是否有所改善。使用既定的抑郁和焦虑严重程度分级（即轻微、轻度、中度或重度）来分析抑郁和焦虑发生率的变化。
术后1年，BDI-II和大多数QOLIE-31子量表有中度到大幅改善，对BAI和其余QOLIE-31子量表的影响较小。术后1年，抑郁和焦虑水平显著降低。抑郁、焦虑和生活质量的改善显著，且不受性别、教育程度或手术半球的影响。
本研究支持癫痫手术对美国以西班牙语为母语、主要为无证移民的西班牙裔癫痫患者（PWE）的抑郁、焦虑和生活质量具有积极益处。这些结果有助于向这一特定人群宣传IE手术可能带来的益处，并可加强术前咨询。
