Presurgical depression and anxiety are not associated with worse epilepsy surgery outcome five years postoperatively

Hamada H. Altalib, Anne T. Berg, Xiangyu Cong, Barbara G. Vickrey, Michael R. Sperling, Shlomo Shinnar, John T. Langfitt, Thaddeus S. Walczak, Carl W. Bazil, Nitin Sukumar, Orrin Devinsky

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose: Anxiety and depression have been associated with poor seizure control after epilepsy surgery. This study explored the effect of presurgical anxiety or depression on two- and five-year seizure control outcomes. Methods: Adult subjects were enrolled between 1996 and 2001 in a multicenter prospective study to evaluate outcomes of resective epilepsy surgery. A Poisson regression was used to analyze the association of depression and anxiety with surgical outcome, while adjusting for gender, age, ethnicity, number of years with seizures, and presence of mesial temporal sclerosis. Results: The relative risk (RR) of presurgical depression on two-year seizure-free outcome in this cohort is 1.12 (95% confidence interval (CI), 0.84–1.49) and 1.06 (CI, 0.73–1.55) on five-year seizure free outcome. The RR of presurgical anxiety on two-year seizure outcome is 0.73 (CI, 0.50–1.07) and 0.70 (CI, 0.43–1.17) on five-year seizure outcome. When including Engel classes I and II, the RRs of presurgical depression, anxiety, or both two years after surgery were 0.96 (p = 0.59), 0.73 (p < 0.05), and 0.97 (p = 0.70), respectively, and they were 0.97 (p = 0.82), 0.84 (p = 0.32), and 0.89 (p = 0.15), respectively, five years after surgery. Only presurgical anxiety was associated with worse epilepsy surgery outcome two year after surgery but not at five years postsurgery. Depression was not a risk factor for poor epilepsy surgical outcome in the long term. Conclusion: These findings from a prospective study that utilized a standardized protocol for psychiatric and seizure outcome assessment suggest that presurgical mood disorders have no substantial impact on postsurgical seizure outcome for up to five years after surgery.

Original languageEnglish (US)
Pages (from-to)7-12
Number of pages6
JournalEpilepsy and Behavior
Volume83
DOIs
StatePublished - Jun 2018

Bibliographical note

Funding Information:
Dr. Berg receives support from grant NINDS-R37-NS31146 and the Pediatric Epilepsy Research Foundation .

Funding Information:
Dr. Altalib was supported by the Swebilius Foundation .

Funding Information:
Dr. Vickrey serves on the NIA-funded CHOICE study (Indiana University), Data Safety and Monitoring Board. She receives funding from the California Community Foundation an research support from grant NINDS-U54-N5081764 (PI).

Funding Information:
Dr. Vickrey serves on the NIA-funded CHOICE study (Indiana University), Data Safety and Monitoring Board. She receives funding from the California Community Foundation an research support from grant NINDS-U54-N5081764 (PI).

Publisher Copyright:
© 2018

Keywords

  • Cohort
  • Epidemiology
  • Neuropsychiatry

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