Chapter 64
Presurgical psychiatric evaluation
Andres M. Kanner,
Andres M. Kanner
University of Miami Miller School of Medicine, Miami, FL, USA
Search for more papers by this authorAndres M. Kanner,
Andres M. Kanner
University of Miami Miller School of Medicine, Miami, FL, USA
Search for more papers by this authorBook Editor(s):Simon Shorvon MA MB BChir MD FRCP,
Emilio Perucca MD PhD FRCP(Edin),
Jerome Engel Jr. MD PhD,
Simon Shorvon MA MB BChir MD FRCP
Professor in Clinical Neurology and Consultant Neurologist
UCL Institute of Neurology, University College London, National Hospital for Neurology and Neurosurgery, London, UK
Search for more papers by this authorEmilio Perucca MD PhD FRCP(Edin)
Professor of Medical Pharmacology and Director, Clinical Trial Center
Clinical Pharmacology Unit, Department of Internal Medicine and Therapeutics University of Pavia, C. Mondino National Neurological Institute Pavia, Italy
Search for more papers by this authorJerome Engel Jr. MD PhD
Jonathan Sinay Distinguished Professor of Neurology and Director UCLA Seizure Disorder Center
Neurobiology, and Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California, Los Angeles, USA
Search for more papers by this authorFirst published: 02 October 2015
Summary
Epilepsy surgery has revolutionized the management of patients with treatment-resistant focal epilepsy. This chapter aims to make the case for a pre-surgical psychiatric evaluation (PPE) in every surgical candidate. It tries to identify the obstacles precluding the performance of such evaluation. The chapter provides clinicians with practical and user-friendly protocols that can even be performed by neurologists. The evidence presented is indicative of a high prevalence of psychiatric comorbidity in epilepsy surgery candidates. This psychiatric comorbidity has significant implications in the patients‘ risks of postsurgical psychiatric complications, psychosocial adjustment as well as seizure outcome. Neuropsychological evaluations complement psychiatric evaluations. Accordingly, a PPE must be included in the presurgical evaluation of every surgical candidate. A better understanding of the risks factors for postsurgical psychiatric complications or the remission of presurgical psychiatric disorders after an anterotemporal lobectomy (ATL) can yield valuable data on potential pathogenic mechanisms operant in both type of disorders.
References
- Hesdorffer DC, Ishihara L, Mynepalli L, Webb DJ, Weil J, Hauser WA. Epilepsy, suicidality, and psychiatric disorders: a bidirectional association. Ann Neurol 2012; 72: 184–191.
- Kanner AM. Depression in epilepsy: prevalence, clinical semiology, pathogenic mechanisms and treatment. Biol Psychiatry 2003; 54: 388–398.
- Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the national comorbidity study. Arch Gen Psychiatry 1994; 51: 8–19.
- Toone BK, Garralda ME, Ron MA. The psychoses of epilepsy and the functional psychoses: a clinical and phenomenological comparison. Br J Psychiatry 1982; 141: 256–261.
- McDermott S, Mani S, Krishnaswami S. A population-based analysis of specific behavior problems associated with childhood seizures. J Epilepsy 1995; 8: 110–118.
- Koch-Stoecker S. Psychiatric effects of surgery for temporal lobe epilepsy. In: The Neuropsychiatry of Epilepsy. M Trimble, B Schmitz (eds). Cambridge: Cambridge University Press, 2002: 266–282.
10.1017/CBO9780511544354.018 Google Scholar
- Hill D, Pond DA, Mitchell W, Falconer MA. Personality changes following temporal lobectomy for epilepsy. J Ment Sci 1957; 103: 18–27.
- Kanner AM, Byrne R, Chicharro AV, Wuu J, Frey M. A lifetime psychiatric history predicts a worse seizure outcome following temporal lobectomy. Neurology 2009; 72: 793–799.
- Kanner AM, Tilwalli S, Byrne R. Psychiatric and neurologic predictors of post-surgical psychiatric complications following a temporal lobectomy. Neurology 2005; 64 (Suppl. 1): A–358.
