Abstracts

RATIONALE: Although research has established predictors of mood and psychopathology in adult populations with epilepsy, these long-term outcomes have not been well investigated in young adults with onset of epilepsy in childhood, nor have they been examined after early surgery. The objective of this study was to examine these variables in a group of young adults who had epilepsy surgery in childhood and a non-surgical epilepsy control group.
METHODS: Twenty-four male (21 surgical and 3 non-surgical) and 40 female (28 surgical and 12 non-surgical) individuals with epilepsy of childhood onset, age 18-29, participated in this study. Sixteen individuals in the surgical group and all individuals in the non-surgical group have experienced seizures in the past year. All subjects completed two questionnaires measuring the individual[ssquote]s psychological and physical well-being. The Profile of Mood State (POMS) is a self-administered adjective rating scale that provides information about mood and feelings people may experience. The Symptoms Checklist Revised (SCL-90-R) is a 90-item self-report symptom inventory designed to reflect a respondent[ssquote]s psychological and psychiatric symptoms.
RESULTS: Stepwise regression analyses demonstrated that predictors contributed in the following way (all p values [lt] .05): The surgical group was less prone to depressive symptoms on the POMS (R²=.06), phobic anxiety (R²=.06), and number of expressed symptoms (R²=.21). The presence of seizures was predictive of higher degrees of somatization (R²=.12), confusion and bewilderment (R²=.11), hostility (R²=.10), and the global severity score of the SCL-90-R (R²=.09). Females reported higher levels of hostility (R²=.09) and symptom distress on the SCL-90-R (R²=.06). Greater numbers of antiepileptic drugs (AEDs) were predictive of obsessive-compulsive traits (R²=.09), symptom distress on the SCL-90-R (R²=.09), and depression (R²=.07). Among individuals who underwent surgery, greater number of AEDs was predictive of obsessive-compulsive traits (R²=.13) and symptoms of depression (R²=.09). Females reported higher levels of fatigue (R²=.13). The presence of seizures was predictive of confusion and bewilderment (R²=.22), the SCL-90-R symptom distress score (R²=.18), hostility (R²=.16), somatization (R²=.12), and the SCL-90-R global severity score (R²=.10). The proportion of the individual[ssquote]s life with epilepsy, as well as seizure localization and lateralization did not contribute to the predictive model.
CONCLUSIONS: These results provide preliminary support that epilepsy surgery in childhood reduces the risk for symptoms of psychological distress during early adulthood, in those individuals who are seizure free. At the end of this study, participants should be aware of the variables that predict psychopathology and mood disturbance in young adults with childhood onset epilepsy, and the effects of childhood surgery on these outcomes.
[Supported by: Ontario Mental Health Foundation.]