Beck Depression Inventory in Temporal Lobe Epilepsy with Hippocampal Atrophy: Relation to Lesion Laterality

ABSTRACT

BACKGROUND: Depression is found more frequently in epileptic patients and tends to be more severe in those with temporal lobe epilepsy, than in patients with comparable chronic neurologic diseases or physical handicaps. The purposes of this study were to evaluate (1) the characteristics and frequency of depression in group of temporal lobe epileptic out-patients with hippocampal atrophy; (2) the relationship between depression and the laterality of hippocampal atrophy, and (3) the possible correlation between depression and the duration of epilepsy, sex, education, age, occupation, seizure frequency, and other seizure variables. METHODS: We included 40 temporal lobe epilepsy patients with unilateral hippocampal atrophy on MRI study. We used the Beck Depression Inventory to measure the level of depression. The results were compared with those of 50 normal controls. RESULTS: (1) Epilepsy patients with hippocampal atrophy indicated more severe depression than the normal controls. If we consider the cut-off score for depression as being more than 21 points of the Beck Depression Inventory score, then the frequency of depression in TLE with hippocampal atrophy would be 45% compared to the 14% in controls. (2) Occupation and seizure frequencies were factors related to severe depression. However, the age, age of onset, duration of illness, religion, education, and multi-drug therapy, were not related to the severity of depression. (3) Scores on the BDI questions representing mood symptoms were significantly higher in the left TLE group. However, the frequencies of those representing vegetative and somatic symptoms were not different between the two groups. Self-reproach symptoms increased equally in both temporal lobe epilepsy groups. (4) There were no clear associations between depressive disorders and the laterality of epileptic lesions in the TLE patients. CONCLUSIONS: We found no clear association between the affective disorders in epilepsy and the site of epileptic lesions.