Department of Psychiatry, Hospital Clinic of Barcelona, Barcelona 08036, Spain; University of Barcelona (UB), Barcelona 08007, Spain.
University of Barcelona (UB), Barcelona 08007, Spain.
Epilepsy Behav. 2021 May;118:107921. doi: 10.1016/j.yebeh.2021.107921. Epub 2021 Apr 5.
Psychiatric morbidity in temporal lobe epilepsy (TLE) is frequent and negatively affects patients' life quality. Surgery is the procedure of choice when treating seizures, although the effects on psychiatric disorders remain unclear. We evaluate the effect of surgery on psychiatric disorders in patients with TLE two years after the intervention, to then shed light on how these are related to anxiety and depression symptoms, and Interictal Dysphoric Disorder (IDD).
We included data from 65 patients with TLE whose psychiatric evaluations were performed according to DSM-IV criteria. Anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS) test.
At 2-year follow-up, anxiety and depressive disorders decreased, and psychotic disorders augmented without statistical significance. Baseline psychiatric disorders predisposed to psychiatric pathology at 2-year follow-up and did not correlate with epilepsy outcome after surgery. Postoperative psychiatric disorders correlated with the seizure incidence two years after the intervention, suggesting that epilepsy and psychiatric disorders were associated in processes such as surgery. De novo psychiatric disorders represented 52% of postoperative psychiatric pathology, 62% being psychotic disorders. De novo psychiatric disorders became more frequent from the first year of surgery, occurring mainly in patients free of seizures. The HADS test scores and IDD correlated with psychiatric disorders at 2-year follow-up.
Baseline psychiatric disorders did not influence surgery outcome, but correlated with psychiatric disorders' prevalence two years after surgery. Despite not finding statistical significance, surgery reduced the prevalence of psychiatric disorders, and de novo psychiatric disorders were associated with an improvement in the epilepsy course at 2-year follow-up.
颞叶癫痫（TLE）患者常伴有精神障碍，严重影响患者的生活质量。手术是治疗癫痫的首选方法，但手术对精神障碍的影响尚不清楚。本研究旨在评估 TLE 患者术后 2 年的精神障碍变化，并探讨其与焦虑和抑郁症状及发作间期不愉快心境障碍（ID）的关系。
我们纳入了 65 例 TLE 患者，根据 DSM-IV 标准对其进行了精神评估。采用医院焦虑抑郁量表（HADS）评估焦虑和抑郁症状。
术后 2 年时，焦虑和抑郁障碍减轻，精神病性障碍增加，但无统计学意义。基线期精神障碍与术后 2 年的精神病理学相关，与术后癫痫结局无关。术后精神障碍与干预后 2 年内的癫痫发作频率相关，提示癫痫和精神障碍在手术等过程中存在关联。术后新发精神障碍占术后精神病理学的 52%，其中 62%为精神病性障碍。术后新发精神障碍从手术第 1 年开始更为常见，主要发生在无癫痫发作的患者中。HADS 评分和 IDD 与术后 2 年的精神障碍相关。
基线期精神障碍不影响手术结局，但与术后 2 年的精神障碍发生率相关。尽管无统计学意义，但手术可降低精神障碍的发生率，且术后新发精神障碍与癫痫病程改善相关。
