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Kang HJ, Torres K, Kim MS. Differences in health-related quality of life and somatic symptoms in employed and unemployed patients with epilepsy. Epilepsy Behav Rep 2024; 26:100663. [PMID: 38708365 PMCID: PMC11067481 DOI: 10.1016/j.ebr.2024.100663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/18/2024] [Accepted: 03/29/2024] [Indexed: 05/07/2024] Open
Abstract
This study compared overall and specific aspects of health-related quality of life (HRQOL) and self-report of somatic, anxiety, and depressive symptoms between employed (n = 71) and unemployed (n = 48) patients with epilepsy (PWE). The Quality of Life in Epilepsy (QOLIE-89) and the Personality Assessment Inventory (PAI) were examined. The unemployed group reported significantly worse overall HRQOL including aspects of HRQOL related to epilepsy, physical health, mental health, and cognitive function. Among these four, physical health related HRQOL revealed the most difference between groups. While there were no differences between the groups in the level of social support and social isolation, the unemployed group reported worse social function with respect to work and driving. The unemployed group reported significantly greater somatic symptoms, but not anxiety and depressive symptoms. When specifically examining the subscales of the Somatic Concerns scale, conversion and health concerns, but not somatization, were greater in the unemployed group. Among the Depression subscales, the unemployed group reported greater physiologically manifested depressive symptoms. These findings suggest that along with optimizing seizure control, identifying and addressing presence of physical limitations, dysfunction, and somatic symptoms are also of importance in the care of PWE, particularly for those who are unemployed.
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Affiliation(s)
- Hyun Jin Kang
- Department of Neurology, University of Washington, United States
| | - Karen Torres
- Department of Neurology, University of Washington, United States
| | - Michelle S. Kim
- Department of Neurology, University of Washington, United States
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Passamonti C, Mancini F, Cesaroni E, Bonifazi S, Ceravolo MG, Capecci M, Zamponi N, Scerrati M, Ricciuti RA. Deep brain stimulation in patients with long history of drug resistant epilepsy and poor functional status: Outcomes based on the different targets. Clin Neurol Neurosurg 2021; 208:106827. [PMID: 34329812 DOI: 10.1016/j.clineuro.2021.106827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/13/2021] [Accepted: 07/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) is a widely used surgical procedure for the treatment of patients with drug resistant epilepsy (DRE) and several anatomical target have been described. Indications for DBS includes patients with focal, partial seizure and those for which resective or disconnective surgery are contraindicated, such as involvement of eloquent cortex or significant comorbidities. Despite the SANTE trial has clearly indicated the efficacy of DBS of anterior nucleus of the thalamus (ANT), specific indications regarding the best anatomical target and outcome in patients with severe disability are lacking. Here we described our case series of patients underwent DBS of three different target including ANT, centromedian thalamic nucleus (CMN) and subthalamic nucleus (STN). METHOD Six patients with DRE have been treated with DBS of ANT (n = 3), STN (n = 2) and CMN (n = 1). Outcome has been expressed as seizures frequency reduction and patients functional status after surgery with a follow-up of 5-11 years. RESULTS Four out of six patients show no reduction of seizures frequency after DBS implant with one case of increasing atypical absence. Two cases, one ANT and one CMN, show a significant reduction of seizures frequency of 50-60%. No patients improve relative to functional outcome and one showed psychiatric symptoms worsening. CONCLUSIONS For patients with DRE and severe functional disability, DBS may reduce seizure frequency in some cases, but it does not improve functional outcome.
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Affiliation(s)
- C Passamonti
- Unit of Hospital Psychology, Ospedali Riuniti, Ancona, Italy
| | - F Mancini
- Clinic of Neurosurgery, Ospedali Riuniti, Ancona, Italy.
| | - E Cesaroni
- Child and adolescent psychiatry, Ospedale Salesi, Ancona, Italy
| | - S Bonifazi
- Clinic of Neurosurgery, Ospedali Riuniti, Ancona, Italy
| | - M G Ceravolo
- Department of Experimental and Clinical Medicine, "Università Politecnica delle Marche", Ancona, Italy
| | - M Capecci
- Department of Experimental and Clinical Medicine, "Università Politecnica delle Marche", Ancona, Italy
| | - N Zamponi
- Child and adolescent psychiatry, Ospedale Salesi, Ancona, Italy
| | - M Scerrati
- Clinic of Neurosurgery, Ospedali Riuniti, Ancona, Italy
| | - R A Ricciuti
- Unit of Neurosurgery, Ospedale Belcolle, Viterbo, Italy
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Lima EM, Gois J, Paiva ML, Vincentiis S, Moschetta S, Valente KDR. Anxiety symptoms are the strongest predictor of quality of life in temporal lobe epilepsy. Seizure 2021; 88:78-82. [PMID: 33838568 DOI: 10.1016/j.seizure.2021.03.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/10/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE It is established that the severity of depressive and anxiety symptoms is associated with poorer quality of life (QOL) in persons with drug-resistant epilepsy. We aimed to verify the presence of subsyndromic depressive episodes (SDEs) and subsyndromic anxiety episodes (SAEs) in persons with temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) compared to healthy controls and to determine the impact of depressive and anxiety symptoms on patients' QOL. METHODS We prospectively evaluated 35 persons with TLE-HS and 90 healthy controls. QOL was assessed by the Epilepsy Surgery Inventory (ESI) and QOL in Epilepsy Inventory-31 (QOLIE-31). The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI-X) were used to assess symptoms, and SDEs and SAEs diagnosis were made considering the total scores of BDI (<9) and STAI-Trait (<49), respectively. RESULTS Persons with TLE-HS had higher symptoms on BDI, STAI-S, and STAI-T. They have 3.011 greater odds of presenting SDEs and 7.056 times odds, SAEs. The depressive and anxiety symptoms, added in the model with epilepsy-related factors, accounted for a significant increase in the variance in several aspects of QOL. Anxiety-trait symptoms are the most critical individual determinant of the QOL. CONCLUSION Our results demonstrated that persons with TLE-HS had greater odds of presenting SDE and SAE than healthy controls. Besides, there was a relationship between anxiety and depressive symptoms and worse QOL in TLE-HS. It is essential to be aware of psychiatric symptoms, even though these symptoms do not meet the criteria to be considered a "disorder."
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Affiliation(s)
- Ellen Marise Lima
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil.
| | - Juliana Gois
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Maria Luisa Paiva
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Silvia Vincentiis
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Sylvie Moschetta
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
| | - Kette Dualibi Ramos Valente
- Department of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School (IPq/HCFMUSP), Brazil
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Zhong R, Chen Q, Li M, Li N, Zhang X, Lin W. Sex differences in anxiety in patients with epilepsy: Status and risk factors analysis. Epilepsy Behav 2021; 116:107801. [PMID: 33578225 DOI: 10.1016/j.yebeh.2021.107801] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Evidence has indicated that there may be sex differences in the prevalence of and risk factors for anxiety in patients with epilepsy (PWE). The prevalence and risk factors for anxiety in male and female PWE in Northeast China were investigated. METHODS A consecutive cohort of patients with epilepsy (PWE) from the First Hospital of Jilin University was recruited. Anxiety symptoms were assessed using the 7-item Generalized Anxiety Disorder-7 questionnaire (GAD-7; Chinese version). Multivariate logistic regression analyses were used to confirm independent risk factors for anxiety in male and female patients. RESULTS Anxiety was prevalent in 28.2% (n = 162) of the total sample of patients, in 23.2% (n = 79) of males, and in 35.5% (n = 83) of females. Younger age (P = 0.033), higher seizure frequency over the last year (P = 0.003), and higher C-NDDI-E scores (P = 0.001) were risk factors for anxiety in males with epilepsy. Only higher C-NDDI-E scores (P = 0.001) had an independent effect on the risk of anxiety in females with epilepsy. CONCLUSION Anxiety is a common psychiatric comorbidity among PWE. There were sex differences in the prevalence and risk factors for anxiety in patients.
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Affiliation(s)
- Rui Zhong
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Qingling Chen
- Department of Hepatology, Second People's Clinical College of Tianjin Medical University, Tianjin Second People's Hospital, Tianjin, China
| | - Mengmeng Li
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Nan Li
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Xinyue Zhang
- Department of Neurology, The First Hospital of Jilin University, Changchun, China
| | - Weihong Lin
- Department of Neurology, The First Hospital of Jilin University, Changchun, China.
