Background. Because of the apparent frequency and impact on patients’ quality of life, it is important to investigate the emotional domain of neurosurgical patients with drug-resistant epilepsy. The objective of this study was to investigate gender-specific signs of depression and anxiety in neurosurgical patients with drug-resistant epilepsy.Design and methods. In 2019–2020, Polenov Neurosurgical Institute studied comorbid emotional disturbances in 46 neurosurgical patients with drug-resistant epilepsy in two gender groups: Group 1 — male patients and Group 2 — female patients, using HADS, GAD-7, and Beck’s Depression Inventory in-depth screening.Results. The mean age of participants in the study was 30.8 ± 7.1 years. The male-to-female ratio was 1.5 to 1. The disease lasted an average of 19.2 years, with a mean age of onset of 11.7 years. HADS: normal in 74 % and 61 % of cases, subclinical anxious/depressed in 10 % and 17 % of cases, and clinical anxious/depressed in 16 % and 22 % of cases, respectively. On the GAD-7 scale, 57 % and 50 % were minimally anxious, 25 % and 11 % mildly anxious, 7 % and 33 % moderately anxious and 11 % and 6 % severely anxious. On the Beck’s Depression Inventory, 50 % and 37 % had no depressive symptoms, 32 % and 26 % had mild depression, 7 % and 23 % had moderate depression, 7 % and 5 % had severe depression, and 4 % and 9 % had clinical depression. Personalisation of treatment approaches for patients with affective disorders is driven by two key points: the inclusion of medications with antidepressant and antianxiety effects in addition to AEDs, and consideration of the effect of a given AED on the emotional domain.Conclusion. Among neurosurgical patients with drug-resistant epilepsy, patients without symptoms of anxiety and depression predominate in both male and female patients. In the long-term course of drug-resistant epilepsy, the gender differences in the emotional range of patients flatten out. There is a need to expand the sample and further investigate gender characteristics of neurosurgical patients in order to personalise the treatment of drug-resistant epilepsy.