Mood and Anxiety are as Important in the Treatment of Epilepsy Surgery as the Surgery Itself

In the January 31, 2014, published ahead of print issue of the journal Neurology, Doctors Hamid and colleagues representing a multi-center epilepsy surgery consortium examine the complex relationship between depression, anxiety, seizure control, and quality of life outcomes after epilepsy surgery.

• The study enrolled 373 patients from seven epilepsy centers with comprehensive diagnostic evaluation, psychiatric and follow-up quality of life evaluations.
  • Patients were evaluated before surgery and then up to 60 months after surgery.
  • A number of studies were done, including QOLIE 89, Beck Depression Inventory, and Beck Anxiety Inventory, and the results were analyzed.
• The investigators found that the groups with excellent and good seizure control showed a positive effect on their overall quality of life compared to those with fair and poor seizure control.
• The depression and anxiety inventory scores were both highly and negatively associated with overall quality of life.
• Increases in depression and anxiety scores were associated with decreased overall quality of life scores.
• The authors concluded that depression anxiety is strongly and independently associated with worse quality of life after epilepsy surgery. Even after partial seizure control, controlling for depression and anxiety levels improved quality of life. The management of mood and anxiety is a critical component to post-surgery care.