- Cleary RA, Thompson PJ, Fox Z, Foong J. Predictors of psychiatric and seizure outcome following temporal lobe epilepsy surgery. Epilepsia 2012; 53: 1705–1712.
- Rayner G, Wilson SJ. Psychiatric care in epilepsy surgery: who needs it? Epilepsy Curr 2012; 12: 46–50.
- Devinsky O, Barr WB, Vickrey BG, et al. Changes in depression and anxiety after resective surgery for epilepsy. Neurology 2005; 65: 1744–1942.
- Wrench J, Wilson SJ, Bladin PF. Mood disturbance before and after seizure surgery: a comparison of temporal and extratemporal resections. Epilepsia, 2004; 45: 534–543.
- Ring HA, Moriarty J, Trimble MR. A prospective study of the early postsurgical psychiatric associations of epilepsy surgery. J Neurol Neurosurg Psychiatry 1998; 64: 601–604.
- Glosser G, Zwill AS, Glosser DS, et al. Psychiatric aspects of temporal lobe epilepsy before and after anterior temporal lobectomy. J Neurol Neurosurg Psychiatry 2000; 68: 53–58.
- Blumer D, Wakhlu S, Davies K, et al. Psychiatric outcome of temporal lobectomy for epilepsy: incidence and treatment of psychiatric complications. Epilepsia 1998; 39: 478–486.
- Wrench JM, Rayner G, Wilson SJ. Profiling the evolution of depression after epilepsy surgery. Epilepsia 2011; 52: 900–908.
- Quigg M, Broshek DK, Heidal-Schultz S, et al. Depression in intractable partial epilepsy varies by laterality of focus and surgery. Epilepsia 2003; 44: 419–424.
- Barbieri V, Cardinale F, Luoni A, et al. Risk factors for postoperative depression in 150 subjects treated for drug-resistant focal epilepsy. Epidemiol Psychiatr Sci 2011; 20: 99–105.
- Kohler CG, Carran MA, Bilker W, et al. Association of fear auras with mood and anxiety disorders after temporal lobectomy. Epilepsia 2001; 42: 674–481.
- Kanemoto K, Kim Y, Miyamoto T, Kawasaki J. Presurgical postictal and acute interictal psychoses are differentially associated with postoperative mood and psychotic disorders. J Neuropsychiatry Clin Neurosci 2001; 13: 243–247.
- Pope RA, Centeno M, Flügel D, et al. Neural correlates of de novo depression following left temporal lobe epilepsy surgery: a voxel based morphometry study of pre-surgical structural MRI. Epilepsy Res 2014; 108: 517–525.
- Salzberg M, Taher T, Davie M, et al. Depression in temporal lobe epilepsy surgery patients: an FDG-PET study. Epilepsia 2006; 47: 2125–2130.
- Wrench JM, Wilson SJ, Bladin PF, Reutens DC. Hippocampal volume and depression: insights from epilepsy surgery. J Neurol Neurosurg Psychiatry 2009; 80: 539–544.
- Halley SA, Wrench JM, Reutens DC, Wilson SJ. The amygdala and anxiety after epilepsy surgery. Epilepsy Behav 2010; 18: 431–436.
- Sawrie SM, Martin RC, Kuzniecky R, et al. Subjective versus objective memory change after temporal lobe epilepsy surgery. Neurology 1999; 53: 1511–1517.
- Hamid H, Devinsky O, Vickrey BG, et al. Suicide outcomes after resective epilepsy surgery. Epilepsy Behav 2011; 20: 462–464.
- Shaw P, Mellers J, Henderson M, Polkey C, David AS, Toone BK. Schizophrenia-like psychosis arising de novo following a temporal lobectomy: timing and risk factors. J Neurol Neurosurg Psychiatry 2004; 75: 1003–1008.
- Leinonen E, Tuunainen A, Lepola U. Postoperative psychoses in epileptic patients after temporal lobectomy. Acta Neurol Scand 1994; 90: 394–399.
