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Risk factors for postoperative depression: A retrospective analysis of 248 subjects operated on for drug‐resistant epilepsy
Author(s) -
Barbieri Valentina,
Cardinale Francesco,
Gozzo Francesca,
Pelliccia Veronica,
Nobili Lino,
Casaceli Giuseppe,
Fuschillo Dalila,
Castana Laura,
Cossu Massimo,
Lo Russo Giorgio,
Tassi Laura,
Gambini Orsola
Publication year - 2015
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13118
Subject(s) - depression (economics) , medicine , levetiracetam , logistic regression , epilepsy , retrospective cohort study , anxiety , multivariate analysis , carbamazepine , risk factor , bivariate analysis , relative risk , history of depression , multivariate statistics , psychiatry , confidence interval , statistics , mathematics , economics , macroeconomics
Summary The aim of this retrospective case series analysis was to identify the predictors of postoperative depression (PostOp‐D) in a sample of 248 subjects with focal drug‐resistant focal epilepsy. The presence or absence of PostOp‐D during a 12‐month follow‐up period was the outcome variable. Demographic, neurologic, psychiatric characteristics, and antiepileptic therapy were the explanatory variables. After preliminary bivariate analysis, a multivariate logistic regression model was fitted to identify variables associated with PostOp‐D. Sixty‐seven patients (27%) experienced PostOp‐D. At multivariate analysis, lifetime depression, age at surgery, and levetiracetam ( LEV ) are positive predictors of PostOp‐D; carbamazepine ( CBZ ) and anxiety disorders are protective factors. LEV increases the risk for PostOp‐D by about half; the relative risk ( RR ) is 1.48. Conversely, CBZ decreases the risk for PostOp‐D by about half ( RR 0.59). Our results suggest that careful psychiatric evaluation and follow‐up should be recommended for subjects at risk. It is advisable to treat patients with depression before surgery. Antiepileptic drugs should be selected carefully when patients present with not modifiable risk factors, such as positive personal history for depression.