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Psychopathology after epilepsy surgery: a retrospective study

Published online by Cambridge University Press:  01 September 2022

C. Adão*
Affiliation:
Centro Hospitalar de Lisboa Ocidental, Psychiatry Department, Lisboa, Portugal
D.F. Rodrigues
Affiliation:
Centro Hospitalar de Lisboa Ocidental, Psychiatry Department, Lisboa, Portugal
A.S. Sequeira
Affiliation:
Centro Hospitalar de Lisboa Ocidental, Psychiatry Department, Lisboa, Portugal
B. Silva
Affiliation:
University of Birmingham, Clinical Neuropsychiatry, Birmingham, United Kingdom
A. Velosa
Affiliation:
Centro Hospitalar de Lisboa Ocidental, Psychiatry Department, Lisboa, Portugal
*
*Corresponding author.

Abstract

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Introduction

In patients submitted to refractory epilepsy surgery, psychiatric comorbidity is high (affecting 1 in every 3 patients), with descriptions of improvement, worsening and emergence of de novo psychopathology.

Objectives

Identifying the prevalence of psychopathology and associated risk factors in a group of patients submitted to refractory epilepsy surgery.

Methods

Retrospective observational study. Non systematic literature review.

Results

We observed 42 patients, 45.2% female and 54.8% male, with an average age of 46.5 years (SD±11.6). The average age of presentation of epilepsy was 18.8 years (SD±12.7), 97.6% with temporal lobe epilepsy and 2.4% with parietal lobe epilepsy, 50% in each hemisphere. 19% had surgical complications and 40.5% had post-surgical recurrence of crisis. 45.2% presented with pre-surgical psychopathology (33.3% affective disorders, 16.7% anxiety disorders, 2.4% psychotic disorders, 2.4% neurodevelopmental disorders and 2.4% substance use disorders). Post-surgically, 50% improved, 20.8% maintained and 29.2% worsened their psychopathology and 21.4% had de novo psychopathology. We didn’t find associations between the analyzed variables and the worsening or appearance of de novo psychopathology.

Conclusions

The worsening or appearance of de novo psychopathology is a well known phenomenon in patients submitted to refractory epilepsy surgery. In our sample there were cases of improvement, maintenance, worsening and emergence of de novo psychopathology, however we weren’t able to identify the factors associated with these different outcomes. Our study was retrospective and had a small sample, as limitations. Further, better-designed studies are necessary to identify risk factors for psychiatric disorders, allowing their effective prevention and treatment.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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