Sofilkanych N. Cognitive and affective disorders in patients with temporal lobe epilepsy

Were examined and treated 133 patients with non-psychotic mental disorders due to temporal lobe epilepsy. They were randomized into four groups depending on the type of therapy (psychopharmacotherapy, psychotherapy, a combination of psychotherapy and psychopharmacotherapy, surgery of epilepsy), to assess the effectiveness by 1, 3 and 6 months after starting treatment. There has been a comprehensive assessment of mental status of patients, individual characteristics of affective and cognitive disorders. Described in detail the structure and psychopathological features of mental disorders in studied patients. It was found a significant prevalence of mood disorders compared with cognitive ones among non-psychotic mental disorders due to temporal lobe epilepsy; and their direct correlation with the severity of temporal lobe epilepsy (frequency and severity of attacks). It was determined that 70,7 % of patients have cognitive impairment, nearly 1/2 masked by affective disorders and were detected only phenomenologically as a part of depressive and anxiety syndromes. Examined person have moderate cognitive deficits, decline auditory short-term memory, attention moderate decrease. 60,9 % of patients have depressive symptoms, 51,9 % of patients have anxiety symptoms. Depression and anxiety were moderate. Was proved and implemented the improvement of treatment tactics in cognitive and affective disorders for patients with organic non-psychotic mental disorders due to temporal lobe epilepsy by differentiating interventions according to clinical psychopathological disease' features. It was found a decrease in cognitive functions, such as memory and attention, directly after surgery with the beginning of recovery from 3 to 6 months after surgery. The most effective treatment for non-psychotic mental disorders due to temporal lobe epilepsy was a combination of CBT and psychopharmacotherapy that contributed to reliably reduction of depression, anxiety and mild cognitive impairment. It was noted that cognitive behavioral therapy is the most effective in improving the volume of auditory short-term memory and psychopharmacotherapy is most effective in attention restore. Were identified preferred target intervention (depression, anxiety, general cognitive deficits, impaired memory or attention), allowing to differentiate the amount of therapy with an emphasis on psychotherapy or pharmacological component.