Date of Award
MD (Medical Doctor)
Professor David Cotter
Professor Mary Cannon
Epilepsy, Surgery, Psychiatry, Intellectual Disability, Comorbidity.
Epilepsy is a common disease with a prevalence of 0.5-1% of the population. The literature on psychopathology in refractory epilepsy is conflicting. In refractory epilepsy, surgical intervention is considered to reduce seizure frequency and in some cases prevent seizures. It has been reported that neurosurgical intervention for epilepsy is associated with significant undesirable psychiatric consequences. This study looked at psychiatric and psychosocial comorbidity in a sample of pre-operative epilepsy surgery candidates and also examined patients who proceeded to surgery at one year post-operatively to see whether surgery had positive or negative consequences on patients' mental health.
This study examined a sample of patients with medically refractory epilepsy and a prospective cohort study was conducted on a sub-group of this sample who underwent surgery and had psychiatric follow-up at one year postoperatively. This study used the Structured Clinical Interview for DSM IV (SCID I) to examine for an Axis I psychiatric diagnosis and the presence o f a personality disorder was assessed for using SCID II. The Hospital Anxiety and Depression Scale (HADS) and Quality of Life in Epilepsy 89 (QOLIE 89) were the subjective rating scales utilized.
The findings of this study demonstrated the high prevalence of psychiatric comorbidity (54.4%) in patients with medically refractory epilepsy. A total of 48 patients had pre-operative and post-operative assessments at one year. There was a highly significant reduction post-operatively with the number of patients with a psychiatric diagnosis (p
Overall, this study demonstrated that undergoing surgery for medically refractory epilepsy had an overall positive impact on mental health with a significant reduction in the prevalence of psychiatric symptoms and an improved quality of life for patients.
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Clancy MJ. Psychiatric and psychosocial comorbidity before and one year after epilepsy surgery. [MD Thesis]. Dublin: Royal College of Surgeons in Ireland; 2015.