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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
Corresponding

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

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Footnotes

Authors contributed equally as first author.

Authors contributed equally as last author.

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