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Lozano-García A, Hampel KG, Villanueva V, González-Bono E, Cano-López I. The number of anti-seizure medications mediates the relationship between cognitive performance and quality of life in temporal lobe epilepsy. Epilepsy Behav 2021; 115:107699. [PMID: 33412368 DOI: 10.1016/j.yebeh.2020.107699] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To assess whether cognitive performance predicts quality of life (QOL) in patients with drug-resistant temporal lobe epilepsy (TLE), using the Epitrack cognitive screening tool, while considering the mediating role of the number of anti-seizure medications (ASMs) and controlling for seizure-related, social, and emotional factors. METHODS Seventy-five adult patients with drug-resistant TLE (mean age = 39.76 years, SD = 11.66) underwent a presurgical neuropsychological assessment. MAIN OUTCOME MEASURES Cognitive performance (Epitrack), depression (BDI-II), trait anxiety (STAI); and QOL (QOLIE-31) were assessed. RESULTS Adjusting for seizure-related, social, and emotional factors, the Epitrack total score significantly contributed to QOL composite score, and energy and cognitive self-rating subscales. We found a significant indirect effect of the Epitrack total score on QOL composite score and seizure worry and social functioning subscales via the number of ASMs. CONCLUSION Our findings underline the relevance of cognitive functioning on QOL and the clinical utility of Epitrack to track cognitive side effects of ASMs and, consequently, to predict and manage QOL in this population.
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Affiliation(s)
- Alejandro Lozano-García
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010 Valencia, Spain
| | - Kevin G Hampel
- Refractory Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Bulevar sur, s/n Carretera de Malilla, 46026 Valencia, Spain
| | - Vicente Villanueva
- Refractory Epilepsy Unit, Neurology Service, Hospital Universitario y Politécnico La Fe, Bulevar sur, s/n Carretera de Malilla, 46026 Valencia, Spain
| | - Esperanza González-Bono
- IDOCAL/Department of Psychobiology, Psychology Center, University of Valencia, Avda. Blasco Ibañez, 21, 46010 Valencia, Spain
| | - Irene Cano-López
- Valencian International University, C/Pintor Sorolla, 21, 46002 Valencia, Spain.
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Campos-Fernández D, Fonseca E, Olivé-Gadea M, Quintana M, Abraira L, Seijo-Raposo I, Santamarina E, Toledo M. The mediating role of epileptic seizures, irritability, and depression on quality of life in people with epilepsy. Epilepsy Behav 2020; 113:107511. [PMID: 33129044 DOI: 10.1016/j.yebeh.2020.107511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE Psychiatric comorbidity is common in epilepsy and has a considerable impact on patient quality of life (QoL). This study aimed to analyze the relationship between seizure frequency, irritability, and depression and describe how they mediate each other's effect on QoL in epilepsy. METHODS This is a cross-sectional study of consecutive adults seen at an outpatient epilepsy clinic of a tertiary hospital in Barcelona, Spain. All the patients were evaluated for psychiatric comorbidity and administered the State-Trait Anger Expression Inventory-2 (STAXI-2), the Hospital Anxiety and Depression Scale (HADS), and the Quality Of Life in Epilepsy Inventory-10 (QOLIE-10). Mediation analysis with multiple linear regression followed by the Sobel test was performed. RESULTS We studied 157 patients. Seizure frequency (R = -0.193, P = .053), irritability (R = 0.216, P = .039), and depression (R = -0.598, P < .001) had all a negative effect on QoL. In the adjusted linear regression model, depression was the only independent predictor of impaired QoL (B = -2.453 [95% confidence interval (CI): -3.161, -1.744], P < .001). The Sobel test showed that depression exerted a significant mediating effect on seizure frequency (Z = -1.984; P = .047) and irritability (Z = -3.669; P < .001) in their influence on QoL. CONCLUSION Depression is an independent predictor of worse QoL and significantly mediated the effects of irritability and poor seizure control on QoL impairment in patients with epilepsy.
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Affiliation(s)
- Daniel Campos-Fernández
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Elena Fonseca
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
| | - Marta Olivé-Gadea
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Manuel Quintana
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Laura Abraira
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Iván Seijo-Raposo
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Estevo Santamarina
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Manuel Toledo
- Epilepsy Unit, Neurology Department, Vall d'Hebron Hospital, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain; Epilepsy Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain; Medicine Department, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
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Addis B, Minyihun A, Aschalew AY. Health-related quality of life and associated factors among patients with epilepsy at the University of Gondar comprehensive specialized hospital, northwest Ethiopia. Qual Life Res 2020; 30:729-736. [PMID: 33070287 DOI: 10.1007/s11136-020-02666-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Epilepsy is a global public health problem that causes a profound physical, psychological and social consequences. However, as such evidence in our country is limited, this study aimed to assess the health-related quality of life (HRQOL) and associated factors among patients with epilepsy. METHODS An institution-based cross-sectional study was conducted on 370 patients with epilepsy. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31) was used to measure HRQOL. Multiple linear regression was fitted to assess the association between HRQOL and the independent variables, and a P-value < 0.05 and a 95% confidence interval were used to declare statistical significance. RESULTS More than 55% of the participants were male, and the mean age of the participants was 29.64 (11.09) years. The overall HRQOL score was 55.81 (14.00). The scale scores ranged from 46.50 (15.55) to 64.98 (19.43). Out of the seven scales, the energy scale score was the lowest. Frequency of seizure, anxiety, depression, perceived stigma and adverse drug event were negatively associated with HRQOL, whereas social support had a significant positive association. CONCLUSION This study revealed that the HRQOL of patients was low and that its energy and emotional scales were the most affected. The presence of depression, anxiety and stigma adversely affected patient HRQOL. Therefore, healthcare professionals should be aware of the emotional state of the role it plays for HRQOL. Interventions aimed at reducing psychosocial problems and stigmatization are also needed to improve the patient HRQOL.
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Affiliation(s)
- Banchlay Addis
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Amare Minyihun
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Andualem Yalew Aschalew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Silva B, Canas-Simião H, Cordeiro S, Velosa A, Oliveira-Maia AJ, Barahona-Corrêa JB. Determinants of quality of life in patients with drug-resistant focal epilepsy. Epilepsy Behav 2019; 100:106525. [PMID: 31525553 DOI: 10.1016/j.yebeh.2019.106525] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 08/27/2019] [Accepted: 08/27/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Focal drug-resistant epilepsy (DRE) has been associated with a significant burden of psychiatric comorbidity and low health-related quality of life (HRQoL). There is ample disagreement in previous studies as to which factors decisively influence HRQoL in this population. Here, we sought to assess the relationship between sociodemographic factors, epilepsy-related variables, and psychiatric comorbidity with HRQoL in a well-defined group of patients with focal DRE. METHODS We consecutively recruited a sample of adult patients with confirmed focal DRE being considered for epilepsy surgery in a reference center in Lisbon, Portugal. Psychiatric diagnoses were defined according to the Mini-International Neuropsychiatric Interview (M.I.N.I.), and HRQoL was measured using the Quality-of-Life in Epilepsy Inventory (QOLIE-31). Associations with QOLIE-31 total score were tested using regression models. RESULTS Among the forty patients included in the study, being diagnosed with a mood disorder was significantly associated with a lower total QOLIE-31 score (β = -21.18, p = 0.001) in univariate analysis. Multivariate analysis additionally identified female gender as a second determinant of lower HRQoL (β = -21.22, p = 0.001 for being diagnosed with a mood disorder; β = -8.98, p = 0.048 for female gender; adjusted R2 = 0.290). Sociodemographic and epilepsy-related variables were not associated with HRQoL. CONCLUSIONS In our sample of adult patients with focal DRE, female gender and being diagnosed with a mood disorder were the only factors significantly associated with a poorer HRQoL. While clinical care often focuses on seizure control, epilepsy-related factors such as seizure frequency were not shown to have a significant influence on HRQoL. We suggest that an early comprehensive psychiatric evaluation and intervention can help improve HRQoL in these patients.
