Seizure severity is associated with quality of life independent of seizure frequency

Abstract Depressive disorders are the most frequent psychiatric comorbidity in epilepsy. Depressive mood affects negatively quality of life (QOL) ratings, sometimes having greater impact than seizure-related variables. Women with epilepsy are a specific subgroup at risk of comorbid depression in consequence of certain biopsychosocial demands. The AIM of this study was to assess the relative contribution of mood, seizure-related and demographic variables on QOL scores in women with epilepsy of childbearing age. SUBJECTS AND METHODS: A psychiatric assessment was carried out of 65 women with epilepsy (aged 18-55, mean 37.23 ± 11.83 yrs). Comorbid depressive disorder was diagnosed according to ICD-10 criteria. Its severity was evaluated on the Hamilton Depression Rating Scale (HAMD-17). A questionnaire for demographic and seizure-related variables was completed. Two self-assessment questionnaires were administered: the Seizure Severity Questionnaire (SSQ) and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31). The data were analysed using SPSS for Windows (version 17.0). Univariate correlation and multiple stepwise regression analyses were performed to explore the association between possible prognostic variables (independent variables) and QOLIE-31 overall and subscale scores (dependent variables). RESULTS: Analysis showed that demographic factors: employment and education; seizurerelated factors: seizure severity, seizure frequency, antiepileptic drug therapy and comorbid depressive disorder were the variables significantly associated with QOLIE-31 overall score (p < 0.01). A three variable model accounted for 64.8% of the variance in QOLIE-31 overall score including seizure severity, comorbid depression and seizure frequency. CONCLUSIONS: Clinical factors are the strongest predictors of QOL of women with epilepsy in our study, seizure severity and comorbid depression being the main contributors. Paying attention to the psychological needs of women with epilepsy will have a positive effect on their QOL.

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Neuropsychiatric symptoms, seizure severity, employment, and quality of life of Jordanians with epilepsy

Epilepsy & Behavior ◽

10.1016/j.yebeh.2013.01.013 ◽

2013 ◽

Vol 27 (1) ◽

pp. 272-275 ◽

Cited By ~ 11

Author(s):

H. Hamid ◽

A.S. Kasasbeh ◽

M.J. Suleiman ◽

X. Cong ◽

H. Liu ◽

...

Keyword(s):

Quality Of Life ◽

Neuropsychiatric Symptoms ◽

Seizure Severity

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Comorbid mental disorders and quality of life of people with epilepsy attending primary health care clinics in rural Ethiopia

PLoS ONE ◽

10.1371/journal.pone.0238137 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0238137

Author(s):

Ruth Tsigebrhan ◽

Abebaw Fekadu ◽

Girmay Medhin ◽

Charles R. Newton ◽

Martin J. Prince ◽

...

Keyword(s):

Quality Of Life ◽

Health Care ◽

Primary Health Care ◽

Mental Disorders ◽

Seizure Frequency ◽

Functional Disability ◽

Social Outcomes ◽

Primary Health ◽

Comorbid Mental Disorders

Background Evidence from high-income countries demonstrates that co-morbid mental disorders in people with epilepsy adversely affect clinical and social outcomes. However, evidence from low-income countries is lacking. The objective of this study was to measure the association between co-morbid mental disorders and quality of life and functioning in people with epilepsy. Methods A facility-based, community ascertained cross-sectional survey was carried out in selected districts of the Gurage Zone, Southern Ethiopia. Participants were identified in the community and referred to primary health care (PHC) clinics. Those diagnosed by PHC workers were recruited. Co-morbid mental disorders were measured using a standardised, semi-structured clinical interview administered by mental health professionals. The main outcome, quality of life, was measured using the Quality of Life in Epilepsy questionnaire (QOLIE-10p). The secondary outcome, functional disability, was assessed using the 12-item World Health Organization Disability Assessment Schedule (WHODAS-2). Results The prevalence of comorbid mental disorders was 13.9%. Comorbid mental disorders were associated with poorer quality of life (Adjusted (Adj.) β -13.27; 95% CI -23.28 to-3.26) and greater disability (multiplier of WHODAS-2 score 1.62; 95% CI 1.05, 2.50) after adjusting for hypothesised confounding factors. Low or very low relative wealth (Adj. β = -12.57, 95% CI -19.94 to-5.20), higher seizure frequency (Adj.β coef. = -1.92, 95% CI -2.83 to -1.02), and poor to intermediate social support (Adj. β coef. = -9.66, 95% CI -16.51 to -2.81) were associated independently with decreased quality of life. Higher seizure frequency (multiplier of WHODAS-2 score 1.11; 95% CI 1.04, 1.19) was associated independently with functional disability. Conclusion Co-morbid mental disorders were associated with poorer quality of life and impairment, independent of level of seizure control. Integrated and comprehensive psychosocial care is required for better health and social outcomes of people with epilepsy.

