Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/9929
Title: Characterizing psychosocial outcome trajectories following seizure surgery.
Authors: Wilson, Sarah J;Bladin, Peter F;Saling, Michael M;Pattison, Philippa E
Affiliation: sarahw@unimelb.edu.au
Comprehensive Epilepsy Program, Epilepsy Research Institute, Austin Hospital, Melbourne, Australia
Issue Date: 26-Apr-2005
Citation: Epilepsy & Behavior : E&b 2005; 6(4): 570-80
Abstract: We have developed a new approach to characterizing psychosocial outcome after seizure surgery that allows us to identify diverse individual trajectories as well as subgroups of patients with similar outcomes.Eighty-nine anterior temporal lobectomy (ATL) patients were recruited through our Seizure Surgery Follow-up and Rehabilitation Program. The Austin CEP Interview was used to measure psychosocial adjustment presurgery, at discharge, and 1, 3, 6, 12, and 24 months postsurgery. Patient outcome trajectories were characterized across this time frame using a profile-focused form of dual clustering that leads to a lattice representation.Two major, distinct outcome subgroups were identified. Fifty-eight percent (58%) of patients reported good outcomes, characterized by improved family dynamics, enhanced vocational and social functioning, and driving by 24 months postsurgery. A range of trajectories led to these outcomes, including the experience of early postoperative adjustment difficulties. In contrast, 31% of patients perceived their outcomes as poor, reporting affective disturbance at 12 months and difficulties discarding sick role behaviors. Early anxiety served as a marker of poor outcomes, while resolution of early anxiety and vocational change at 12 months were indicators of good outcomes at 24 months. The remaining 11% of patients reported minimal adjustment features.For the majority of patients, seizure surgery gives rise to an evolving process of postoperative adjustment that leads to distinct outcome trajectories. Our approach questions the clinical sensitivity of health-related quality of life measures that average across patients to provide a unitary measure of outcome. Although preliminary, the findings have implications for postoperative treatment, including the identification of markers of longer-term outcomes.
Internal ID Number: 15907751
URI: http://ahro.austin.org.au/austinjspui/handle/1/9929
DOI: 10.1016/j.yebeh.2005.02.015
URL: http://www.ncbi.nlm.nih.gov/pubmed/15907751
Type: Journal Article
Subjects: Adaptation, Psychological.physiology
Adolescent
Adult
Anterior Temporal Lobectomy.methods
Child
Epilepsy, Temporal Lobe.psychology.surgery
Female
Follow-Up Studies
Humans
Male
Middle Aged
Personality Inventory.statistics & numerical data
Postoperative Period
Prospective Studies
Sick Role
Social Adjustment
Time Factors
Treatment Outcome
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.