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Affiliation(s)
- Bruno Silva
- Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira 126, 1300-598 Lisbon, Portugal; NOVA Medical School|Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 130, 1169-056 Lisbon, Portugal; CADIn - Neurodevelopment, Estrada da Malveira 800, 2750-782 Cascais, Portugal.
| | - Hugo Canas-Simião
- Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira 126, 1300-598 Lisbon, Portugal
| | - Susana Cordeiro
- Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira 126, 1300-598 Lisbon, Portugal
| | - Ana Velosa
- Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira 126, 1300-598 Lisbon, Portugal
| | - Albino J Oliveira-Maia
- Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira 126, 1300-598 Lisbon, Portugal; NOVA Medical School|Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 130, 1169-056 Lisbon, Portugal; Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Av. Brasilia, 1400-038 Lisbon, Portugal
| | - J Bernardo Barahona-Corrêa
- Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira 126, 1300-598 Lisbon, Portugal; NOVA Medical School|Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 130, 1169-056 Lisbon, Portugal; Champalimaud Research and Clinical Centre, Champalimaud Centre for the Unknown, Av. Brasilia, 1400-038 Lisbon, Portugal; CADIn - Neurodevelopment, Estrada da Malveira 800, 2750-782 Cascais, Portugal
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Taskiran E, Matur Z, Gül G, Bebek N, Baykan B, Gökyigit A, Gürses C. The Impact of Affective State on Quality of Life in Focal Epilepsy in Turkey. J Neurosci Rural Pract 2019; 10:267-272. [PMID: 31001016 PMCID: PMC6454954 DOI: 10.4103/jnrp.jnrp_324_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Context: Seizures and accompanying situations including social, medical, and psychiatric problems threaten the quality of life (QOL) in patients with epilepsy. The World Health Organization defines health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. Aims: This study examines the prevalence of both depression and anxiety symptoms and also impact of the affective state on QOL in patients with focal epilepsy in Turkey. Settings and Design: One hundred and five patients with focal epilepsy over 18 years old were included in this study. The patients were classified into four groups according to the presence of AS and seizure control. Subjects and Methods: Patients’ affective symptoms (AS) and QOL were examined using the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and QOL in Epilepsy Inventory-31 (QOLIE-31). Statistical Analysis Used: We used descriptive statistics, Chi-square test, independent samples t-test, one-way analysis of variance, Mann–Whitney U-test, Kruskal–Wallis H-test, and also Pearson's and Spearman's correlation test for correlations. Results: There were positive correlations between total QOLIE-31 score and epilepsy surgery, employment, and seizure freedom, whereas negative correlations were found with antiepileptic drug use, anxiety, and depression. Statistically significant differences were found in QOLIE-31 totals and subscores between Groups 3 and 4 (P < 0.05). Conclusions: The presence of AS has a negative impact on QOL in patients with focal epilepsy. Physicians should be aware that psychiatric comorbidities in epilepsy have a severe impact and epilepsy treatment requires comprehensive management.
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Affiliation(s)
- Emine Taskiran
- Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Zeliha Matur
- Department of Neurology, Istanbul Bilim University Faculty of Medicine, Istanbul, Turkey
| | - Günay Gül
- Department of Neurology, Neurology Clinic, Bakirkoy Training and Research Hospital for Psychiatric and Neurological Disorders, Istanbul, Turkey
| | - Nerses Bebek
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Betül Baykan
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ayşen Gökyigit
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Candan Gürses
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Picardi A, Gigantesco A, Tarolla E, Stoppioni V, Cerbo R, Cremonte M, Alessandri G, Lega I, Nardocci F. Parental Burden and its Correlates in Families of Children with Autism Spectrum Disorder: A Multicentre Study with Two Comparison Groups. Clin Pract Epidemiol Ment Health 2018; 14:143-176. [PMID: 30158998 PMCID: PMC6080067 DOI: 10.2174/1745017901814010143] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND The effects of having a child with Autism Spectrum Disorder (ASD) on parents are multifaceted and pervasive. While ample evidence has been provided that these families are under severe stress, there are still several knowledge gaps and unresolved questions. OBJECTIVE This study aimed at quantifying the subjective and objective burden of ASD in mothers and fathers, and at improving the understanding of the interplay between parental burden, child's characteristics, and parents' coping resources and strategies. METHODS The parents of 359 children/adolescents with ASD were compared to parents of age-matched patients with Down syndrome (N=145) and Type 1 diabetes mellitus (N=155). Child's clinical characteristics and parents' caregiving burden, psychological distress, coping resources and strategies were assessed. RESULTS The parents of children with ASD reported higher objective and subjective burden, more frequent psychological distress, lower social support. Mothers reported greater subjective burden than fathers. Structural equation modeling showed that the most consistent positive and negative predictors of objective and subjective burden were ASD symptom severity and social support, respectively. Other positive predictors were engagement, distraction and disengagement coping, intellectual disability, and adaptive functioning. Other negative predictors were spiritual wellbeing and hardiness. Some effects were indirect through social support and coping strategies. CONCLUSION This study confirmed that parents of children with ASD carry a huge caregiving burden, and added to our understanding of the factors associated with burden. The findings may help inform the design of effective interventions aimed at reducing burden among the parents of children with ASD.
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Affiliation(s)
- Angelo Picardi
- Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome. Italy
| | - Antonella Gigantesco
- Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome. Italy
| | | | - Vera Stoppioni
- Department of Pediatrics and Child and Adolescent Neuropsychiatry, Marche Nord Hospital, Fano, Italy
| | - Renato Cerbo
- Child Neuropsychiatry Unit and Centre for Neurodevelopmental Disorders, Pescara, Italy
| | - Maurizio Cremonte
- Neurological and Psychiatric Child Unit, Pediatric Department, Alessandria Hospital, Alessandria, Italy
| | | | - Ilaria Lega
- Women’s Health Unit, National Centre of Epidemiology Surveillance and Health Promotion, Italian National Institute of Health, Rome. Italy
| | - Franco Nardocci
- Italian Society for Child and Adolescent Neuropsychiatry, Italy
- Italian Autism Foundation, Rome, Italy
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Abstract
The incidence and prevalence of adults diagnosed with epilepsy is higher compared to those diagnosed in childhood, yet the experience of living with adult-onset epilepsy has rarely been examined. Hence, the current study took a phenomenological approach to examining the experience of living with epilepsy following diagnosis in adulthood. Semi-structured interviews were conducted with 39 people from across the UK, diagnosed with epilepsy between the ages of eighteen and sixty, at two points in time, six months apart. Phenomenological analysis identified three central themes: the unpredictability of seizure occurrence; the ripple effect; and re-evaluating the future. Despite the accepted consensus in the epilepsy literature that living and coping with epilepsy becomes more difficult the older a person is diagnosed, the current findings indicated that this is inadequate. Rather, it is more suitable to consider that those living with adult-onset epilepsy have a specific experience of the condition and particular support needs, given that they once lived their lives as people without epilepsy.
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Affiliation(s)
- Stephanie Kılınç
- School of Social Science, Business and Law, Teesside University, Borough, Road, Middlesbrough TS1 3BX, UK.
| | - Anna van Wersch
- School of Social Science, Business and Law, Teesside University, Borough, Road, Middlesbrough TS1 3BX, UK
| | | | - Alison Guy
- School of Social Science, Business and Law, Teesside University, Borough, Road, Middlesbrough TS1 3BX, UK
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Mollaoğlu M, Mollaoğlu M, Durna Z. Validity and Reliability of the Quality of Life in Epilepsy Inventory (QOLIE-10) For Turkey. ACTA ACUST UNITED AC 2017; 54:239-243. [PMID: 29033636 DOI: 10.5152/npa.2016.13809] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 02/27/2016] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The purpose of this study was to test as a shortened form of the health-related quality of life for patients with epilepsy inventory (QOLIE). METHODS A study of 148 adult epileptic patients admitted to the Neurology Outpatient Clinic at Cumhuriyet University Hospital in Sivas was used to derive a brief screening tool from a longer instrument (QOLIE-31). RESULTS The 10-item questionnaire (QOLIE-10) contains general and epilepsy-specific dimensions grouped into three domains: Epilepsy Effects (memory, physical effects, and mental effects of medication), Mental Health (energy, depression, overall quality of life), and Role Functioning (seizure worry, work, driving, social limits). Cronbach's alpha (measure of internal consistency) was high, as were the associations between QOLIE-10 and the Nottingham Health Profile (NHP). High correlations between QOLIE-10 and NHP domains (emotional reactions, energy, physical mobility, and social isolation) were found. CONCLUSION The QOLIE-10 questionnaire is considered to be a valid and reliable tool for use in Turkey. Health professionals are encouraged to use this questionnaire to routinely examine the influences of the disease process in epilepsy patients.
