Psychiatric disorders as predictors of epilepsy surgery outcome

Our aim was to determine if a history of a mental disorder predicts a worst neurological outcome for patients undergoing epilepsy surgery.

We conducted an ambispective observational study including people with refractory epilepsy who underwent resective surgery. Demographic, psychiatric, and neurological data were collected, before and one year after surgery. Presurgical interviews included a psychiatric evaluation and the determination of prevalent and lifetime psychiatric diagnosis. The one-year postsurgical outcome was classified according to the Engel Outcome Scale. Predictors of postsurgical Engel class were determined using an ordered logistic regression model.

A lifetime history of any mental disorder was a significant predictor of a higher Engel Class (p = 0.017).

This study shows that psychiatric lifetime diagnoses are associated with worse surgical outcome and highlighted the importance of the inclusion of these diagnoses in the evaluation of the potential success of the surgery.