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Quality of life in a residential setting

Psychiatric Bulletin ◽

10.1192/pb.13.9.492 ◽

1989 ◽

Vol 13 (9) ◽

pp. 492-494 ◽

Cited By ~ 2

Author(s):

Ian Leonard

Keyword(s):

Quality Of Life ◽

Seizure Frequency ◽

Psychiatric Illness ◽

David Lewis ◽

Residential Setting ◽

Mental Handicap ◽

Clinical Measures

The David Lewis Centre for Epilepsy has approximately 300 adult residents. All have epilepsy, which is often only partly alleviated by available treatments; many have mental handicap or psychiatric illness, adding to their total disability. The Centre's explicit aim of understanding and caring for people with epilepsy implies concern not just for clinical measures such as seizure frequency, but for our residents' quality of life.

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The effects of epileptic seizures upon quality of life

Journal of Epilepsy and Clinical Neurophysiology ◽

10.1590/s1676-26492009000300003 ◽

2009 ◽

Vol 15 (3) ◽

pp. 110-113 ◽

Cited By ~ 5

Author(s):

Priscila Camile Barioni Salgado ◽

Fernando Cendes

Keyword(s):

Quality Of Life ◽

Seizure Frequency ◽

Seizure Control ◽

Epileptic Seizures ◽

Anxiety And Depression ◽

Co Morbidity ◽

Item Quality ◽

Patients With Epilepsy ◽

And Control

OBJECTIVE: understand the psychological considerations of the relationship between the effect of seizures upon the patients' perception of seizure control, depression, anxiety and quality of life (QoL). METHODS: 151 adult patients with epilepsy diagnosed for over two years were interviewed and responded the 31-Item Quality of Life in Epilepsy (QOLIE-31), the Trait Form of the State/Trait Anxiety Inventory (STAI II) and the Beck Depression Inventory (BDI). RESULTS: 45 patients were depressed (29.8%) and 29 (19.2%) had anxiety. Depression scores ranged from 0 to 49 (M=7.4; SD=8.9) and anxiety scores ranged from 19 to 69 (M=41.5, SD=11.9). Total QoL score was correlated to seizure control (p<0.001), perception of epilepsy control (p<0.001), anxiety (p<0.001), and depression (p=0.003). The perception of epilepsy control was correlated to seizure control (p<0.001), seizure frequency (p=0.001), anxiety (p<0.001) and depression (p<0.001). Seizure control was associated to anxiety (p=0.033) and depression (p<0.001). There was co-morbidity between anxiety and depression (p<0.001). CONCLUSION: This study highlights the importance of the seizure frequency and control to the evaluation of perception of epilepsy control and shows that anxiety and depression in epilepsy are predicted by seizure-related (seizure frequency and control) and psychosocial aspects (perception of control and QoL) together.

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Nine-year prospective efficacy and safety of brain-responsive neurostimulation for focal epilepsy

Neurology ◽

10.1212/wnl.0000000000010154 ◽

2020 ◽

Vol 95 (9) ◽

pp. e1244-e1256 ◽

Cited By ~ 13

Author(s):

Dileep R. Nair ◽

Kenneth D. Laxer ◽

Peter B. Weber ◽

Anthony M. Murro ◽

Yong D. Park ◽

...

Keyword(s):

Quality Of Life ◽

Seizure Frequency ◽

Focal Epilepsy ◽

Responder Rate ◽

Seizure Freedom ◽

Open Label ◽

Cognitive Domains ◽

Signed Rank

ObjectiveTo prospectively evaluate safety and efficacy of brain-responsive neurostimulation in adults with medically intractable focal onset seizures (FOS) over 9 years.MethodsAdults treated with brain-responsive neurostimulation in 2-year feasibility or randomized controlled trials were enrolled in a long-term prospective open label trial (LTT) to assess safety, efficacy, and quality of life (QOL) over an additional 7 years. Safety was assessed as adverse events (AEs), efficacy as median percent change in seizure frequency and responder rate, and QOL with the Quality of Life in Epilepsy (QOLIE-89) inventory.ResultsOf 256 patients treated in the initial trials, 230 participated in the LTT. At 9 years, the median percent reduction in seizure frequency was 75% (p < 0.0001, Wilcoxon signed rank), responder rate was 73%, and 35% had a ≥90% reduction in seizure frequency. We found that 18.4% (47 of 256) experienced ≥1 year of seizure freedom, with 62% (29 of 47) seizure-free at the last follow-up and an average seizure-free period of 3.2 years (range 1.04–9.6 years). Overall QOL and epilepsy-targeted and cognitive domains of QOLIE-89 remained significantly improved (p < 0.05). There were no serious AEs related to stimulation, and the sudden unexplained death in epilepsy (SUDEP) rate was significantly lower than predefined comparators (p < 0.05, 1-tailed χ2).ConclusionsAdjunctive brain-responsive neurostimulation provides significant and sustained reductions in the frequency of FOS with improved QOL. Stimulation was well tolerated; implantation-related AEs were typical of other neurostimulation devices; and SUDEP rates were low.ClinicalTrials.gov identifierNCT00572195.Classification of evidenceThis study provides Class IV evidence that brain-responsive neurostimulation significantly reduces focal seizures with acceptable safety over 9 years.

