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Psychological outcome profiles in childhood‐onset temporal lobe epilepsy
Author(s) -
Micallef Silvana,
Spooner Claire G.,
Simon Harvey A.,
Wrennall Jacquie A.,
Wilson Sarah J.
Publication year - 2010
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/j.1528-1167.2010.02664.x
Subject(s) - epilepsy , psychosocial , psychology , anxiety , worry , depression (economics) , cohort , psychiatry , pediatrics , temporal lobe , quality of life (healthcare) , clinical psychology , medicine , psychotherapist , economics , macroeconomics
Summary Purpose: To examine the effect of childhood‐onset temporal lobe epilepsy (TLE) on long‐term psychological function and to identify outcome profiles related to the natural course and treatment of TLE. Methods: Psychological function was studied in a prospective, community‐based cohort of childhood‐onset TLE, approximately 13 years following seizure onset. Fifty‐three patients were assessed using a semi‐structured psychosocial interview, supplemented by self‐report questionnaires measuring quality‐of‐life, depression, self‐esteem, and anxiety. Results: Common patterns were observed, giving rise to four distinct patient groups and psychological outcomes: (1) patients who experienced spontaneous remission of their seizures fared best; their psychological profile was characterized by heightened worry about the possibility of seizure recurrence; (2) patients who progressed to surgery and were seizure free reported adjustment difficulties associated with learning to become “well”; (3) patients who progressed to surgery and were not seizure free had the poorest psychological outcomes, with depression featuring prominently; and (4) patients with ongoing intractable epilepsy reported psychological and social features consistent with the effects of their chronic illness. Discussion: Patients with childhood‐onset TLE face distinctive long‐term psychological challenges. The specific nature of these challenges can be understood in terms of the natural evolution and treatment of their epilepsy.