PSYCHOSOCIAL FUNCTION FOLLOWING TEMPORAL LOBECTOMY - INFLUENCE OF SEIZURE CONTROL AND LEARNED HELPLESSNESS

Learned helplessness is the perception that one's behaviour cannot produce a desired outcome. Individuals with intractable epilepsy who have learned that the occurrence of a seizure is beyond their control can develop such a helpless attitude with cognitive, affective and behavioral components which may generalize to many aspects of life. Post-operative testing was done on 42 patients, aged 17–60 years with I.Q. >80 who had temporal lobectomies (25 R, 17 L) with follow-up 1–14 years (mean 5 years). In addition to seizure outcome, psychosocial adjustment was measured using the Washington Psychosocial Inventory (WPSI) and a structured interview. Three variables of learned helplessness were also assessed: internal or external locus of control, resourcefulness, and depression. Seizure outcome was: completely seizure free, 36%; >90% improvement, 38% <90% improvement, 26%. Overall post-operative psychosocial adjustment was good, marked improvement in lifestyle was noted by 85%, personality change for the better by 65% and improved mood by 47%. A transient mood disorder was noted by 38% in the first six months following surgery. Psychosocial adjustment was better in patients who were seizure free or had >90% reduction in seizures compared to those with <90% improvement. Two measures of learned helplessness, depression and lack of resourcefulness correlated with poor post-operative psychosocial adjustment. Other variables beside seizure control must be considered in determining the ultimate outcome of epilepsy surgery. © 1994, British Epilepsy Association. All rights reserved.