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

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.

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