- Jensen I, Larsen JK. Mental aspects of temporal lobe epilepsy. Follow-up of 74 patients after resection of a temporal lobe. J Neurol Neurosurg Psychiatry 1979; 42: 256–265.
- Mace CJ, Trimble MR. Psychosis following temporal lobe surgery: a report of six cases. J Neurol Neurosurg Psychiatry 1991; 54: 639–644.
- Andermann LF, Savard G, Meencke HJ, McLachlan R, Moshe S, Andermann F. Psychosis after resection of ganglioglioma or DNET: evidence for an association. Epilepsia 1999; 40: 83–87.
- Calvet E, Caravotta PG, Scévola L, et al. Psychosis after epilepsy surgery: report of three cases. Epilepsy Behav 2011; 22: 804–807.
- Carran MA, Kohler CG, O'Connor MJ, Bilker WB, Sperling MR. Mania following temporal lobectomy. Neurology 2003; 61: 770–774.
- Stevens JR: Psychiatric consequences of temporal lobectomy for intractable seizures. a 20–30-year follow-up of 14 cases. Psychol Med 1990; 20: 529–545.
- Christodoulou C, Koutroumanidid M, Hennessy MJ, et al. Postictal psychosis after temporal lobectomy. Neurology 2002; 59: 1432–1435.
- Kanner AM, Ostrovskaya A. Long-term significance of postictal psychotic episodes I: are they predictive of bilateral ictal foci? Epilepsy Behav 2008; 12: 150–153.
- Manchanda R, Miller H, McLachlan RS. Postictal psychosis after right temporal lobectomy. J Neurol Neurosurg Psychiatry 1993; 56: 277–279.
- Devinsky O, Abrahmson H, Alper K, et al. Postictal psychosis: a case control study of 20 patients and 150 controls. Epilepsy Res 1995; 20: 247–253.
- Umbricht D, Degreef G, Barr WB, et al. Postictal and chronic psychosis in patients with temporal lobe epilepsy. Am J Psychiatry 1995; 152: 224–231.
- Kanemoto K, Kawasaki J, Kawai I. Postictal psychosis: a comparison with acute interictal and chronic psychoses. Epilepsia 1996; 37(Suppl. 6): 551–556.
- Kanner AM, Ostrovskaya A. Long-term significance of postictal psychotic episodes II: are they predictive of interictal psychotic episodes? Epilepsy Behav 2008; 12: 154–156.
- Kulaksizoglu IB, Bebek N, Baykan B, et al. Obsessive-compulsive disorder after epilepsy surgery. Epilepsy Behav 2004; 5: 113–118.
- Roth RM, Jobst BC, Thadani VM, Gilbert KL, Roberts DW. New-onset obsessive-compulsive disorder following neurosurgery for medication-refractory seizure disorder. Epilepsy Behav 2009; 14: 677–680.
- Ferguson SM, Rayport M. The adjustment to living without epilepsy. J Nerv Ment Dis 1965; 140: 26–37.
- Ney GC, Barr WB, Napolitano C, et al. New-onset psychogenic seizures after surgery for epilepsy. Arch Neurol 1998; 55: 726–730.
- Glosser G, Roberts D, Glosser DS. Nonepileptic seizures after resective epilepsy surgery. Epilepsia 1999; 40: 1750–1754.
- Reuber M, Kurthen M, Fernandez G, et al. Epilepsy surgery in patients with additional psychogenic seizures. Arch Neurol 2002; 59: 82–86.
- Naga AA, Devinski O, Barr WB. Somatoform disorders after temporal lobectomy. Cogn Behav Neuro 2004; 17: 57–61.
- Koch-Stoecker S. Personality disorders as predictors of severe postsurgical psychiatric complications in epilepsy patients undergoing temporal lobe resections. Epilepsy Behav 2002; 3: 526–531.
- Altshuler L, Rausch R, DeIrahim S, Kay J, Crandall P. Temporal lobe epilepsy, temporal lobectomy and major depression. J Neuropsychiatry Clin Neurosci 1999; 11: 436–443.
