Changes in depression and anxiety after resective surgery for epilepsy

Area of Science:

• Neurology
• Psychiatry
• Neurosurgery

Background:

• Refractory epilepsy often co-occurs with depression and anxiety, impacting quality of life.
• Resective epilepsy surgery is a treatment option for drug-resistant epilepsy.
• Understanding the impact of surgery on mental health is crucial for patient care.

Purpose of the Study:

• To evaluate changes in depression and anxiety symptoms following resective epilepsy surgery.
• To identify factors associated with improvements in affective symptoms post-surgery.

Main Methods:

• Prospective multicenter study data analyzed for 358 patients undergoing resective epilepsy surgery.
• Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) assessed pre- and post-operatively up to 24 months.
• Statistical analyses (chi-squared) used to correlate proportions and identify relationships.

Main Results:

• Prevalence of moderate to severe depression was 22.1% and anxiety was 24.7% before surgery.
• Postoperative depression and anxiety rates decreased significantly at 3, 12, and 24 months.
• At 24 months, 8.2% of seizure-free patients reported moderate to severe depression/anxiety, versus 17.6% and 14.7% of those with ongoing seizures.

Conclusions:

• Resective epilepsy surgery leads to significant improvements in depression and anxiety.
• Seizure freedom post-surgery is associated with greater reductions in affective symptoms.
• Neither seizure focus laterality/localization nor surgical site influenced baseline or postoperative affective symptoms.