THE IMPACT OF EPILEPTIC FOCUS LATERALIZATION ON THE STRUCTURE OF DEPRESSIVE SYMPTOMATOLOGY IN FOCAL EPILEPSY.

Abstract

Focal epilepsy commonly involves affective disturbances that compromise treatment adherence and exacerbate seizure frequency.

Aim: To assess the impact of epileptic-focus lateralization on the severity of depressive symptoms in patients with focal epilepsy.

Materials and methods: Sixty patients (30 left-hemisphere, 30 right-hemisphere) were evaluated with the Hamilton Depression Rating Scale (HAM-D), State-Trait Anxiety Inventory (STAI), Patient Health Questionnaire-15 (PHQ-15), Emotional Reactivity Index (ERI), a depression-awareness scale, and speech productivity measures. Data were analyzed using the Shapiro-Wilk test for normality, Student's t-test, and Mann-Whitney U-test (p<0.05).

Results: Left-hemispheric group: Predominance of apathy, anhedonia, and heightened self-reflection; mean HAM-D 7.5±1.2, with 76.6% meeting the threshold for clinically significant depression (HAM-D≥8). Right-hemispheric group: Predominance of anxiety (STAI 9.0±1.0), somatiform complaints (PHQ-15 7.0±1.5), and emotional lability (ERI 8.0±1.2); 83.3% exhibited high anxiety, and 71% significant somatization (PHQ-15≥10). Speech productivity was markedly reduced (2.0±1.1), with monotony and low spontaneity.

Conclusions: Epileptic-focus lateralization shapes affective disturbance profiles and should guide personalized psychopharmacological and psychotherapeutic strategies in focal epilepsy.