- Kanner Morris HH, Stagno S, Chelvne G, Luders HL. Remission of an obsessive-compulsive disorder following a right temporal lobectomy. Neuropsychol Neuropsychiatry Behav Neurol 1993; 6: 126–129.
- Barbieri V, Lo Russo G, Francione S, Scarone S, Gambini O. Association of temporal lobe epilepsy and obsessive-compulsive disorder in a patient successfully treated with right temporal lobectomy. Epilepsy Behav. 2005; 6: 617–619.
- Kanemoto K, Kim Y, Miyamoto T, Kawasaki J. Presurgical postictal and acute interictal psychoses are differentially associated with postoperative mood and psychotic disorders. J Neuropsychiatry Clin Neurosci 2001; 13: 243–247.
- Reutens DC, Savard G, Andermann F, Dubeau F, Olivier A. Results of surgical treatment in temporal lobe epilepsy with chronic psychosis. Brain 1997; 120: 1929–1936.
- Marchetti RL, Fiore LA, Valente KD, Gronich G, Nogueira AB, Tzu WH. Surgical treatment of temporal lobe epilepsy with interictal psychosis: results of six cases. Epilepsy Behav 2003; 4: 146–152.
- Marchetti RL, Tavares AG, Gronich G, Fiore LA, Ferraz RB. Complete remission of epileptic psychosis after temporal lobectomy: case report. Arq Neuropsiquiatr 2001; 59(3-B): 802–805.
- D'Alessio L, Scévola L, Fernandez Lima M, et al. Psychiatric outcome of epilepsy surgery in patients with psychosis and temporal lobe drug-resistant epilepsy: a prospective case series. Epilepsy Behav 2014; 37: 165–170.
- Kanner AM, Balabanov AJ. Neurorehabilitation in epilepsy. In: ME Selzer, L Cohen, FH Gage (eds). Textbook of Neural Repair and Rehabilitation, vol. 2. Cambridge: Cambridge University Press, 2006: 542–559.
- Lendth M, Helmstaedter C, Elger CE. Pre- and postoperative socioeconomic development of 151 patients with focal epilepsies. Epilepsia 1997; 38: 1330–1337.
- Reeves AL, So EL, Evans RW, et al. Factors associated with work outcome after anterior temporal lobectomy for intractable epilepsy. Epilepsia 1997; 38: 689–695.
- Anhoury S, Brown RJ, Krishnamoorthy ES, Trimble MR. Psychiatric outcome following temporal lobectomy: a predictive study. Epilepsia 2000; 41: 1608–1615.
- de Araújo Filho GM, Gomes FL, Mazetto L, et al. Major depressive disorder as a predictor of a worse seizure outcome one year after surgery in patients with temporal lobe epilepsy and mesial temporal sclerosis. Seizure 2012; 8: 619–623.
- Guarnieri R, Walz R, Hallak JE, et al. Do psychiatric comorbidities predict postoperative seizure outcome in temporal lobe epilepsy surgery? Epilepsy Behav 2009; 14: 529–534.
- Adams SJ, Velakoulis D, Kaye AH, Corcoran NM, O'Brien TJ. Psychiatric history does not predict seizure outcome following temporal lobectomy for mesial temporal sclerosis. Epilepsia 2012; 53: 1700–1704.
- Kanner AM. Can neurobiologic pathogenic mechanisms of depression facilitate the development of seizure disorders? Lancet Neurol 2012: 11: 1093–1102.
- Kanner AM. Do psychiatric comorbidities have a negative impact on the course and treatment of seizure disorders? Curr Opin Neurol 2013; 26: 208–213.
- McLellan A, Davies S, Heyman I, et al. Psychopathology in children with epilepsy before and after temporal lobe resection. Dev Med Child Neurol 2005; 47 : 666–672.
- Colonnelli MC, Cross JH, Davies S, et al. Psychopathology in children before and after surgery for extratemporal lobe epilepsy. Dev Med Child Neurol 2012; 54: 521–526.
- LaFrance W. Kanner AM. Epilepsy. In: DV Jeste, JH Friedman (eds). Psychiatry for Neurologists. Totowa, NJ: Humana Press, 2006: 191–208.
