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İşcan Ayyildiz N, Bingöl N. The effects of web-based animation-supported progressive relaxation exercises applied to individuals with epilepsy on fatigue and sleep quality: A randomized controlled study. Epilepsy Behav 2024; 154:109734. [PMID: 38554645 DOI: 10.1016/j.yebeh.2024.109734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/09/2024] [Accepted: 03/03/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE The study was conducted to determine the effects of Progressive Relaxation Exercise, supported by mobile-based animation, on fatigue and sleep quality of individuals with epilepsy. MATERIAL-METHOD The study was conducted in a randomized controlled design with a pretest-posttest model on epileptic individuals who applied to Giresun University, Faculty of Medicine, Neurology Outpatient Clinic between February and December 2022. By using power analysis, the sample of the study was determined as 60 epilepsy patients (30 in the Control Group, 30 in the Experimental Group). The data were collected by face-to-face interview technique with the Personal Information Form, Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS). Frequencies, percentages, arithmetic mean, standard deviations, Pearson Correlation Analysis, Paired t-Test, Student's t-Test, and Chi-Square Test were used in the evaluation of the study data. RESULTS When the Control Group's mean scores in the pre-test and post-tests, which were performed with an interval of 6 weeks, were compared, a statistically significant difference was detected between the FSS and PSQI scores (p>0.05). The mean Fatigue Severity Scale score was found to be 5.24 ± 0.69 before the Progressive Relaxation Exercises and 3.82 ± 0.77 after the exercises. The mean scores of the individuals on the Fatigue Severity Scale after the relaxation exercises were found to be lower at a statistically significant level than the mean scores before the relaxation exercises (p<0.001). The differences between subjective sleep quality (p<0.001), sleep latency (p<0.001), daytime dysfunction (p<0.001), and total sleep quality (p<0.001) score averages after the Progressive Relaxation Exercises were statistically significant compared to the pre-exercises status. When the post-test scores of the participants in the Experimental Group was examined, significant, moderate, and positive differences were detected between the FSS and Total PSQI scores (r: 0.373-p: 0.042), Subjective Sleep Quality (r: 0.487-p: 0.006), which is one of the sub-dimensions of PSQI, Sleeping Pill Use (r: 0.531-p: 0.003), and Daytime Dysfunction (r: 0.461-p: 0.01) scores. CONCLUSION It was determined that individuals with epilepsy experience fatigue and deterioration in sleep quality and there is a reciprocal relationship between the severity of fatigue and sleep quality in these individuals. Progressive Relaxation Exercises applied with the animation-supported web-based mobile intervention technique reduce the fatigue levels of individuals and increase sleep quality.
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Affiliation(s)
| | - Nuray Bingöl
- Department of Medical Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey.
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Marquina C, Foster E, Chen Z, Vaughan DN, Abbott DF, Tailby C, Jackson GD, Kwan P, Ademi Z. Work productivity, quality of life, and care needs: An unfolding epilepsy burden revealed in the Australian Epilepsy Project pilot study. Epilepsia Open 2024; 9:739-749. [PMID: 38358341 PMCID: PMC10984321 DOI: 10.1002/epi4.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/14/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE Epilepsy is a common and serious neurological disorder. This cross-sectional analysis addresses the burden of epilepsy at different stages of the disease. METHODS This pilot study is embedded within the Australian Epilepsy Project (AEP), aiming to provide epilepsy support through a national network of dedicated sites. For this analysis, adults aged 18-65 years with first unprovoked seizure (FUS), newly diagnosed epilepsy (NDE), or drug-resistant epilepsy (DRE) were recruited between February-August 2022. Baseline clinicodemographic data were collected from the participants who completed questionnaires to assess their quality of life (QOLIE-31, EQ-5D-5L), work productivity (Work Productivity and Activity Impairment [WPAI]), and care needs. Univariate analysis and multivariate regression was performed. RESULTS 172 participants formed the study cohort (median age 34, interquartile range [IQR]: 26-45), comprising FUS (n = 44), NDE (n = 53), and DRE (n = 75). Mean QOLIE-31 score was 56 (standard deviation [SD] ± 18) and median EQ-5D-5L score was 0.77 (IQR: 0.56-0.92). QOLIE-31 but not EQ-5D-5L scores were significantly lower in the DRE group compared to FUS and NDE groups (p < 0.001). Overall, 64.5% of participants participated in paid work, with fewer DRE (52.0%) compared with FUS (76.7%) and NDE (72.5%) (p < 0.001). Compared to those not in paid employment, those in paid employment had significantly higher quality of life scores (p < 0.001). Almost 5.8% of participants required formal care (median 20 h/week, IQR: 12-55) and 17.7% required informal care (median 16 h/week, IQR: 7-101). SIGNIFICANCE Epilepsy is associated with a large burden in terms of quality of life, productivity and care needs. PLAIN LANGUAGE SUMMARY This is a pilot study from the Australian Epilepsy Project (AEP). It reports health economic data for adults of working age who live with epilepsy. It found that people with focal drug-resistant epilepsy had lower quality of life scores and were less likely to participate in paid employment compared to people with new diagnosis epilepsy. This study provides important local data regarding the burden of epilepsy and will help researchers in the future to measure the impact of the AEP on important personal and societal health economic outcomes.