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Affiliation(s)
- Mukadder Mollaoğlu
- Department of Nursing, Cumhuriyet University Health Sciences Faculty, Sivas, Turkey
| | | | - Zehra Durna
- İstanbul Bilim University, Florence Nightingale High School Nursing, İstanbul, Turkey
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13
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Saadi A, Patenaude B, Nirola DK, Deki S, Tshering L, Clark S, Shaull L, Sorets T, Fink G, Mateen F. Quality of life in epilepsy in Bhutan. Seizure 2016; 39:44-48. [PMID: 27257785 DOI: 10.1016/j.seizure.2016.05.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/27/2016] [Accepted: 05/04/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To assess the quality of life in epilepsy (QOLIE) among adults in the lower middle-income country of Bhutan and assess the potential demographic and clinical associations with better QOLIE. METHODS People with clinically diagnosed epilepsy were prospectively enrolled at the Jigme Dorji Wangchuck National Referral Hospital in Thimphu (2014-2015). Regression models were constructed to assess the potential impact of age, sex, residence in the capital city, wealth quintile, educational attainment, seizure in the prior year, seizures with loss of consciousness, self-reported stigma score, and need for multiple antiepileptic drugs. RESULTS The mean Bhutanese 48.4/100 ± 17.3 [corrected] score among 172 adults (mean age 31.1 years, 93 female) was 48.9/100±17.7. Younger age, lower educational attainment level, and increased self-perceived stigma were each observed to have an independent, negative association with QOLIE (p<0.05), while a patient's wealth quintile, sex, seizure frequency, seizure type and number of antiepileptic drugs were not. Education appeared to be most strongly associated with QOL at the high school and college levels. CONCLUSIONS There are potentially modifiable associations with low QOLIE. Addressing the educational level and self-perceived stigma of PWE may have an especial impact. The low QOLIE in Bhutan may reflect cultural approaches to epilepsy, health services, or other factors including those outside of the health sector.
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Affiliation(s)
- Altaf Saadi
- Partners Neurology Residency, Massachusetts General Hospital and Brigham and Woman's Hospital, Boston, USA.
| | | | | | - Sonam Deki
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
| | - Lhab Tshering
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
| | - Sarah Clark
- Massachusetts General Hospital, Boston, USA.
| | | | - Tali Sorets
- Massachusetts General Hospital, Boston, USA.
| | - Guenther Fink
- Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Farrah Mateen
- Massachusetts General Hospital, Boston, USA; Harvard Medical School, Boston, USA.
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14
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Mollaoğlu M, Durna Z, Bolayir E. Validity and Reliability of the Quality of Life in Epilepsy Inventory (QOLIE-31) for Turkey. Noro Psikiyatr Ars 2015; 52:289-295. [PMID: 28360726 DOI: 10.5152/npa.2015.8727] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 08/03/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The purpose of this study was to evaluate reliability and validity of the 31-item Quality of Life in Epilepsy Inventory (QOLIE-31) in Turkish epileptic patients. METHODS This study was performed methodologically. To standardize the inventory, using a standard "forward-backward" translation and cultural adaptation procedure the English version of the QOLIE-31 was translated to Turkish. Language equivalence of the scale was provided. The opinions of experts were considered regarding the content validity of the scale. Reliability of the scale was determined with the test-retest reliability, item-total correlation and internal consistency analysis. For the construct validity, QOLIE-31 was compared with Nottingham Health Profile (NHP) scale and pre validity was determined. RESULTS One hundred and forty-eight epileptic patients (62 females, 86 males), with a mean age of 32.5 (SD: 10.71) years were enrolled in the study. Content Validity Index of instrument was .85. Alpha reliability was .91. Item-total correlations were between .46 and .74 (p=.001). The mean score for the quality of life of epileptic patients was found to be moderate level (56.4; SD: 17.3). The mean score of Seizure Worry subscale was the lowest (48.9, SD: 29.82), while social function subscale (60.1, SD: 20.12) was found to be highest. As expected, correlations between QOLIE-31 and NHP subscales were fairly strong, particularly between those subscales with close or interdependent content. Thus, Emotional Well-Being correlated with NHP Emotional Reactions, Social Isolation and Pain; Social Function with NHP Social Isolation and Physical Mobility; Seizure Worry with NHP Social Isolation and Emotional Reactions; and Cognitive Function with NHP Energy, Emotional Reactions and Pain. CONCLUSION The Turkish version of the QOLIE-31 questionnaire has good structural characteristics, is a reliable and valid instrument and can be used for measuring the effect of epilepsy on the quality of life.
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Affiliation(s)
- Mukadder Mollaoğlu
- Department of Medical Nursing, Cumhuriyet University Faculty of Health Sciences, Sivas, Turkey
| | - Zehra Durna
- Department of Medical Nursing, Bahçeşehir University Faculty of Health Sciences, İstanbul, Turkey; İstanbul Bilim University Florence Nightingale Hospital, High School of Nursing, İstanbul, Turkey
| | - Ertuğrul Bolayir
- Department of Neurology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
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Quality of life is social – Towards an improvement of social abilities in patients with epilepsy. Seizure 2015; 26:12-21. [DOI: 10.1016/j.seizure.2014.12.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 10/30/2014] [Accepted: 12/16/2014] [Indexed: 12/20/2022] Open
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Giovagnoli AR, Parente A, Tarallo A, Casazza M, Franceschetti S, Avanzini G. Self-rated and assessed cognitive functions in epilepsy: impact on quality of life. Epilepsy Res 2014; 108:1461-8. [PMID: 25060995 DOI: 10.1016/j.eplepsyres.2014.06.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 06/07/2014] [Accepted: 06/28/2014] [Indexed: 10/25/2022]
Abstract
AIM OF THE STUDY To compare the effects of perceived and assessed cognitive functions on quality of life (QoL) in patients with epilepsy (PWE). METHODS The study analyzed the data from a series of PWE who compiled the Quality of Life in Epilepsy-89 Inventory (QOLIE-89) and the Multiple Ability Self-Report Questionnaire (MASQ) for QoL and perceived cognitive abilities, respectively. The State-Trait Anxiety and Beck Depression inventories were used to assess mood. Neuropsychological tests evaluated abstract reasoning, attention, conceptual-motor tracking, constructional praxis, language, verbal and non-verbal memory, abstraction, category shifting, verbal fluency, and visual-spatial abilities. RESULTS The QOLIE-89 overall score was predicted by the Mood and Attention and Executive Functions factors and MASQ scores, explaining 38, 6, and 4% of its variance, while disease duration, seizure frequency, and schooling determined 16%. The QOLIE-89 Psychosocial, Cognitive, and Physical Performance sub-domains related to mood. The Cognitive and Physical Performance factors also related to the MASQ and Attention and Executive Functions factor scores, respectively. CONCLUSIONS In PWE, self-rated and assessed cognitive deficits may influence QoL, explaining 10% of its variance irrespective from mood and clinical variables. Treating cognitive deficits and their perception may help improve QoL.
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Affiliation(s)
- Anna Rita Giovagnoli
- Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy.
