***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To determine changes in depression and anxiety after  resective surgery .  Methods : Data from subjects enrolled in a prospect i ve multicenter study of resective epilepsy surgery  were review ed with the Beck Psychiatric Symptoms Scales ( Beck Depression Inventory [ BDI ] and Beck Anxiety Inventory [ BAI ] ) and Composite International Diagnostic Interview ( CIDI ) up to a 24-month period . χ2 analyses were used to correlate proportions . Results : A total of 358 presurgical BDI and 360 BAI results were review ed . Moderate and severe levels of depression were reported in 22.1 % of patients , and similar levels of anxiety were reported by 24.7 % . Postoperative rates of depression and anxiety declined at the 3- , 12- , and 24-month follow-up periods . At the 24-month follow-up , moderate to severe levels of depression symptoms were reported in 17.6 and 14.7 % of the patients who continued to have postoperative seizures . Moderate to severe depression and anxiety were found in 8.2 % of those who were seizure-free . There was no relationship , prior to surgery , between the presence or absence of depression and anxiety and the laterality or location of the seizure onset . There were no significant relationships between depression or anxiety at 24-month follow-up and the laterality or location of the surgery . Conclusions :  Depression and anxiety in patients with refractory epilepsy significantly improve after epilepsy surgery , especially in those who are seizure-free . Neither the lateralization nor the localization of the seizure focus or surgery was associated with the risk of affective symptoms at baseline or after surgery PURPOSE Psychological interventions in the treatment of epilepsy have been developed and evaluated for many years but the amount of research has hardly made an impact on how epilepsy is treated . The purpose of this study was to develop and evaluate a psychological treatment program consisting of acceptance and commitment therapy ( ACT ) together with some behavioral seizure control technology shown to be successful in earlier research . METHODS The method consisted of a r and omized controlled trial group design with repeated measures ( n=27 ) . All participants had an EEG verified epilepsy diagnosis with drug refractory seizures . Participants were r and omized into one of two conditions , ACT or supportive therapy ( ST ) . Therapeutic effects were measured by examining changes in quality of life ( SWLS and WHOQOL ) and seizure index ( frequency x duration ) . Both treatment conditions consisted of only nine hours of professional therapy distributed in two individual and two group sessions during a four-week period . RESULTS The results showed significant effects over all of the dependent variables for the ACT group as compared to the ST group at six- and twelve-month follow-ups . CONCLUSIONS The results from this study suggest that a short-term psychotherapy program combined with anticonvulsant drugs may help to prevent the long-term disability that occurs from drug refractory seizures OBJECTIVES The goals of this study were to observe behavioral changes in patients receiving levetiracetam ( LEV ) , a newer antiepileptic drug ( AED ) , and to answer the question of whether LEV exerts a specific effect on impulse control and aggression . METHODS We asked 288 consecutive patients with epilepsy on LEV ( 90 % polytherapy , mean dose=2689 mg ) and 135 relatives whether LEV caused a positive or negative behavioral change .  Forty-three patients on other AEDs served as a control group . Ratings were related to patient characteristics , efficacy , dose , drug load , bidirectional ratings of change in behavioral domains , and question naires on personality ( Fragebogens zur Persönlichkeit bei zerebralen Erkrankungen ) and impulsivity ( Barratt Impulsiveness Scale-11 ) . RESULTS LEV was rated as very effective by 40 % of the patients . In contrast to only 9 % of the controls , a considerable number of patients reported a behavioral change while taking LEV ( 12 % very negative , 25 % negative , 16 % positive , 6 % very positive ) . Negative ratings were due to loss of self-control , restlessness , sleep problems , and , most importantly , aggression . Positive ratings were due to increased energy , vigilance , and activation . Increases in psychomotor speed , concentration , and remote memory indicated subjectively experienced positive effects on cognition . The proxy reports indicated reliable self-reports . Reported change was not related to type of epilepsy , co-therapy , dose , drug load , or psychiatric history . Negative effects were , however , associated with poorer seizure control , mental retardation , indicators of an organic