? The proposed study would be the first controlled prospective investigation of the incidence and predictors of depressive disorders in individuals with chronic temporal lobe epilepsy (TLE). Beginning four years ago, a large cohort of individuals with TLE and healthy controls underwent a baseline psychiatric interview, MRI, cognitive testing, and assessment of quality of life. For this project, a consecutive series of individuals with TLE and controls (n = 118) will be seen four years later in order to: 1) determine the prospective incidence and relative risk of DSM-IV major depression and other depressive disorders in chronic TLE compared to controls; 2) identify the psychiatric, stressful life events, MRI, and clinical epilepsy variables predictive of prospective episodes of major depression and other depressive disorders over the interval; 3) identify the incidence of depressive episodes which meet the DSM-IV-TR criteria for minor depressive disorder and recurrent brief depressive disorder. The methodology will include: l) a comprehensive standardized psychiatric re-interview of DSM-IV Axis I disorders (SCID); 2) identification of stressful life events that occurred over the interval; and 3) review of medical records with participant interview to determine change in interval regarding seizure frequency and treatment. This study will make a significant contribution to understanding a major psychiatric complication in epilepsy and will integrate psychosocial, neurobiological, and clinical factors to provide a more comprehensive understanding of depressive episodes in epilepsy. ? ? ?
