Personality disorders as predictors of severe postsurgical psychiatric complications in epilepsy patients undergoing temporal lobe resections

Purpose. Psychiatric disorders emerging after temporal lobe resections are a serious problem threatening the surgical success of patients with epilepsy. The present study aims to find psychiatric predictors that would indicate patients’ risk to developing severe psychiatric complications after surgery. Methods. One hundred adult patients who had temporal lobe resections were followed prospectively over 2 years. Preoperative psychiatric diagnoses and postoperative development of the patients were documented. As a criterion of severe postoperative complication, admission to a psychiatric hospital was chosen. Results. Patients with personality disorders are at higher risk of suffering from postoperative psychiatric complications as compared with patients with other preoperative psychiatric conditions (such as depression) or with patients with no preoperative psychiatric diagnosis whatsoever. Conclusions. Personality disorders are caused by organic dispositions and negative environmental influence. They indicate a high mental vulnerability and compromise the brain’s ability to combat stress. As a consequence patients with personality disorders are prone to suffer from severe psychiatric complications after epilepsy surgery. To minimize the negative influence of personality disorders in the process of surgical interventions, psychotherapeutic efforts are needed to reduce perisurgical stress factors and to strengthen the self-efficacy and social skills of these patients.