psychosyndrome , and nonplanning impulsiveness . CONCLUSION The results indicate that LEV exerts a dose-independent stimulating effect that can be positive or negative . Aggression is a prominent feature . Lack of efficacy , mental retardation , and presumably also pre-intake disposition ( organic psychosyndrome , impulsivity ) may be helpful in predicting whether additional activation under LEV will be positive or negative A few previous studies have revealed impairments in remote memory in patients with temporal lobe epilepsy , but many questions about the importance of lesion side , type of material , seizure history and deficits in other aspects of cognitive functions remain unanswered . In this study , patients who had undergone unilateral ( 15 right and 15 left ) temporal lobectomy ( TL ) for the relief of epilepsy and 15 control subjects completed a range of public and autobiographical memory tests . Deficits in recall and recognition of details related to past famous world events were observed for both left and right TL groups . In addition , the left TL group showed impaired retrieval of famous names and TL patients as a group generated significantly fewer names of people from their own past . Current seizure- and medication-status influenced performance on a few measures , but duration of epilepsy and age of onset had no significant impact . Underlying cognitive deficits ( especially naming ability ) contributed to , but could not completely explain difficulties remembering the past . In particular , deficits in the ability to retrieve highly specific information learned in the past , such as names of famous people or details about famous events , remained evident in analyses that controlled for the impact of related cognitive skills Considerable interest has been focused on the psychiatric complications of medically refractory temporal lobe epilepsy ( TLE ) before and after epilepsy surgery .  The aim of the present study was to evaluate the psychiatric status , quality of life , and level of disability in medically refractory mesial temporal lobe epilepsy ( MTLE ) patients , a homogenous subgroup of patients with TLE , before and after anterior temporal lobectomy ( ATL ) . The study population consisted of 22 patients with medically refractory MTLE who were c and i date s for ATL . Patients were examined before surgery as well as in the third and sixth months of the postoperative period . Psychiatric diagnosis was determined by using SCID-I. To rate the severity of psychiatric disorders , BPRS , HDRS , and HARS were employed on each visit . WHO-DAS-II and WHOQOL-BREF were used to determine the level of disability and quality of life . Preoperatively , six patients had a psychiatric diagnosis . Three months after surgery , six of the patients had psychiatric diagnoses . Five of these six patients had not been previously diagnosed . There was no significant difference between preoperative and postoperative follow-up evaluations in terms of HDRS , HARS , and BPRS ratings . With respect to the total scores and domains of WHO-DAS-II , the change in pre- and postoperative evaluations was statistically significant only for the social life attendance domain . There was no significant difference in the mean scores on the WHOQOL-BREF domains or on the first question about general evaluation of quality of life . For the second question on the level of satisfaction with health , the difference between the three ratings was statistically significant . Preoperative and postoperative rates of psychiatric disorders in our sample were low . While social phobia was frequently seen preoperatively , the postoperative period was spearheaded by major depressive disorder . The decrease in disability in attendance to social life and improvement in the quality of health were in concordance with the literature , indicating the positive results of surgical treatment of epilepsy on quality of life . This study suggests that surgical intervention might be one of the causes of postoperative psychiatric disorders in patients with MTLE Objective – To explore effectiveness , tolerability and changes in quality of life in patients with epilepsy converting to topiramate ( TPM ) from carbamazepine ( CBZ ) or oxcarbazepine ( OXC ) due to insufficient effectiveness and /or tolerability Quality of life is impaired in patients with epilepsy and can be improved by effective therapy . R and omised clinical trials have shown that lamotrigine treatment is associated with improved quality of life . However , little information is available on quality of life or treatment effects in patients with epilepsy in the general population . The objective of this study was to estimate the impact of lamotrigine on quality of life in a naturalistic