LONG-TERM EFFECTS OF PEDIATRIC EPILEPSY SURGERY: THE INFLUENCE OF SEIZURE STATUS ON PSYCHIATRIC OUTCOME IN YOUNG ADULTS
Abstract number :
2.415
Submission category :
Year :
2003
Submission ID :
3870
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Kristin Kelly, Mary Lou Smith, Irene Elliott, Janet Olds, Lynn McCleary, Sharon Whiting, Lucy Lach, Alan Lowe, Tom Snyder Psychology, University of Toronto, Toronto, ON, Canada; Psychology, Hospital for Sick Children, Toronto, ON, Canada; Children[apos]s
Individuals with intractable epilepsy are at risk for psychiatric disorders. It is assumed that early elimination of seizures will improve psychiatric outcome, but this hypothesis has not been rigorously tested. The objective of this study was to examine psychiatric status in a group of young adults as a function of seizure control, comparing a group with the eradication of seizures through surgery in childhood and a group who have experienced at least one seizure in the past year irrespective of treatment.
Forty-three individuals (22 seizure-free in past 12 months), age 18-29, participated in this study. The seizure-free group and the group with seizures were comparable with respect to gender, age, age of seizure onset (all before 16 years of age), proportion of life with epilepsy, and past psychiatric history for which they reported receiving treatment. All participants were administered a comprehensive and fully structured standardized psychiatric interview designed for assessing mental disorders according to the definitions of the Diagnostic Criteria for Research of ICD-10 and the Diagnostic and Statistical Manual of Mental Disorders (DSM). The Composite International Diagnostic Interview Short Form (World Health Organization, 1993) investigates a 12-month prevalence for six DSM-IV mental disorders and two DSM-III-R substance disorders: major depression, generalized anxiety, specific phobia, social phobia, agoraphobia, panic attack, alcohol dependence, and drug dependence.
Chi-square analyses demonstrated that a significantly greater proportion of the group with seizures met criteria for a psychiatric diagnosis compared with the seizure-free group, [chi][sup2](1, N = 39) = 3.95, p = .05. When each psychiatric disorder was analyzed separately, a difference was found only for depression, with a higher proportion of the seizure group meeting criteria, [chi][sup2](1, N = 37) = 4.85, p = .03. No effects due to gender or number of antiepileptic medications were found.
These results provide preliminary support that during early adulthood being seizure-free for at least the past twelve months reduces the risk for psychiatric diagnoses during early adulthood. Overall, these results suggest that young adults do in fact exhibit psychiatric disorders as a function of seizure status. These findings suggest a long-term positive effect of early surgery, provided that seizure-free status is attained.
[Supported by: Ontario Mental Health Foundation]