| | - Annalisa Parente
- Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy
| | - Anna Tarallo
- Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy
| | - Marina Casazza
- Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy
| | - Silvana Franceschetti
- Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy
| | - Giuliano Avanzini
- Department of Diagnostics and Applied Technology, Fondazione IRCCS Istituto Neurologico C. Besta, Milano, Italy
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Guerrini R, Scerrati M, Rubboli G, Esposito V, Colicchio G, Cossu M, Marras CE, Tassi L, Tinuper P, Paola Canevini M, Quarato P, Giordano F, Granata T, Villani F, Giulioni M, Scarpa P, Barbieri V, Bottini G, Del Sole A, Vatti G, Spreafico R, Lo Russo G. Overview of presurgical assessment and surgical treatment of epilepsy from the Italian League Against Epilepsy. Epilepsia 2013; 54 Suppl 7:35-48. [DOI: 10.1111/epi.12308] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Renzo Guerrini
- Pediatric Neurology Unit and Laboratories; Children's Hospital A. Meyer-University of Florence; Florence Italy
| | - Massimo Scerrati
- Neurosurgery; University Hospital - Polytechnic University of Marche; Ancona Italy
| | - Guido Rubboli
- IRCCS Institute of Neurological Sciences; Bellaria Hospital; Bologna Italy
- Danish Epilepsy Center; Epilepsy Hospital, Dianalund Denmark
| | - Vincenzo Esposito
- Neurosurgery; I.R.C.C.S. Neuromed; Pozzilli (IS) Italy
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | | | - Massimo Cossu
- C. Munari Epilepsy Surgery Center; Niguarda Hospital; Milan Italy
| | - Carlo Efisio Marras
- Neurosurgery Unit; Department of Neuroscience e Neurorehabilitation; Bambino Gesù Children Hospital; Rome Italy
| | - Laura Tassi
- C. Munari Epilepsy Surgery Center; Niguarda Hospital; Milan Italy
| | - Paolo Tinuper
- Neurological Clinic; Bellaria Hospital IRCCS Institute of Neurological Sciences of Bologna and Department of Biomedical and Neuromotor Sciences; University of Bologna; Bologna Italy
| | - Maria Paola Canevini
- Epilepsy Center; San Paolo Hospital and Department of Health Sciences; University of Milan; Milan Italy
| | - Pierpaolo Quarato
- Epilepsy Surgery Unit; Department of Neurological Sciences; IRCCS “NEUROMED”; Pozzilli (IS) Italy
| | - Flavio Giordano
- Pediatric Neurosurgery Unit; Children's Hospital Meyer-University of Florence; Florence Italy
| | - Tiziana Granata
- Department of Pediatric Neuroscience; Carlo Besta Neurological Institute; Milan Italy
| | - Flavio Villani
- Clinical Epileptology and Experimental Neurophysiology Unit; Carlo Besta Neurological Institute; Milan Italy
| | - Marco Giulioni
- Division of Neurosurgery; IRCCS Institute of Neurological Sciences of Bologna; Bellaria Hospital; Bologna Italy
| | - Pina Scarpa
- Cognitive Neuropsychology Centre; Niguarda Hospital; Milan Italy
| | - Valentina Barbieri
- Psychiatric Branch; Department of Medicine, Surgery and Dentistry; University of Milan and San Paolo Hospital; Milan Italy
| | - Gabriella Bottini
- Cognitive Neuropsychology Centre; Niguarda Hospital; Milan Italy
- Department of Psychology; University of Pavia; Pavia Italy
| | - Angelo Del Sole
- Department of Diagnostic Services; Unit of Nuclear Medicine; San Paolo Hospital and Department of Health Sciences; University of Milan; Milan Italy
| | - Giampaolo Vatti
- Department of Neurological and Sensorial Sciences; University of Siena; Siena Italy
| | - Roberto Spreafico
- Clinical Epileptology and Experimental Neurophysiology Unit; Carlo Besta Neurological Institute; Milan Italy
| | - Giorgio Lo Russo
- C. Munari Epilepsy Surgery Center; Niguarda Hospital; Milan Italy
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Farrace D, Tommasi M, Casadio C, Verrotti A. Parenting stress evaluation and behavioral syndromes in a group of pediatric patients with epilepsy. Epilepsy Behav 2013; 29:222-7. [PMID: 24034672 DOI: 10.1016/j.yebeh.2013.07.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 07/16/2013] [Accepted: 07/22/2013] [Indexed: 11/30/2022]
Abstract
The aim of the present work was to measure the amount of stress in parents of children with epilepsy and to determine whether and how parenting stress is linked to behavioral symptoms of the children. Parenting stress was measured with the Parenting Stress Index (PSI) and behavioral symptoms with the Child Behavior Checklist (CBCL). Data obtained from 26 parents of children with epilepsy were compared with those obtained from 31 parents of healthy children. Children with epilepsy obtained higher scores in all the subscales of PSI and in almost all the subscales of CBCL compared with healthy children. Epilepsy caused a high level of parenting stress and of problematic behaviors since the behavioral symptoms predicting the degree of parenting stress significantly differed between healthy children and children with epilepsy. Therefore, parents of children with epilepsy should be offered psychological support to cope with parenting stress and to improve the relationship with their children.
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Affiliation(s)
- Davide Farrace
- Department of Sciences in Quantitative Economics, Philosophy and Education, Gabriele D'Annunzio University, Chieti-Pescara, Italy
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Jehi L, Tesar G, Obuchowski N, Novak E, Najm I. Quality of life in 1931 adult patients with epilepsy: seizures do not tell the whole story. Epilepsy Behav 2011; 22:723-7. [PMID: 22019018 DOI: 10.1016/j.yebeh.2011.08.039] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 08/23/2011] [Accepted: 08/27/2011] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of the work described here was to characterize quality of life (QOL) and its determinants in a large cohort of adult patients with epilepsy. METHODS Validated measures reflecting disease severity and psychosocial functioning were electronically collected on all outpatients seen during 2009. Multivariate regression adjusting for repeated measures identified determinants of QOL, as defined by the Quality of Life in Epilepsy Questionnaire-10 (QOLIE-10). RESULTS Seven thousand seven hundred eighty-four visits from patients with epilepsy were identified. The questionnaire completion rate was 77%, yielding 5960 records corresponding to 1931 individual patients for analysis. Following multivariate modeling, the two most clinically significant QOL predictors were seizure severity (mean QOLIE-10 score=28.8 if LSSS>40 vs 19.2 otherwise) and depression (mean QOLIE-10 score=31.7 if PHQ-9≥10 vs 19.3 otherwise). CONCLUSIONS Optimizing quality of life in patients with epilepsy requires an approach that extends beyond controlling seizures. Collection of validated health status measures improving patient management is possible within the setting of routine clinical care.
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Affiliation(s)
- Lara Jehi
- Epilepsy Center, Cleveland Clinic, Cleveland, OH 44124, USA.
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20
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Garcia CS. Depression in temporal lobe epilepsy: a review of prevalence, clinical features, and management considerations. EPILEPSY RESEARCH AND TREATMENT 2011; 2012:809843. [PMID: 22957244 PMCID: PMC3420378 DOI: 10.1155/2012/809843] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Accepted: 09/10/2011] [Indexed: 11/17/2022]
Abstract
Depression in temporal lobe epilepsy has been established as a frequent occurrence, and various possible mechanisms for this significant comorbidity have been posited. However, there is still little to guide a clinician in the recognition and management of depression in patients with temporal lobe epilepsy. This is in part due to the lack of consistent findings in earlier studies, which was likely partly due to variabilities in methodology, sampling, and diagnosis of both temporal lobe epilepsy and depression. However, in recent years, significant effort has been made to address these issues and provide a framework for diagnosis and management of depression in this population. The following is a review of the literature, with special emphasis on clinical phenomenology of depressive symptoms, described bidirectional risk between depression and temporal lobe epilepsy, and treatment strategies in the context of potential drug interactions with antiepileptic drugs.
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Affiliation(s)
- C. S. Garcia
- Department of Psychiatry, Schulich School of Medicine, University of Western Ontario, London, ON, Canada N6A 5C1
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Taylor RS, Sander JW, Taylor RJ, Baker GA. Predictors of health-related quality of life and costs in adults with epilepsy: a systematic review. Epilepsia 2011; 52:2168-80. [PMID: 21883177 DOI: 10.1111/j.1528-1167.2011.03213.x] [Citation(s) in RCA: 258] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Given the high burden of epilepsy on both health-related quality of life (HRQoL) and costs, identification of factors that are predictive of either reduced HRQoL or increased expenditure is central to the better future targeting and optimization of existing and emerging interventions and management strategies for epilepsy. METHODS Searches of Medline, Embase, and Cochrane Library (up to July 2010) to identify studies examining the association between demographic, psychosocial, and condition-related factors and HRQoL, resource utilization or costs in adults with epilepsy. For each study, predictor factor associations were summarized on the basis of statistical significance and direction; the results were then combined across studies. KEY FINDINGS Ninety-three HRQoL and 16 resource utilization/cost studies were included. Increases in seizure frequency, seizure severity, level of depression, and level of anxiety and presence of comorbidity were strongly associated with reduced HRQoL. The majority of studies were cross-sectional in design and had an overall methodologic quality that was judged to be "moderate" for HRQoL studies and "poor" for health care resource or costs studies. In the 53 multivariate studies, age, gender, marital status, type of seizure, age at diagnosis, and duration of epilepsy did not appear to be associated with HRQoL, whereas the predictive influence of educational and employment status, number of antiepileptic drugs (AEDs) and AED side effects was unclear. The association between predictive factors and HRQoL appeared to be consistent across individuals whether refractory or seizures controlled or managed by AEDs. There were insufficient multivariate studies (five) to reliably comment on the predictors of resource utilization or cost in epilepsy. SIGNIFICANCE In addition to seizure control, effective epilepsy management requires the early detection of those most at risk of psychological dysfunction and comorbidity, and the targeting of appropriate interventions. There is need for more rigorous studies with appropriate multivariate statistical methods that prospectively investigate the predictors of HRQoL, resource utilization, and costs in epilepsy.
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Affiliation(s)
- Rod S Taylor
- Peninsula College of Medicine & Dentistry, University of Exeter, Exeter, United Kingdom.
