Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-05-30T14:57:32.282Z Has data issue: false hasContentIssue false

Psychiatric and psychosocial morbidity 1 year after epilepsy surgery

Published online by Cambridge University Press:  24 November 2020

S. Patel*
Affiliation:
Department of Liaison Psychiatry, Beaumont Hospital, Dublin, Ireland
M. Clancy
Affiliation:
Department of Liaison Psychiatry, University Hospital Waterford, Waterford, Ireland
H. Barry
Affiliation:
Department of Liaison Psychiatry, Beaumont Hospital, Dublin, Ireland
N. Quigley
Affiliation:
Department of Psychiatry, St. Vincent’s Hospital, Fairview, Dublin, Ireland
M. Clarke
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
M. Cannon
Affiliation:
Department of Liaison Psychiatry, Beaumont Hospital, Dublin, Ireland Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
N. Delanty
Affiliation:
Department of Liaison Psychiatry, Beaumont Hospital, Dublin, Ireland Future Neuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
K. C. Murphy
Affiliation:
Department of Liaison Psychiatry, Beaumont Hospital, Dublin, Ireland Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
D. Cotter*
Affiliation:
Department of Liaison Psychiatry, Beaumont Hospital, Dublin, Ireland Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
*
*Address for correspondence: Dr S. Patel, Department of Liaison Psychiatry, Beaumont Hospital, Beaumont Rd, Dublin 9, Ireland. (Email: sonn.patel@hse.ie) (Email: drcotter@rcsi.ie) [D.C.]
*Address for correspondence: Dr S. Patel, Department of Liaison Psychiatry, Beaumont Hospital, Beaumont Rd, Dublin 9, Ireland. (Email: sonn.patel@hse.ie) (Email: drcotter@rcsi.ie) [D.C.]

Abstract

Objectives:

There is a high rate of psychiatric comorbidity in patients with epilepsy. However, the impact of surgical treatment of refractory epilepsy on psychopathology remains under investigation. We aimed to examine the impact of epilepsy surgery on psychopathology and quality of life at 1-year post-surgery in a population of patients with epilepsy refractory to medication.

Methods:

This study initially assessed 48 patients with refractory epilepsy using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Hospital Anxiety and Depression Scale (HADS) and the Quality of Life in Epilepsy Inventory 89 (QOLIE-89) on admission to an Epilepsy Monitoring Unit (EMU) as part of their pre-surgical assessment. These patients were again assessed using the SCID-I, QOLIE-89 and HADS at 1-year follow-up post-surgery.

Results:

There was a significant reduction in psychopathology, particularly psychosis, following surgery at 1-year follow-up (p < 0.021). There were no new cases of de novo psychosis and surgery was also associated with a significant improvement in the quality of life scores (p < 0.001).

Conclusions:

This study demonstrates the impact of epilepsy surgery on psychopathology and quality of life in a patient population with refractory surgery. The presence of a psychiatric illness should not be a barrier to access surgical treatment.

Type
Original Research
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Authors contributed equally as first author.

Authors contributed equally as last author.

