Abstracts

Rationale: Depression is the most frequent psychiatric comorbidity in patients with epilepsy. Epidemiological studies indicate that 10-20 % of the patients with controlled epilepsy and 20-60% with recurrent seizures have a depressive disorder. The aim of this study was to analyse clinical, electrical and imaging features in refractory temporal lobe epilepsy (RTLE) patients with or without comorbid depression. Methods: We selected a sample of 33 patients with RTLE and depression comorbidity, and they were compared with 27 RTLE patients without any psychiatric disorders in DSM IV. Psychiatric assessment was performed using SCID I of DSM IV. All 60 RTLE patients were evaluated with Video- EEG monitoring and MRI, and were candidates to epilepsy surgery. Sex, age, age of epilepsy onset and epilepsy time duration, febrile convulsions, generalized seizures, status history, presence of unilateral and bilateral hippocampal sclerosis or other structural lesions, and laterality of epileptic discharges diagnosed by video-eeg were determined. Student t Test and Chi Square were determined. Results: Female gender and the presence of more extended lesions than hippocampal sclerosis (hippocampal sclerosis plus, dual pathology and malformation of cortical development) were more frequent in the group with depression (p<0.05). Conclusions: Both neurobiological and environmental factors have been involved in the etiology and pathogenesis of depression in epileptic patients. We found that RTLE women have more incidence of depression, as it occurs in the non epileptic population. Furthermore, the existence of more diffuse anatomical compromise than isolated hippocampal sclerosis was also observed in the depression group.