Changes in depression and anxiety after resective surgery for epilepsy
Changes in depression and anxiety after resective surgery for epilepsy
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DOI：
10.1212/01.wnl.0000187114.71524.c3
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发表时间：
2005-12-13
期刊：
影响因子：
9.9
通讯作者：
Spencer, SS
中科院分区：
文献类型：
--
作者：
Devinsky, O;Barr, WB;Spencer, SS
目的：了解手术后患者抑郁、焦虑情绪的变化。方法：采用Beck精神病学症状量表(Beck抑郁问卷[BDI]和Beck焦虑问卷[BAI])和综合国际诊断访谈(CIDI)对参加癫痫切除手术前瞻性多中心研究的受试者的数据进行回顾，最长达24个月。CHI(2)分析被用来关联比例。结果：共回顾了358例BDI和360例BAI结果。22.1%的患者报告有中度和重度抑郁，24.7%的患者报告了类似程度的焦虑。术后抑郁和焦虑的发生率在3个月、12个月和24个月的随访期内下降。在24个月的随访中，17.6%和14.7%的患者报告了中度到重度的抑郁症状，这些患者术后仍有癫痫发作。在那些没有癫痫发作的人中，有8.2%的人有中度到重度的抑郁和焦虑。在手术前，抑郁和焦虑的存在或不存在与癫痫发作的偏侧性或位置之间没有关系。在24个月的随访中，抑郁或焦虑与手术的偏侧性或位置之间没有显著的关系。结论：难治性癫痫患者术后抑郁和焦虑明显改善，尤其是那些无癫痫发作的患者。癫痫灶或手术的偏侧化或定位与基线或手术后情感性症状的风险均无关联。
Objective: To determine changes in depression and anxiety after resective surgery. Methods: Data from subjects enrolled in a prospective multicenter study of resective epilepsy surgery were reviewed with the Beck Psychiatric Symptoms Scales ( Beck Depression Inventory [BDI] and Beck Anxiety Inventory [BAI]) and Composite International Diagnostic Interview (CIDI) up to a 24-month period. chi(2) analyses were used to correlate proportions. Results: A total of 358 presurgical BDI and 360 BAI results were reviewed. Moderate and severe levels of depression were reported in 22.1% of patients, and similar levels of anxiety were reported by 24.7%. Postoperative rates of depression and anxiety declined at the 3-, 12-, and 24-month follow-up periods. At the 24-month follow-up, moderate to severe levels of depression symptoms were reported in 17.6 and 14.7% of the patients who continued to have postoperative seizures. Moderate to severe depression and anxiety were found in 8.2% of those who were seizure-free. There was no relationship, prior to surgery, between the presence or absence of depression and anxiety and the laterality or location of the seizure onset. There were no significant relationships between depression or anxiety at 24- month follow-up and the laterality or location of the surgery. Conclusions: Depression and anxiety in patients with refractory epilepsy significantly improve after epilepsy surgery, especially in those who are seizure-free. Neither the lateralization nor the localization of the seizure focus or surgery was associated with the risk of affective symptoms at baseline or after surgery.