Depression and Suicide After Temporal Lobe Epilepsy Surgery: A Systematic Review
Abstract number :
2.382
Submission category :
16. Epidemiology
Year :
2022
Submission ID :
2203932
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:22 AM
Authors :
R Grace Couper, MSc – Western University; Christopher Hue, MD, PhD – Clinical Neurological Sciences – Western University; Tresah Antaya, MPH – Western University; Manuel Herrera, MD, PhD – Instituto Nacional de Ciencias Neurológicas; Jaime Parra, MD, PhD – Epilepsy Unit – Hospital San Rafael; Jorge Burneo, MD, MSPH, FAAN, FAES, FRCPC – Western University; Ana Suller-Marti, MD, MSc, CSCN-EEG – Clinical Neurological Sciences – Western University
Rationale: Psychiatric comorbidities, including depression and suicide, contribute substantially to the illness burden of patients with refractory temporal lobe epilepsy (TLE). The aim of this systematic review was to synthesize the existing literature assessing the effect of TLE surgery on (1) depression prevalence and (2) severity and estimating the incidence of (3) de novo depression and (4) attempted and completed suicide following TLE surgery.
Methods: A literature search was performed using Ovid Medline, Embase, Clarivate Web of Science, Cochrane Library, and ProQuest Dissertations and Theses. Studies of patients with TLE who underwent TLE surgery and reported estimates of at least one of the following outcomes were included: pre- and post-operative depression prevalence or severity, the incidence of post-operative de novo depression, or attempted or completed suicide. The search yielded 2,127 citations related to TLE surgery and post-operative depression or suicide. After full-text review of 116 articles, 18 met the final eligibility criteria.
Results: Most studies reported a reduced or similar prevalence (n=12) and severity of depression (n=5) post-operatively, compared with the pre-operative period. Eleven studies reported the incidence of post-operative de novo depression, which ranged from 0% to 38% over follow-up periods of three months to nine years. Four studies assessed the incidence of post-operative attempted or completed suicide, with completed suicide incidence ranging from 0% to 3% over follow-up periods of one to four years.
Conclusions: Overall, the effect of TLE surgery on depression and suicide remains unclear, as many studies did not assess the statistical significance of depression prevalence or severity changes following TLE surgery. Therefore, timely psychosocial follow-up for patients after TLE surgery should be considered. Future longitudinal studies with consistent measures are needed to elucidate the effect of TLE surgery on the prevalence and severity of depression and estimate the incidence of de novo depression and suicide following surgery.
Funding: None
Epidemiology