Depression has become one of the most commonly reported and studied psychiatric co-morbidities of epilepsy. While different forms of depression have been specifi cally related to epilepsy, this paper focuses on neurobiological and psychosocial factors that predict major depression in patients with intractable focal epilepsy. It then examines how these factors may affect patient trajectories and outcome following epilepsy surgery. This provides a model of relevant clinical markers for epilepsy clinicians to identify patients at risk of depression so that preventative treatment strategies can be implemented.

It is well-established that the diagnosis of a chronic or life-threatening illness typically gives rise to signifi cant adjustment issues, as an individual seeks to make the necessary changes to lifestyle and self-perceptions to accommodate the diagnosis. Despite this, an understanding of the psychosocial adjustment process surrounding newly-diagnosed epilepsy is only beginning to emerge, with available evidence suggesting that management of this process may signifi cantly impact longer-term medical and psychosocial outcomes.