Psychiatric disorders in surgical candidates for epilepsy surgery

D' ALESSIO L, SCÉVOLA L, ODDO S, KAUFFMAN M, PAPAYANNIS C, SOLÍS P, SEOANE E, CONSALVO D, KONOPKA H, DONNOLI V, KOCHEN S.

Buenos Aires

Congreso; 15th World Congress of Psychiatry; 2011

Asociación Mundial de Psiquiatría

ntroduction: Patients with RE (refractory epilepsy), surgical candidates, have a high prevalence of psychiatric disorders. However, psychiatric contraindications for epilepsy surgery are not clear, and there are many controversies in the literature; while some patients become better after surgery from their psychiatric condition, others can develop de novo depression or psychosis. Objectives: The aim of this study was to determine the subtypes of psychiatric disorders before and after epilepsy surgery (one year follow up), in a population with RE who underwent epilepsy surgery for intractable epilepsy. Methods: All patients included in this study underwent a complete clinical, electrophysiological, and image evaluation to confirm RE. Psychiatric assessment was performed before and after surgery (one year), and DMS IV Structural Interview for psychiatric disorders for Axis I and II in combination with Ictal classification for psychosis was used. Results: 74 patients with RE who underwent epilepsy surgery were included in this study and 52 patients completed psychiatric assessment after surgery during the first year. More frequent psychiatric disorders before surgery were affective (depression), anxiety, psychotic disorders and personality disorders. 22 (42%) patients developed psychiatric complications after surgery, and 6 of this group (11.5%), developed the novo psychiatric disorders. More frequent psychiatric disorders after surgery were depression, anxiety disorders, and psychosis. 8 (15%) patients with psychiatric condition before surgery showed a better psychiatric outcome after surgery. Conclusions: Psychiatric assessment between patients with RE becomes very important because of the high risk of psychiatric co morbidity before and after surgery.