treatment setting . The study included adult patients with epilepsy in whom lamotrigine therapy was initiated . Each subject completed the  Quality of Life in Epilepsy Inventory (QOLIE)-31 quality of life question naire at inclusion and at a follow-up visit in the next 4 months . Demographic information and medical history were provided by the investigator . These were evaluated as potential determinants of change in quality of life using logistic regression . Three hundred and forty-one patients were evaluated , 192 starting lamotrigine in combination with another drug , 90 as a first-line monotherapy , 45 as a switch from another drug and 14 as a reduction to monotherapy from a previous combination . Baseline scores on the QOLIE-31 ranged from 53.8 in the combination group to 69.5 in the first-line group . 34.6 % of patients were considered to be responders , with no significant differences between treatment regimen . Most improvement was seen for the energy-fatigue and medication effects subscales and , for the first-line group , seizure worry . Seizure type was the only determinant of improvement of quality of life identified . In conclusion , lamotrigine treatment is associated with improved quality of life , regardless of treatment regimen The aim of this prospect i ve , multicenter , open-label study was to investigate the efficacy of levetiracetam ( LEV ) and determine its effects on cognitive and neuropsychological function .  Sixty-nine patients were evaluated for effects of LEV  on seizure control , cognitive ( Mini-Mental State Examination [ MMSE ] ) and neuropsychological ( Symptom Checklist-90 Revised [ SCL-90-R ] ) functions , and quality of life ( Quality of Life in Epilepsy--10 [ QOLIE-10 ] ) assessment s at 3 and 12 months of follow-up . Thirty-nine percent of patients achieved seizure freedom , and 68 % had a > or = 50 % seizure frequency reduction after 1 year of LEV ( 1235.5+/-392.7 mg/day ) . There were also significant improvements in mean MMSE score and in the recall and language items of MMSE . There were modest improvements in interpersonal sensitivity and paranoid ideation scales of the SCL-90-R , and improvements in cognition and medication effect items of the QOLIE-10 . The results demonstrate that LEV not only effectively reduces seizure frequency , but also possibly contributes to improvements in neuropsychological functions such as recall , language , interpersonal sensitivity , and paranoid ideation PURPOSE To assess anger/hostility during treatment with lamotrigine adjunctive therapy versus levetiracetam adjunctive therapy in patients with partial seizures . METHODS This r and omized , double-blind , parallel-group study in adults with partial seizures included an 8-week escalation phase , during which adjunctive lamotrigine ( n = 132 ) or adjunctive levetiracetam ( n = 136 ) was titrated to a target dose , and a 12-week , double-blind maintenance phase , during which dosages of study medication and concomitant antiepileptic drugs were maintained . The primary endpoint was change from baseline to the end of the maintenance phase ( week 20 ) in the Anger-Hostility subscale score of the Profile of Mood States ( POMS ) . RESULTS Improvement with lamotrigine relative to levetiracetam was observed for mean + /- SD ( st and ard deviation ) change from baseline to the end of the maintenance phase ( week 20 ) on the Anger-Hostility subscale  ( lamotrigine -2.0 + /- 8.2 , levetiracetam -0.3 + /- 8.4 ; p = 0.024 ) ( the primary endpoint ) ; the Anger-Hostility subscale on weeks 5 , 6 , 7 , 8 , 9 , 11 , 12 , 14 , 16 , 18 , and 19 ; and the Total Mood Disturbance score on weeks 6 , 7 , 8 , 9 , 11 , 12 , 17 , 19 , and 20 . Improvement ( p < 0.05 ) with lamotrigine relative to levetiracetam was also observed on the POMS subscales Depression-Dejection , Vigor-Activity , Fatigue-Inertia , and Confusion-Bewilderment . No difference in seizure frequency was observed between groups . The most common adverse events with both medications were headache and dizziness . DISCUSSION Adjunctive lamotrigine significantly improved Anger-Hostility subscale scores relative to adjunctive levetiracetam in patients with partial seizures at the end of 20 weeks . This difference was consistently observed throughout the treatment period . Similar improvement with lamotrigine versus levetiracetam was observed for other mood symptoms AIM The purpose of this prospect i 
    Output:
    
The most frequent PSDs found in people with epilepsy were depressive symptoms , memory functions , quality of life , anxiety , stigma , locus of control , cognitive functions in general , and emotional functions in general .
It can be stated that patients ' life areas are affected by cognitive , emotional , and psychological problems .