PSYCHIATRIC MORBIDITY AFTER SURGERY FOR EPILEPSY - SHORT-TERM FOLLOW-UP OF PATIENTS UNDERGOING AMYGDALOHIPPOCAMPECTOMY

The aim was to assess the occurrence and type of psychiatric disorders of patients with medically intractable epilepsy in relation to surgic al treatment, with special reference to amygdalohippocampectomy (AHE). The design was a retrospective psychiatric interview study, including Present State Examination (PSE) and diagnostic classification accordi ng to the International Classification of Diseases-8th revision (ICD-8 ) and ICD-10. Forty seven (94% of total) patients operated on between 1987 and mid-1991 in the Danish epilepsy surgery programme were studie d. The main group of interest included 37 patients treated by AHE. The presence of psychiatric disorders before and after operation was asse ssed by PSE (including the Catego classification) and by ordinary clin ical procedures, making use of all available information (hospital cas e notes and presurgical psychiatric assessments independent of the stu dy). Four patients in the AHE group developed depressive disorders of various durations and severity after operation (in three (8%) patients these occurred de novo). One other patient with AHE with a presumed p ersonality disorder who underwent AHE developed a severe depression, a s did one patient after a lesionectomy. No patients developed new para noid hallucinatory psychoses. No association was found between presenc e of psychiatric disorders and neither right sided cerebral dominance nor histopathological findings. In conclusion, the postoperative psych iatric morbidity in this sample of patients treated with AHE is of the same magnitude as described in recent series of patients undergoing t emporal lobe for medically intractable Likewise, affective disorders ( depressive conditions) constitute the most prominent psychiatric probl em after surgery for epilepsy.