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Study of inter-relationship of depression, seizure frequency and quality of life of people with epilepsy in India

Mental Illness ◽

10.1108/mi.2014.5169 ◽

2014 ◽

Vol 6 (1) ◽

pp. 1-4

Author(s):

Shubham Mehta ◽

Alok Tyagi ◽

Richa Tripathi ◽

Mahesh Kumar

Keyword(s):

Quality Of Life ◽

Seizure Frequency ◽

Well Being ◽

Significant Negative Correlation ◽

Cross Sectional Study ◽

Psychological Consequences ◽

Clinical Predictors ◽

Cross Sectional ◽

Assess Quality

Epilepsy is a chronic neurological disorder that can have profound physical, social and psychological consequences. We aimed to assess the clinical predictors of quality of life of people with epilepsy. We recruited 31 patients suffering from epilepsy in this cross-sectional study. Their clinical profile was recorded. Quality Of Life in Epilepsy (QOLIE-31) was used to assess quality of life of our patients. Depression was screened by Neurological Disorders Depression Inventory in Epilepsy (NDDI-E). Among all the clinical variables, only seizure frequency significantly correlated with seizure worry (P=0.002), emotional well-being (P=0.026) and social functions (P=0.013) subscales of QOLIE-31. NDDIE score showed a significant negative correlation with all the subscales of QOLIE-31 except medication effects (P=0.993). A significant positive correlation was also noted between seizure frequency and NDDI-E score (r=0.417, P=0.020). Seizure frequency and depression are the most important predictors of quality of life in epilepsy patients. The management of patients with epilepsy should not only be aimed at just preventing seizures but the treating clinicians should also be cognizant about depression which itself can significantly affect the quality of life of patients.

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The sociodemographic, clinical and pharmacotherapy characteristics influencing quality of life in patients with epilepsy: A cross-sectional study

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.145193 ◽

2014 ◽

Vol 05 (S 01) ◽

pp. S007-S012 ◽

Cited By ~ 1

Author(s):

G. Ranjana ◽

S. Dwajani ◽

Chanda Kulkarni ◽

G. R. K Sarma

Keyword(s):

Quality Of Life ◽

Regression Analysis ◽

Multiple Regression Analysis ◽

Seizure Frequency ◽

Focal Epilepsy ◽

Negative Influence ◽

Monthly Income ◽

Cross Sectional ◽

Patients With Epilepsy

ABSTRACT Context: Quality of life (QOL) assessment in patients with epilepsy (PWE) is increasingly recognized as an important component in the management of epilepsy. Aims: The objective of the present study was to assess influence of sociodemographic, clinical and pharmacotherapy characteristics collectively on QOL in adult PWE. Settings and Design: This was a cross-sectional, observational study in patients with confirmed diagnosis of epilepsy. Materials and Methods: QOL was assessed using modified QOLIE-10 questionnaire for epilepsy. Univariate and multiple regression analysis were done to determine factors associated with poor QOL, respectively. Results: There were 451 PWE, with a mean age 27.3 ± 8.15 years, 251 (56%) males and 191 (42%) had monthly income < 5000 Indian national rupees (INR)/month. The QOLIE score was 64.1 ± 15.97 (Mean ± SD). The univariate analysis showed factors such as lower monthly income, focal epilepsy, seizure frequency, antiepileptic drug (AED) polytherapy, conventional AEDs and frequent adverse drug reactions (ADRs) had significant negative influence on various domains of QOLIE-10 questionnaire. Multiple regression analysis showed seizure frequency as a significant predictor of most QOL domains and overall score, while ADRs as a significant predictor of all the domains. Seizure type was a predictive factor for domains like emotional well-being and overall score. Conclusion: Present findings showed patients on monotherapy had better QOL while those having lower monthly income, having focal epilepsy and who received conventional AEDs had negative influence on QOL scores. Further, higher seizure frequency and occurrence of ADRs were significant predictors of all the domains of QOL in PWE.

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