{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T05:40:39Z","timestamp":1781415639189,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T00:00:00Z","timestamp":1491350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Desitin (Hamburg, Germany)"},{"name":"Eisai (Frankfurt, Germany)"},{"name":"UCB (Monheim, Germany)"},{"name":"Grifols (Frankfurt, Germany)"},{"name":"Diamed (K\u00f6ln, Germany)"},{"name":"Fresenius Medical Care (Bad Homburg, Germany)"},{"name":"Biogen (Ismaning, Germany)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine whether psychiatric comorbidity is a predictor of long\u2010term seizure outcome following temporal lobe epilepsy surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A sample of 434 adult patients who received temporal lobe resection to treat epilepsy between 1991 and 2009 and were psychiatrically assessed before surgery were followed for 2\u00a0years to assess seizure outcome. Stepwise multivariate logistic regression analyses were used to assess the impact of psychiatric variables on complete seizure freedom (Engel <jats:styled-content style=\"fixed-case\">class IA<\/jats:styled-content>), and freedom from disabling seizures (Engel class I). Lifetime histories of three psychiatric syndromes (<jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content>: psychosis; depression; other) and five personality disorders (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>:<jats:styled-content style=\"fixed-case\"> DSM\u2010IV<\/jats:styled-content> Clusters A, B, and C; organic personality disorder; other) were considered as predictors, complemented by age at onset, duration of epilepsy, type of lesion (mesiotemporal sclerosis vs. other), and year of surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seizure\u2010freedom rates were significantly higher (p\u00a0&lt;\u00a00.001) in patients with no history of <jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> (N\u00a0=\u00a0138; Engel class <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>: 61.6%; Engel class I: 87.7%) than in those with any <jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> (N\u00a0=\u00a0296; Engel <jats:styled-content style=\"fixed-case\">class IA<\/jats:styled-content>: 39.5%; Engel class I: 58.8%). Particularly low seizure\u2010freedom rates were found in patients with a diagnosis of psychosis (N\u00a0=\u00a032, Engel <jats:styled-content style=\"fixed-case\">class IA<\/jats:styled-content>: 21.9%; Engel class I: 40.6%), organic <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> (N\u00a0=\u00a048, Engel <jats:styled-content style=\"fixed-case\">class IA<\/jats:styled-content>: 25.0%; Engel class I: 35.4%) or a double diagnosis of <jats:styled-content style=\"fixed-case\">PS<\/jats:styled-content> plus <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> (N\u00a0=\u00a097; Engel class <jats:styled-content style=\"fixed-case\">IA<\/jats:styled-content>: 27.8%; Engel class I: 45.5%). No other variables emerged as significant risk factors in multivariate logistic regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Patients with and without psychiatric comorbidities can benefit from temporal lobe epilepsy surgery; however, psychiatric comorbidities are negatively associated with postoperative seizure\u2010freedom rates. Surgical outcome is related to the type and extent of preoperative psychiatric morbidity, which underscores the prognostic value of presurgical psychiatric evaluation. The data support the argument that there are common pathogenetic mechanisms underlying both epilepsy and psychiatric conditions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.13736","type":"journal-article","created":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T19:26:57Z","timestamp":1491420417000},"page":"983-993","source":"Crossref","is-referenced-by-count":53,"title":["Psychiatric lifetime diagnoses are associated with a reduced chance of seizure freedom after temporal lobe surgery"],"prefix":"10.1111","volume":"58","author":[{"given":"Steffi C.","family":"Koch\u2010Stoecker","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy Evangelical Clinic Bethel Bielefeld Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian G.","family":"Bien","sequence":"additional","affiliation":[{"name":"Epilepsy Center Bethel Krankenhaus Mara Bielefeld Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Schulz","sequence":"additional","affiliation":[{"name":"Epilepsy Center Bethel Krankenhaus Mara Bielefeld Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodor W.","family":"May","sequence":"additional","affiliation":[{"name":"Society for Epilepsy Research Epilepsy Center Bethel Bielefeld Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38488.462037.8F"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23601"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318245f461"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2010.02907.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181f25b16"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1499-1654.2000.001608.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2012.05.005"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2011.12.001"},{"issue":"6","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1046\/j.1528-1157.42.s6.3.x","article-title":"Psychiatric disorders before and after surgery for epilepsy","volume":"42","author":"Inoue Y","year":"2001","journal-title":"Epilepsia"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2011.03015.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2012.03604.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2008.09.007"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1157.1998.tb01409.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12100"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12105"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.57.11.1375"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2009.09.017"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2012.07.002"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000343850.85763.9c"},{"key":"e_1_2_10_21_1","first-page":"609","volume-title":"Surgical treatment of the epilepsies","author":"Engel J","year":"1993"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2009.01.002"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2012.06.022"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2012.03569.x"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1525-5050(02)00530-9"},{"key":"e_1_2_10_26_1","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_10_27_1","volume-title":"Structured Clinical Interview (SCID) for DSM\u2010IV Axis I Disorders (Axis II personality disorders)","author":"First MB","year":"1997"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2006.10.002"},{"issue":"2","key":"e_1_2_10_29_1","first-page":"9","article-title":"Evidence supporting the temporal lobe epilepsy personality syndrome","volume":"53","author":"Blumer D","year":"1999","journal-title":"Neurology"},{"issue":"2","key":"e_1_2_10_30_1","first-page":"13","article-title":"Evidence against the existence of a temporal lobe epilepsy personality syndrome","volume":"53","author":"Devinsky O","year":"1999","journal-title":"Neurology"},{"key":"e_1_2_10_31_1","volume-title":"The ICD\u201010. 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