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23
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Assessment of psychosocial adjustment in patients with temporal lobe epilepsy using a standard measure. Epilepsy Behav 2011; 20:89-94. [PMID: 21145288 DOI: 10.1016/j.yebeh.2010.10.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 10/29/2010] [Accepted: 10/30/2010] [Indexed: 11/23/2022]
Abstract
Despite the growing evidence of poor psychosocial adjustment, at present there is no formal method of assessment of social adjustment in patients with temporal lobe epilepsy (TLE). First, we assessed social adjustment in patients with TLE using a self-report questionnaire and compared the results with those from quality-of-life (QOL) scales. Second, we verified the influence of cognitive performance and clinical variables of epilepsy on social adjustment and QOL. We evaluated 35 people with TLE and 38 healthy controls. Patients had worse social adjustment, and it was correlated with worse perception of cognitive function. Attention and verbal memory dysfunctions were negatively correlated with social adjustment. However, there was no significant correlation between cognitive performance and QOL. Regarding clinical variables, persons with left TLE showed worse social adjustment and patients with frequent seizures showed worse QOL. These findings indicate the relevance of evaluating social adjustment and emphasize the importance of cognitive rehabilitation to improved social adjustment.
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Canevini MP, De Sarro G, Galimberti CA, Gatti G, Licchetta L, Malerba A, Muscas G, La Neve A, Striano P, Perucca E. Relationship between adverse effects of antiepileptic drugs, number of coprescribed drugs, and drug load in a large cohort of consecutive patients with drug-refractory epilepsy. Epilepsia 2010; 51:797-804. [PMID: 20545754 DOI: 10.1111/j.1528-1167.2010.02520.x] [Citation(s) in RCA: 136] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bautista RED, Glen ET. Seizure severity is associated with quality of life independent of seizure frequency. Epilepsy Behav 2009; 16:325-9. [PMID: 19713158 DOI: 10.1016/j.yebeh.2009.07.037] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2009] [Revised: 07/23/2009] [Accepted: 07/24/2009] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The goal of the work described here was to determine whether seizure severity is associated with quality of life and if this association exists independent of seizure frequency. METHODS We administered a survey questionnaire to patients followed at the Comprehensive Epilepsy Program, University of Florida Health Sciences Center/Jacksonville. RESULTS The study population comprised 142 subjects. On univariate analysis, increased seizure severity (as measured with the revised Liverpool Seizure Severity Scale, LSSS) and seizure frequency were significantly associated with poorer Quality of Life in Epilepsy-10 (QOLIE-10) scores. Most items on the LSSS were significantly associated with QOLIE-10 scores, as well as the various scales of the QOLIE-10. Likewise, all QOLIE-10 scales were significantly associated with overall LSSS scores. The correlation between seizure severity and frequency was insignificant. On multiple linear regression, both seizure severity and frequency were independently associated with QOLIE-10 scores. CONCLUSION Seizure severity is associated with quality of life and this association exists independent of seizure frequency.
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Affiliation(s)
- Ramon Edmundo D Bautista
- Comprehensive Epilepsy Program, Department of Neurology, University of Florida Health Sciences Center/Jacksonville, Jacksonville, FL 32209, USA.
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Abstract
Epilepsy creates significant morbidity, disability, and loss of productivity worldwide. Although unpredictable seizures define epilepsy, the cognitive and emotional difficulties encountered by people with epilepsy may have an even greater impact on everyday function. Epilepsy is associated with lower quality of life (QOL); while this is partially attributable to ongoing seizures, QOL is independently affected by comorbid affective disorders like depression and anxiety. These can accompany all types of epilepsy, but may be especially noteworthy in partial epilepsy syndromes with foci in the frontal or temporal lobes. There is growing evidence that epileptogenic lesions disrupt cortical networks that carry out emotional processing. In addition to epilepsy itself, treatment strategies also affect cognitive functioning and mood. Antiepileptic drugs, vagal nerve stimulation, and surgical resection have all been associated with changes in mood, emotional processing, and social cognition. Overall, the relationship between epilepsy and emotion is vastly complex; when assessing emotional difficulties in a person with epilepsy, we must consider the psychosocial impact of the disease on the patient, the underlying pathophysiology of the disease, and the effects of ongoing treatments.
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Affiliation(s)
- John D Hixson
- UCSF Department of Neurology, UCSF Epilepsy Center, San Francisco, CA 94143-0138, USA.
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Meneses RF, Pais-Ribeiro J, da Silva AM, Giovagnoli AR. Neuropsychological predictors of quality of life in focal epilepsy. Seizure 2009; 18:313-9. [DOI: 10.1016/j.seizure.2008.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Revised: 11/11/2008] [Accepted: 11/20/2008] [Indexed: 11/15/2022] Open
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Buschmann F, Wagner K, Metternich B, Biethahn S, Zentner J, Schulze-Bonhage A. The impact of extratemporal epilepsy surgery on quality of life. Epilepsy Behav 2009; 15:166-9. [PMID: 19250976 DOI: 10.1016/j.yebeh.2009.02.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2009] [Revised: 02/20/2009] [Accepted: 02/21/2009] [Indexed: 11/28/2022]
Abstract
Quality of life (QOL) with respect to seizure outcome, cognitive performance, and depressive symptoms was analyzed in 21 adult patients undergoing extratemporal epilepsy surgery (EXTLE). The Subjective Handicap of Epilepsy questionnaire was administered before and 1 year after surgery. Additionally, cognitive performance, depressive symptoms (Beck Depression Inventory), and seizure frequency were assessed. After surgery, seizure frequency decreased and various aspects of QOL significantly improved. Improvements in the domain of Work and Activities correlated with a reduction in complex partial seizure frequency. Alterations in the subscale change correlated with a decrease in simple partial seizure frequency. The present results provide detailed evidence that patients with extratemporal epilepsy benefit from epilepsy surgery.
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Affiliation(s)
- F Buschmann
- Epilepsy Center, University Hospital Freiburg, Breisacher Strasse 64, Freiburg, Germany.
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Validity and reliability of the Portuguese-Brazilian version of the Quality of Life in Epilepsy Inventory-89. Epilepsy Behav 2009; 14:465-71. [PMID: 19138756 DOI: 10.1016/j.yebeh.2008.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2008] [Revised: 12/02/2008] [Accepted: 12/13/2008] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this article was to report the translation of the Quality of Life in Epilepsy Inventory-89 (QOLIE-89) into a Portuguese-Brazilian version and evaluate its reliability and validity. METHODS This study involved 105 outpatients: 54 patients with refractory temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) and 51 with juvenile myoclonic epilepsy (JME). Reliability and test-retest reliability were assessed. Relationships between QOLIE-89 domains and other questionnaires (Nottingham Health Profile, Beck Depression Inventory, Adverse Event Profile, Neuropsychological Evaluation), and external measures such as demographic and clinical variables were analyzed to examine construct validity. RESULTS Internal consistency (Cronbach's alpha=0.73-0.92) and test-retest reliability (intraclass correlation coefficient=0.60-0.84) for individual domains were acceptable. For construct validity, we verified high correlations between the QOLIE-89 and the Nottingham Health Profile, Beck Depression Inventory, Adverse Event Profile, and Neuropsychological Evaluation. For clinical characteristics, the patients with juvenile myoclonic epilepsy had better quality-of-life scores on 11 of 17 QOLIE-89 subscales compared with patients with temporal lobe epilepsy (P<0.05). CONCLUSION These results support the reliability and validity of the Portuguese-Brazilian translation of QOLIE-89.
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Canuet L, Ishii R, Iwase M, Ikezawa K, Kurimoto R, Azechi M, Takahashi H, Nakahachi T, Teshima Y, Takeda M. Factors associated with impaired quality of life in younger and older adults with epilepsy. Epilepsy Res 2009; 83:58-65. [DOI: 10.1016/j.eplepsyres.2008.09.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Revised: 09/09/2008] [Accepted: 09/14/2008] [Indexed: 10/21/2022]
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Abstract
INTRODUÇÃO: Várias comorbidades psiquiátricas à epilepsia são prevalentes e podem reduzir a qualidade de vida ligada à saúde (QVLS) das pessoas com epilepsia (PE). OBJETIVOS: Abordar a magnitude do problema, distribuição dos transtornos psiquiátricos mais associados, segundo a distribuição por idade e gênero. Reconhecer: os fatores de risco para essas comorbidades e a sua classificação/diagnóstico; os índices de multimorbidade de potencial uso em epileptologia e a sua aplicabilidade na avaliação da QVLS; repercussão na prática clínica da abordagem das mencionadas comorbidades. MÉTODOS: Revisão narrativa sobre comorbidade psiquiátrica, principalmente com artigos dos últimos 10 anos de base populacional. RESULTADOS: Os transtornos psiquiátricos são mais prevalentes nas PE do que na população geral, sendo os transtornos do humor, ansiedade, psicoses, esquizofrenia, transtornos de personalidade e dependência alcoólica os mais comuns. Vários deles são mais prevalentes em qualquer faixa etária das PE do que na população geral, e mais nas mulheres do que nos homens, e tendem a repercutir negativamente no seu nível sócio-econômico. O diagnóstico dessas comorbidades é limitado: não costuma haver distinção entre transtornos psiquiátricos gerais e os especificamente relacionados à epilepsia. CONCLUSÃO: Os transtornos psiquiátricos são comuns nas PE, especialmente os do humor, mas as taxas são diversas assim como as metodologias empregues, e há necessidade de sua melhor abordagem para melhor controle clínico dos pacientes, melhoria da sua QVLS e redução de custos dos cuidados à saúde.