References

Adams, SJ, Velakoulis, D, Kaye, AH, Corcoran, NM, O’Brien, TJ (2012). Psychiatric history does not predict seizure outcome following temporal lobectomy for mesial temporal sclerosis. Epilepsia 53, 17001704.CrossRefGoogle Scholar
Anhoury, S, Brown, RJ, Krishnamoorthy, ES, Trimble, MR (2000). Psychiatric outcome after temporal lobectomy: a predictive study. Epilepsia 41, 16081615.Google ScholarPubMed
Bladin, PF (1992). Psychosocial difficulties and outcome after temporal lobectomy. Epilepsia 33, 898907.CrossRefGoogle ScholarPubMed
Boylan, LS, Flint, LA, Labovitz, DL, Jackson, SC, Starner, K, Devinsky, O (2004). Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy. Neurology 62, 258261.CrossRefGoogle Scholar
Buranee, K, Teeradej, S, Chusak, L, Michael, M (2016). Epilepsy-related psychoses and psychotic symptoms are significantly reduced by resective epilepsy surgery and are not associated with surgery outcome or epilepsy characteristics: a cohort study. Psychiatry Research 245, 333339.CrossRefGoogle ScholarPubMed
Cleary, RA, Baxendale, SA, Thompson, PJ, Foong, J (2013). Predicting and preventing psychopathology following temporal lobe epilepsy surgery. Epilepsy & Behaviour 26, 322334.CrossRefGoogle ScholarPubMed
Cleary, RA, Thompson, PJ, Fox, Z, Foong, J (2012).Predictors of psychiatric and seizure outcome following temporal lobe epilepsy surgery. Epilepsia 53, 17051712.CrossRefGoogle ScholarPubMed
D’Alessio, L, Scévola, L, Fernandez Lima, M, Oddo, S, Solís, P, Seoane, E, Kochen, S (2014). Psychiatric outcome of epilepsy surgery in patients with psychosis and temporal lobe drug-resistant epilepsy: a prospective case series. Epilepsy & Behaviour 37, 165170.CrossRefGoogle ScholarPubMed
Desai, S, Shukla, G, Goyal, V, Srivastava, A, Srivastava, MV, Tripathi, M, Singh, M, Shivanand, K, Sagar, R, Gupta, A, Saratchandra, P, Garg, A, Bal, CS, Behari, M (2014). Changes in psychiatric comorbidity during early postsurgical period in patients operated for medically refractory epilepsy--a MINI-based follow-up study. Epilepsy & Behaviour 32, 2933.CrossRefGoogle ScholarPubMed
Devinsky, O (2003). Psychiatric comorbidity in patients with epilepsy: implications for diagnosis and treatment. Epilepsy & Behaviour 4 (Suppl. 4), S2S10.CrossRefGoogle ScholarPubMed
Devinsky, O, Barr, WB, Vickrey, BG, Berg, AT, Bazil, CW, Pacia, SV, Langfitt, JT, Walczak, TS, Sperling, MR, Shinnar, S, Spencer, SS (2005). Changes in depression and anxiety after resective surgery for epilepsy. Neurology 65, 17441749.CrossRefGoogle ScholarPubMed
Devinsky, O, Vickrey, BG, Cramer, J, Perrine, K, Hermann, B, Meador, K, Hays, RD (1995). Development of the quality of life in epilepsy inventory. Epilepsia 36, 10891104.CrossRefGoogle ScholarPubMed
Engel, J Jr, Levesque, MF, Shields, WD (1992) Surgical treatment of the epilepsies: presurgical evaluation Clin Neurosurg 38, 514534.Google ScholarPubMed
Engel, J Jr, Wiebe, S, French, J, Sperling, M, Williamson, P, Spencer, D, Gumnit, R, Zahn, C, Westbrook, E, Enos, B (2003). Practice parameter: temporal lobe and localized neocortical resections for epilepsy. Epilepsia 44, 741751.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Robert, L, Gibbon, M, Williams, JBW (1996). Structured Clinical Interview for DSM-IV Axis I Disorders Clinician Version (SCID-CV). American Psychiatric Press Inc.: Washington, DC.Google Scholar
Gaitatzis, A, Trimble, MR, Sander, JW (2004). The psychiatric comorbidity of epilepsy. Acta Neurologica Scandanavica 110, 207220.CrossRefGoogle ScholarPubMed
Hamid, H, Blackmon, K, Cong, X, Dziura, J, Atlas, LY, Vickrey, BG, Berg, AT, Bazil, CW, Langfitt, JT, Walczak, TS, Sperling, MR, Shinnar, S, Devinsky, O (2014). Mood anxiety and incomplete seizure control affect quality of life after epilepsy surgery. Neurology 82, 887894.CrossRefGoogle ScholarPubMed
Hamid, H, Liu, H, Cong, X, Devinsky, O, Berg, AT, Vickrey, BG, Sperling, MR, Shinnar, S, Langfitt, JT, Walczak, TS, Barr, WB, Dziura, J, Bazil, CW, Spencer, SS (2011). Long-term association between seizure outcome and depression after resective epilepsy surgery. Neurology 77, 19721976.CrossRefGoogle ScholarPubMed