10.1007/978-1-59259-960-8_16 Google Scholar
- Kanner AM, Kozac AM, Frei M. The use of sertraline in patients with epilepsy: Is it safe? Epilepsy Behav 2000; 1: 100–105.
- First MB, Spitzer RL, Gibbon M, et al. Structured Clinical Interview for DSM IV Axis I Disorders. New York, NY: State Psychiatric Institute, Biometrics Research, 1995.
- Kessler RC, Andrews G, Mroczek D, et al. The World Health Organization Composite International Diagnostic Interview-Short Form (CIDI-SF). Int J Meth Psychiatr Res 1998; 7: 171–185.
10.1002/mpr.47 Google Scholar
- Endicott J, Spitzer RL. A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry 1978; 35: 837–844.
- Robins LN, Helzer JE, Croughan J, et al. National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics and validity. Arch Gen Psychiatry 1981; 38: 381–389.
- Sheehan DV, Lecrubier Y, Sheehan KJ, et al. The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD–10. J Clin Psychiatry 1998; 59(Suppl. 20): 22–33.
- Kaufman J, Birmaher B, Brent D, et al. Schedule for affective disorders and schizophrenia for school-age children: present and life-time version. In: Handbook of Psychiatric Measures. Washington DC: American Psychiatric Association, 2002: 296–302.
- Weissman MM, Wickramaratne P, Adams P, Wolk S, Verdeli H, Olfson M. Brief screening for family psychiatric history: the family history screen. Arch Gen Psychiatry 2000; 57: 675–682.
- Gilliam FG, Barry JJ, Meador KJ, Hermann BP, Vahle V, Kanner AM. Rapid detection of major depression in epilepsy: a multicenter study. Lancet Neurol 2006; 5: 399–405.
- Jones JE, Herman BP, Woodard JL, et al. Screening for major depression in epilepsy with common self-report depression inventories. Epilepsia 2005; 46: 731–735.
- Gadow KD, Sprafkin J. The Symptom Inventories: an Annotated Bibliography. Stony Brook, NY: Checkmate Plus, 1998.
- Derogatis LR, Cleary PA. Confirmation of the dimensional structure of the SCL–90: a study in construct validation. J Clin Psychol 1977; 33: 981–989.
- Hathaway SR, McKinley JC. The Minnesota Multiphasic Personality Inventory Manual (revised edn). New York: Psychological Corporation, 1989.
- Beck AT, Ward CH, Mendelson M, et al. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561–571.
- Zigmond AS, Snaith RP: The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983; 67: 361–370.
- Beck AT, Steer RA. Manual for the Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation, 1990.
- Goldberg D, Bridges K, Duncan-Jones P, Grayson D. Detecting anxiety and depression in general medical settings. Br Med J 1988; 297: 897–899.
- Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959; 32: 50–55.
- Spitzer RL, Kroenke K, Williams JB, et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166: 1092–1097.
- Goodman WK, Price LH, Rasmussen SA, et al. The Yale-Brown Obsessive Compulsive Scale, I: development, use, and reliability. Arch Gen Psychiatry 1989; 46: 1006–1011.
- Nolan EE, Volpe RJ, Gadow KD, et al. Development, gender and comorbidity differences in clinically referred children with ADHD. J Emotion Behav Disord 1999; 7: 11–20.
- Achenbach TM, Edelbrock CS. Child Behavior Checklist. Burlington, VT: TM Achenbach, 1986.
- Kovacs M. Children's Depression Inventory (CDI). Psychopharmacol Bull 1985; 21: 995–998.
- March J. Manual for the Multidimensional Anxiety Scale for Children (MASC). Toronto, Ontario: Multi-Health Systems, 1998.
- Conners CK. The Conners' Ratings Scales. Austin, TX: Pro-Ed, 1985.
- Berg C, Rapoport J, Flament M. The Leyton Obsessional Inventory-Child Version. J Am Acad Child Psychiatry 1986; 25: 84–91.