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Piperidou C, Karlovasitou A, Triantafyllou N, Dimitrakoudi E, Terzoudi A, Mavraki E, Trypsianis G, Vadikolias K, Heliopoulos I, Vassilopoulos D, Balogiannis S. Association of demographic, clinical and treatment variables with quality of life of patients with epilepsy in Greece. Qual Life Res 2008; 17:987-96. [DOI: 10.1007/s11136-008-9375-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2007] [Accepted: 07/03/2008] [Indexed: 10/21/2022]
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Self-proxy agreement and correlates of health-related quality of life in young adults with epilepsy and mild intellectual disabilities. Epilepsy Behav 2008; 13:202-11. [PMID: 18346941 DOI: 10.1016/j.yebeh.2008.02.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Revised: 02/01/2008] [Accepted: 02/06/2008] [Indexed: 11/22/2022]
Abstract
This study investigated health-related quality of life (HRQOL) in young adults with epilepsy and intellectual disabilities. First, agreement between self-reports and proxy reports of HRQOL was examined. Second, medical and psychological contributions to HRQOL were explored. Thirty-six patients were interviewed using the Quality of Life in Epilepsy inventory (QOLIE-31), the Hospital Anxiety and Depression Scale, and the Neuroticism and Extraversion scales of the NEO Five-Factor Inventory. Medical data were taken from files. Professional caregivers completed rephrased QOLIE-31-questionnaires. The perspectives on HRQOL differed systematically: Caregivers underrated their clients' HRQOL on average. Few correlations with medical characteristics emerged, whereas all psychological variables were strongly related to HRQOL. Neuroticism, Age at Disability Onset, and their interaction explained 71% of the HRQOL variance. Results indicate that proxy reports do not provide valid substitutes for most of the self-reported HRQOL subscales. Psychological treatment of negative affectivity and after critical life events in adolescence may improve HRQOL in young adults with epilepsy and mild intellectual disabilities.
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Piazzini A, Beghi E, Turner K, Ferraroni M. Health-related quality of life in epilepsy: findings obtained with a new Italian instrument. Epilepsy Behav 2008; 13:119-26. [PMID: 18396465 DOI: 10.1016/j.yebeh.2008.02.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Revised: 02/25/2008] [Accepted: 02/29/2008] [Indexed: 10/22/2022]
Abstract
The aim of the present study was to evaluate the Epi-QoL, a new Italian-specific measure of health-related quality of life (HRQOL) for adults with epilepsy; the clinical variables that affected the HRQOL score were also assessed. The Epi-QoL is a 46-item self-administered questionnaire focusing on six domains: Physical Functioning, Cognitive Functioning, Emotional Well-Being, Social Functioning, Seizure Worry, and Medication Effects. Eight hundred fifteen patients recruited from 24 secondary and tertiary Italian centers for the care of epilepsy were assessed. The results supported the reliability and validity of the Epi-QoL as a measure of HRQOL. The variables that significantly affected HRQOL scores were: geographic area, gender, seizure frequency, prognostic categories, number of medications, comorbidity, presence of cognitive impairment, psychiatric disturbances, and disability. We believe that a new specific questionnaire for the evaluation of HRQOL in Italy can contribute much to the understanding of the influence of epilepsy on patients' lives.
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Affiliation(s)
- Ada Piazzini
- Epilepsy Center, St Paolo Hospital, Milan, Italy.
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Piperidou C, Karlovasitou A, Triantafyllou N, Terzoudi A, Constantinidis T, Vadikolias K, Heliopoulos I, Vassilopoulos D, Balogiannis S. Influence of sleep disturbance on quality of life of patients with epilepsy. Seizure 2008; 17:588-94. [PMID: 18396419 DOI: 10.1016/j.seizure.2008.02.005] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2007] [Revised: 01/17/2008] [Accepted: 02/29/2008] [Indexed: 11/26/2022] Open
Abstract
The frequency of sleep disturbances in patients with epilepsy and their impact on quality of life (QoL) have been documented in a few reports, and the results are conflicting. We identified 124 consecutive epilepsy out-patients who visited the epilepsy out-patient clinics at the University Hospital of Alexandroupolis, the AHEPA Hospital in Thessaloniki and the Aeginitio Hospital in Athens. We measured excessive daytime sleepiness (EDS) with the Epworth Sleepiness Scale (ESS), obstructive sleep apnea (OSA) with the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ), and insomnia with the Athens Insomnia Scale (AIS). We evaluated quality of life by the Quality of Life in Epilepsy Inventory (QOLIE-31). EDS was found in 16.9% (21/124) of epileptic patients, OSA in 28.2% (35/124), and insomnia in 24.6% (30/122). In multivariate analysis, we found that insomnia was an independent negative factor for Total score (p<0.001), Overall QoL (p=0.002), Emotional well-being (p<0.001), Energy/fatigue (p<0.001), Cognitive functioning (p=0.04) and Social functioning (p=0.03), and OSA only for Cognitive functioning (p=0.01). According to our findings, EDS, OSA, and insomnia are frequent in epileptic patients. Epileptic patients with sleep disturbance, mainly insomnia, have significant QoL impairment.
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Affiliation(s)
- Charitomeni Piperidou
- Department of Neurology, Democritus University of Thrace, University - General Hospital, Alexandroupolis, Greece
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Meldolesi GN, Di Gennaro G, Quarato PP, Esposito V, Grammaldo LG, Morosini P, Cascavilla I, Picardi A. Changes in depression, anxiety, anger, and personality after resective surgery for drug-resistant temporal lobe epilepsy: A 2-year follow-up study. Epilepsy Res 2007; 77:22-30. [PMID: 17904823 DOI: 10.1016/j.eplepsyres.2007.08.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Revised: 07/27/2007] [Accepted: 08/13/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To further elucidate the psychiatric outcome of surgical treatment for temporal lobe epilepsy (TLE). METHODS Fifty-two consecutive patients with drug-resistant TLE and IQ > or = 70 completed the Minnesota Multiphasic Personality Inventory, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Spielberger State-Trait Anger Expression Inventory before epilepsy surgery, after 1 year, and after 2 years. Some patients also completed the 31-item Quality of Life in Epilepsy (N=29) and WHOQOL-100 (N=24) questionnaires. During the follow-up period, patients were maintained on a stable medication regimen. Multivariate repeated measures analysis of variance was used to examine changes in psychiatric variables over time. RESULTS Seizure outcome was excellent (89% in Engel class I after 2 years). There were only a few significant changes over time in the MMPI profile, suggesting a decrease in interpersonal sensitivity, irritability, and social introversion. Anxiety decreased significantly with a gradual decline, anger dropped significantly after remaining basically flat during the first year, while depression showed a gradual but non-significant decline. Younger age and shorter duration of epilepsy were associated with greater improvement in several anger dimensions. In the patient subgroup with quality of life data available, greater improvement in overall quality of life and key life domains (income, work capacity, personal relationships) was found to be associated with greater decrease in depression, anxiety, and anger. CONCLUSION The relatively slow decrease of emotional distress over time and its correlation with changes in some key life domains suggest that patients may experience difficulties in switching from a 'sick' role to a 'normal' role, and may easily be disappointed if expectations of positive life changes are not rapidly met. Some counselling sessions early after surgery may be useful to address these issues. The findings also suggest that surgery may yield greater emotional benefits if performed early.
