Characterising de novo depression after epilepsy surgery

Received 21 January 2008; received in revised form 26 September 2008; accepted 28 September 2008.

Summary

De novo depression is a common psychiatric sequelae of epilepsy surgery. To date, no studies have described possible clinical correlates of de novo depression in this population. This qualitative study presents a detailed analysis of five cases of de novo depression. Data were collected from patients’ medical files and routine in-depth psychosocial and psychiatric interviews (the Austin CEP Interview). All patients who developed de novo depression underwent anterior temporal lobectomy (ATL). Four out of five cases occurred within the first 3 months following surgery, and all were preceded by significant post-operative irritability reported by the patient's family. All experienced post-operative marital/relationship conflict that appeared to be a catalyst for deteriorating mood. Post-operative seizures were not temporally linked to the onset of depressive symptoms. This series provides an initial account of factors associated with de novo depression following anterior temporal lobectomy and may be of use in guiding larger scale studies.

Keywords: Depression, Temporal lobe epilepsy, Anterior temporal lobectomy, Psychosocial adjustment, Epilepsy surgery

a School of Behavioural Science, University of Melbourne, Melbourne, Victoria 3010, Australia

b Department of Clinical Neuropsychology/Comprehensive Epilepsy Program, Austin Health, Melbourne, Australia

c Southern Clinical School, Monash University, Melbourne, Australia

Corresponding author. Tel.: +61 3 8344 8036; fax: +61 3 9347 6618.

1 Tel.: +61 3 8344 7391; fax: +61 3 9347 6618.

2 Tel.: +61 3 9496 2560; fax: +61 3 9496 2219.

3 Tel.: +61 3 9594 5527; fax: +61 3 9594 5662.

PII: S0920-1211(08)00284-2

doi:10.1016/j.eplepsyres.2008.09.007

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