Extended psychosocial follow-up after epilepsy surgery: 1-2-year results from a prospective cohort

Epilepsy surgery is an effective treatment for patients with drug-resistant epilepsy, often resulting in complete seizure control. Various factors, including coping styles, clinical features, and sociodemographic variables, influence psychosocial outcomes following surgery. This study aimed to examine changes in comprehensive psychosocial outcomes following epilepsy surgery and to assess how presurgical variables influenced these results.

This study serves as a follow-up to our previous research, in which we evaluated patients preoperatively and 6 months postoperatively using the Social Adaptation Self-Evaluation Scale (SASS), Epilepsy Self-Efficacy Scale (ESES), Felt Stigma Scale (FSS), Rosenberg Self-Esteem Scale (RSES), and the Coping Orientation to Problems Experienced (COPE) Inventory. Twenty-seven participants who were reachable 1-2 years after surgery were re-assessed using the SASS, ESES, RSES, and FSS. Changes in scale scores over time were evaluated using the Friedman test, and correlations were examined with Spearman's analysis.

Patients demonstrated increased self-efficacy levels following surgery (p = 0.008). Social adaptation levels after surgery were positively correlated with the presurgical active coping, use of emotional social support, and emotional-focused coping (p = 0.006, p = 0.038, p = 0.037, respectively). Postsurgical stigma was negatively correlated with presurgical emotional-focused coping (p = 0.023). The presurgical seizure frequency was negatively correlated with the postsurgical ESES and SASS (p = 0.002, p = 0.020, respectively). Furthermore, individuals who were employed before surgery demonstrated better social adaptation following the procedure (p = 0.007).

The psychosocial outcomes following epilepsy surgery are influenced by factors beyond seizure control. A better understanding of additional factors can elucidate the variability in psychosocial outcomes and empower healthcare providers to engage in more thorough and realistic dialogue about expected outcomes following surgery. Our results highlight key factors to predict psychosocial outcomes before surgery and provide valuable insights from a one-year follow-up. These findings support the need for comprehensive presurgical evaluations to identify psychosocial challenges and improve long-term outcomes for epilepsy surgery patients.