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Affiliation(s)
- G N Meldolesi
- Epilepsy Surgery Unit, Department of Neurological Sciences, IRCCS Neuromed, Pozzilli (IS), Italy
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Mosaku KS, Fatoye FO, Komolafe M, Lawal M, Ola BA. Quality of life and associated factors among adults with epilepsy in Nigeria. Int J Psychiatry Med 2007; 36:469-81. [PMID: 17408000 DOI: 10.2190/r80g-580x-x1h2-6936] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Epilepsy is a common condition worldwide and has been observed to affect quality of life (QOL). Though, much has been written on this subject among western populations, little research has been done in developing countries of Africa including Nigeria. The study aims to identify factors associated with quality of life among adult epilepsy patients in this environment. METHOD Respondents were evaluated using the 10-item Quality of Life in Epilepsy Inventory (QOLIE-10), the 30-item General Health Questionnaire (GHQ-30), the modified Mini Mental State Examination (mMMSE),and the Hospital Anxiety and Depression Scale (HADS). Diagnosis of epilepsy was based on clinical and electroencephalographic findings. RESULTS The mean age of the 51 respondents was 27.7 years (SD = 9.7). Thirteen (25.5%) had an average of 2 seizure episodes in the month preceding the interview, while 37 (72.5%) have had the condition for more than 5 years. Factors that were significantly associated with overall quality of life included being female (p < 0.05), seizure frequency (p < 0.01), using more than 1 anti-epileptic drugs (AEDs) (p < 0.01), GHQ-30 score (p < 0.01), high anxiety score (p < 0.001), and high depression score (p < 0.01). Multiple regression analysis showed that depressive symptoms were the single most important factor explaining low QOL. Other factors were GHQ-30 score, seizure frequency, and being a woman. CONCLUSION Controlling seizures and paying attention to the psychological needs of adult epileptics will have a positive effect on the QOL among Nigerian epileptics.
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Affiliation(s)
- Kolawole S Mosaku
- Department of Mental Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
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Tabb K, Boss-Williams KA, Weiss JM, Weinshenker D. Rats bred for susceptibility to depression-like phenotypes have higher kainic acid-induced seizure mortality than their depression-resistant counterparts. Epilepsy Res 2007; 74:140-6. [PMID: 17400428 PMCID: PMC1940038 DOI: 10.1016/j.eplepsyres.2007.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2006] [Revised: 01/30/2007] [Accepted: 02/26/2007] [Indexed: 11/23/2022]
Abstract
Epidemiological evidence suggests that epilepsy and depression are comorbid diseases. In fact, depression is the most common neuropsychiatric disorder associated with epilepsy, particularly temporal lobe epilepsy, and individuals with a history of depression are at a higher risk for developing epilepsy than the general population. Despite the epidemiological evidence for this link, there has been little experimental evidence to support the connection or elucidate possible underlying mechanisms. In an effort to address this problem and develop an animal model of epilepsy and depression comorbidity, we assessed seizure susceptibility and severity parameters in rats selectively bred for either susceptibility (the SwLo, SUS, and HYPER lines) or resistance (the SwHi, RES, and MON RES lines) to depression-like phenotypes. We found that rats bred for susceptibility to depression-like phenotypes experienced higher mortality following kainic acid-induced seizures than their resistant counterparts. In contrast, most line differences were not recapitulated when flurothyl was used to elicit seizures. Stress reduced kainic acid-induced mortality rates in all lines except the HYPER rats, supporting previously established indications that the stress response of HYPER rats is abnormal. These combined results support a neurobiological link between epilepsy and depression, advancing us towards an animal model of their comorbidity.
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Affiliation(s)
- Kroshona Tabb
- Department of Human Genetics, Emory University School of Medicine, Whitehead 301, 615 Michael Street, Atlanta, GA 30322, USA
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da Silva TI, Ciconelli RM, Alonso NB, Azevedo AM, Westphal-Guitti AC, Pascalicchio TF, Marques CM, Caboclo LOSF, Cramer JA, Sakamoto AC, Yacubian EMT. Validity and reliability of the Portuguese version of the quality of life in epilepsy inventory (QOLIE-31) for Brazil. Epilepsy Behav 2007; 10:234-41. [PMID: 17292675 DOI: 10.1016/j.yebeh.2006.08.022] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Revised: 08/22/2006] [Accepted: 08/23/2006] [Indexed: 11/17/2022]
Abstract
PURPOSE We report the cultural adaptation and psychometric properties of the Quality of Life in Epilepsy-31 Inventory (QOLIE-31) for the Portuguese language and Brazilian culture. METHODS This study involved 150 outpatients: 50 presurgical patients with refractory temporal lobe epilepsy (TLE) related to mesial temporal sclerosis (MTS), 50 patients with juvenile myoclonic epilepsy (JME), and 50 seizure-free patients with TLE. They completed the QOLIE-31, Nottingham Health Profile (NHP), Beck Depression Inventory (BDI), and Adverse Events Profile (AEP) and underwent a neuropsychological evaluation (NE). Internal consistency reliability, interrater and test-retest reliability, and construct validity were assessed. RESULTS QOLIE-31 mean scores were 33.1 (Social Function), 68.9 (Overall Quality of Life), 56.5 (Seizure Worry), 64.1 (Emotional Well-Being), 63.7 (Energy/Fatigue), 38.9 (Cognitive Function), and 49.7 (Medication Effects). Internal consistency was high (Cronbach's alpha), as were the associations between QOLIE-31 and the BDI, NHP, AEP, and NE. CONCLUSION The Portuguese/Brazilian version of the QOLIE-31 inventory showed good reliability, validity, and construct validity.
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Guekht AB, Mitrokhina TV, Lebedeva AV, Dzugaeva FK, Milchakova LE, Lokshina OB, Feygina AA, Gusev EI. Factors influencing on quality of life in people with epilepsy. Seizure 2006; 16:128-33. [PMID: 17157536 DOI: 10.1016/j.seizure.2006.10.011] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2005] [Revised: 07/25/2006] [Accepted: 10/31/2006] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES To assess the influence of different factors on health-related QOL in adults with epilepsy in Moscow, Russia. METHOD We evaluated quality of life in 242 patients (98 de novo and 144 previously inadequately treated) by using QOLIE-31. Partial cryptogenic or symptomatic epilepsy was diagnosed in 214 patients, in 28-idiopathic generalized epilepsy. Stepwise regression analysis was performed to assess the influence of different factors on QOL. RESULTS In patients with epilepsy in Russia the total score of QOLIE-31 was rather low-42.13+/-4.14. Relationship of quality of life (total score) and frequency of seizures and duration of disease was analyzed. Frequency of seizures was the most significant parameter related to QOL (R=0.46 with total score). Duration of disease also correlated with QOL score (R=0.24 with total score). Significant but rather weak association (link) between frequency of seizures and almost all of subscales of quality of life was noticed. Duration of epilepsy correlated with less number of subscales: Energy/fatigue, Medication effects, Social functioning, Overall QOL subscales. When factors influencing on QOL were separately analyzed in newly diagnosed and previously treated patients frequency of seizures was the most important parameter in both groups. CONCLUSIONS Frequency of seizures is the most important factor influencing on QOL in adults with epilepsy (newly diagnosed and previously treated).
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Affiliation(s)
- Alla B Guekht
- Department of Neurology and Neurosurgery, Russian State Medical University, 117049, Leninsky Prospect, 8 Block 8, Moscow, Russia.
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Mantoan MAS, Silva TID, Alonso NB, Noffs MHDS, Marques CM, Rios LB, Azevedo AM, Westphal-Guitti AC, Sakamoto AC, Yacubian EMT. Neuropsychological assessment and quality of life in patients with refractory temporal lobe epilepsy related to hippocampal sclerosis. ACTA ACUST UNITED AC 2006. [DOI: 10.1590/s1676-26492006000700004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION: Epilepsy is a disorder that results in abnormal activity in a group of neurons that may have significant impact on the normal cognitive processes and behavior. Temporal lobe epilepsy (TLE) is the most frequent form of partial epilepsy in adults, and hippocampal sclerosis (HS) the most common neuropathologic finding in patients with medically refractory TLE. Patients with TLE often present cognitive difficulties that may be determined by the effects of epileptic discharges and side of the lesion. And its consequence is that patients have poor effects on quality of life (QOL). PURPOSE: We report the relationship between neuropsychological assessment and QOL under the hypotheses that patients with worst results in neuropsychological assessment have poorer QOL assessed by the QOLIE-31. RESULTS: Regarding seizure frequency, 23 (46%) had had 1-5, 20 (40%) 6-10 and 7 (14%) more than 10 seizures/month. In relation to seizure types, 5 (10%) had had auras, 37 (74%) complex partial seizures and 8 (16%) partial evolving to generalized tonic-clonic seizures (GTCS). Neuropsychological evaluation had a positive correlation with QOLIE-31 domains. QOL evaluations had the worst scores in QOLIE-31 were in Cognitive Function (45.0) and Social Function (46.0). The best was Overall QOL (62.0). CONCLUSION: People with epilepsy have great impact on their QOL not only because of daily seizures but because of the impact seizures cause in their cognitive functions. TLE is an example of how refractory epilepsy can exterminate any possibilities of work, study and live in a society that discriminates someone with epilepsy who also presents cognitive decline.
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