Hermann, BP, Seidenberg, M, Bell, B (2000). Psychiatric comorbidity in chronic epilepsy: identification consequences and treatment of major depression. Epilepsia 41 (Suppl. 2), S31S41.CrossRefGoogle ScholarPubMed
Iranzo-Tatay, C, Rubio-Granero, T, Gutierrez, A, Garcés, M, Conde, R, Gómez-Ibáñez, A, Arques-Egea, S, Sancho-Miñana, L, Hervas-Marín, D, Villanueva, V (2017). Psychiatric symptoms after temporal epilepsy surgery: a one-year follow-up study. Epilepsy & Behaviour 70 (Pt A), 154160.CrossRefGoogle ScholarPubMed
Ives-Deliperi, V, Butler, JT (2017). Quality of life one year after epilepsy surgery. Epilepsy & Behaviour 75, 213217.CrossRefGoogle ScholarPubMed
Johnson, EK, Jones, JE, Seidenberg, M, Hermann, BP (2004). The relative impact of anxiety depression and clinical seizure features on health-related quality of life in epilepsy. Epilepsia 45, 544550.CrossRefGoogle ScholarPubMed
Kanner, AM, Byrne, R, Chicharro, A, Wuu, J, Frey, M (2009). A lifetime psychiatric history predicts a worse seizure outcome following temporal lobectomy. Neurology 72, 793799.CrossRefGoogle ScholarPubMed
Kerr, MP, Mensah, S, Besag, F, de Toffol, B, Ettinger, A, Kanemoto, K, Kanner, A, Kemp, S, Krishnamoorthy, E, LaFrance, WC Jr, Mula, M, Schmitz, B, van Elst, LT, Trollor, J, Wilson, SJ, International League of Epilepsy Commission on the Neuropsychiatric Aspects of Epilepsy (2011). International consensus clinical practice statements for the treatment of neuropsychiatric conditions associated with epilepsy. Epilepsia 52, 21332138.CrossRefGoogle ScholarPubMed
Koch-Stoecker, SC, Bien, CG, Schulz, R, May, TW (2017). Psychiatric lifetime diagnoses are associated with a reduced chance of seizure freedom after temporal lobe surgery. Epilepsia 58, 983993.CrossRefGoogle ScholarPubMed
MacDonald, BK, Cockerell, OC, Sander, JW, Shorvon, SD (2000). The incidence and lifetime prevalence of neurological disorders in a prospective community-based study in the UK. Brain 123 (Pt 4), 665676.CrossRefGoogle Scholar
Macrodimitris, S, Sherman, EM, Forde, S, Tellez-Zenteno, JF, Metcalfe, A, Hernandez-Ronquillo, L, Wiebe, S, Jette, N (2011). Psychiatric outcomes of epilepsy surgery: a systematic review. Epilepsia 52, 880890.CrossRefGoogle ScholarPubMed
Pintor, L, Bailles, E, Fernandez-Egea, E, Sanchez-Gistau, V, Torres, X, Carreno, M, Rumia, J, Matrai, S, Boget, T, Raspall, T, Donaire, A, Bargallo, N, Setoain, X (2007). Psychiatric disorders in temporal lobe epilepsy patients over the first year after surgical treatment. Seizure 16, 218225.CrossRefGoogle ScholarPubMed
Pulsipher, DT, Seidenberg, M, Jones, J, Hermann, B (2006). Quality of life and comorbid medical and psychiatric conditions in temporal lobe epilepsy. Epilepsy & Behaviour 9, 510514.CrossRefGoogle ScholarPubMed
Ramos-Perdigués, S, Baillés, E, Mané, A, Carreño, M, Donaire, A, Rumià, J, Bargalló, N, Boget, T, Setoain, X, Valdés, M, Pintor, L (2018). Psychiatric symptoms in refractory epilepsy during the first year after surgery Neurotherapeutics 15, 10821092.CrossRefGoogle ScholarPubMed
Roberts, GW, Done, DJ, Bruton, C, Crow, TJ (1990). A mock up of schizophrenia: temporal lobe epilepsy and schizophrenia-like psychosis. Biological Psychiatry 28, 127143.CrossRefGoogle ScholarPubMed
Taylor, DC (1972). Mental state and temporal lobe epilepsy A correlative account of 100 patients treated surgically. Epilepsia 13, 727765.CrossRefGoogle ScholarPubMed
Trimble, MR (1991). The Psychoses of Epilepsy. Raven Press: New York.Google ScholarPubMed
Trimble, MR (1992) Behaviour changes following temporal lobectomy with special reference to psychosis Journal of Neurology Neurosurgery and Psychiatry 55, 8991.CrossRefGoogle ScholarPubMed
Victoroff, J (1994). DSM-III-R psychiatric disorders in candidates for epilepsy surgery: lifetime prevalence. Neuropsychiatry Neuropsychology and Behavoural Neurology 7, 8797.Google Scholar
Zigmond, AS, Snaith, RP (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandanvica 67, 361370.CrossRefGoogle ScholarPubMed
Supplementary material: File

Patel et al. supplementary material

Patel et al. supplementary material

Download Patel et al. supplementary material(File)
File 58.3 KB