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From the New York University School of Medicine (Drs. Devinsky, Barr, and Pacia), New York, University of California at Los Angeles (Dr. Vickrey), Northern Illinois University (Dr. Berg), DeKalb, Columbia University Medical School (Dr. Bazil), New York, University of Rochester School of Medicine (Dr. Langfitt), NY, Minnesota Comprehensive Epilepsy Program (Dr. Walczak), St. Paul, MN; Thomas Jefferson University Medical School (Dr. Sperling), Philadelphia, Albert Einstein College of Medicine (Dr. Shinnar), New York, and Yale University School of Medicine (Dr. Spencer), New Haven, CT.
Address correspondence and reprint requests to Dr. O. Devinsky, NYU Epilepsy Center, 403 E. 34 St., 4th fl., New York, NY 10016; e-mail: od4{at}nyu.edu
Objective: To determine changes in depression and anxiety after resective surgery.
Methods: Data from subjects enrolled in a prospective multicenter study of resective epilepsy surgery were reviewed with the Beck Psychiatric Symptoms Scales (Beck Depression Inventory [BDI] and Beck Anxiety Inventory [BAI]) and Composite International Diagnostic Interview (CIDI) up to a 24-month period. 
2 analyses were used to correlate proportions.
Results: A total of 358 presurgical BDI and 360 BAI results were reviewed. Moderate and severe levels of depression were reported in 22.1% of patients, and similar levels of anxiety were reported by 24.7%. Postoperative rates of depression and anxiety declined at the 3-, 12-, and 24-month follow-up periods. At the 24-month follow-up, moderate to severe levels of depression symptoms were reported in 17.6 and 14.7% of the patients who continued to have postoperative seizures. Moderate to severe depression and anxiety were found in 8.2% of those who were seizure-free. There was no relationship, prior to surgery, between the presence or absence of depression and anxiety and the laterality or location of the seizure onset. There were no significant relationships between depression or anxiety at 24-month follow-up and the laterality or location of the surgery.
Conclusions: Depression and anxiety in patients with refractory epilepsy significantly improve after epilepsy surgery, especially in those who are seizure-free. Neither the lateralization nor the localization of the seizure focus or surgery was associated with the risk of affective symptoms at baseline or after surgery.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the December 13 issue to find the title link for this article.
Disclosure: The authors report no conflicts of interest.
Received February 12, 2005. Accepted in final form August 25, 2005.
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