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Affiliation(s)
- Clara Marquina
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and SafetyMonash UniversityMelbourneVictoriaAustralia
| | - Emma Foster
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Zhibin Chen
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - David N. Vaughan
- Florey Institute of Neuroscience and Mental HealthHeidelbergVictoriaAustralia
- Department of NeurologyAustin HealthMelbourneVictoriaAustralia
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - David F. Abbott
- Florey Institute of Neuroscience and Mental HealthHeidelbergVictoriaAustralia
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Chris Tailby
- Florey Institute of Neuroscience and Mental HealthHeidelbergVictoriaAustralia
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
- Department of NeuropsychologyAustin HealthMelbourneVictoriaAustralia
| | - Graeme D. Jackson
- Florey Institute of Neuroscience and Mental HealthHeidelbergVictoriaAustralia
- Department of NeurologyAustin HealthMelbourneVictoriaAustralia
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Patrick Kwan
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Zanfina Ademi
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and SafetyMonash UniversityMelbourneVictoriaAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
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Yesuf W, Hiko D, Alemayehu E, Kusheta S, Shita A, Beyene M. Health-related quality of life in epilepsy and its associated factors among adult patients with epilepsy attending Mizan Tepi University Teaching Hospital, Southwest Ethiopia: a cross-sectional study. BMJ Open 2024; 14:e079165. [PMID: 38262645 PMCID: PMC10806578 DOI: 10.1136/bmjopen-2023-079165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE To determine the mean score of health-related quality of life in epilepsy and its associated factors among adult patients with epilepsy. DESIGN Institution-based cross-sectional study based on random case selection was conducted. SETTING The study was carried out at Mizan-Tepi University Teaching Hospital located in Southwest Ethiopia. PARTICIPANTS A total of 346 patients with epilepsy who visited the psychiatric clinic for follow-up for at least 3 months and who were 18 years or older were included in the study. MAIN OUTCOME MEASURE Health-related quality of life in epilepsy measured using quality-of-life in epilepsy (QOLIE)-31 health survey evaluated as a dependent variable with simple and multivariable linear regressions. RESULTS The overall weighted mean score of health-related quality of life was 55.6 (SD=20.9). Only 50.3% of patients scored above a total score of 50. Age (β=-0.35, 95% CI-0.46 to -0.23), anxiety (β=-6.79, 95% CI -9.26 to -4.32), depression (β=-7.36, 95% CI -10.16 to -4.55), low self-esteem (β=-5.29, 95% CI -8.07 to -2.51), perceived stigma (β=-3.62, 95% CI -6.30 to -0.94), taking medication two times or more times per day (β=-2.4, 95% CI -4.58 to -0.27), being illiterate (β=-4.1, 95% CI -6.87 to -1.31) and having more than two seizures for a year (β=-4.18, 95% CI -6.97 to -1.39) were negatively affecting health-related quality of life while income of >1000 birr per month (β=4.5, 95% CI 2.00 to 6.99), social support (β=0.34, 95% CI 0.27 to 0.40) and being free of seizure for a year (β=6.5, 95% CI 3.66 to 9.33) were positively affecting health-related quality of life. CONCLUSIONS Only half of the patients with epilepsy in the study area are leading a better quality of life and the overall mean health-related quality of life score is lower than the global mean score. Health-related quality of life was inversely associated with age, anxiety, depression, low self-esteem, perceived stigma, taking medication two times a day or more, being illiterate and experiencing more than two seizures in a year. Besides controlling seizures, public educational campaigns should be conducted to raise public awareness regarding the need for social support.
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Affiliation(s)
- Wudu Yesuf
- Department of Public Health, Mizan-Aman College of Health Sciences, Aman, Ethiopia
| | - Desta Hiko
- Department of Epidemiology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Eshetu Alemayehu
- Department of Epidemiology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Samuel Kusheta
- Department of Public Health, Hosanna College of Health Sciences, Hosanna, Ethiopia
| | - Abel Shita
- Department of Public Health, Mizan-Aman College of Health Sciences, Aman, Ethiopia
| | - Melkamu Beyene
- Department of Epidemiology, Mizan-Tepi University, Mizzan, Ethiopia
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Sauer V, Glaser M, Ellwardt E, Saryyeva A, Krauss JK, Ringel F, Groppa S, Winter Y. Favorable combinations of antiseizure medication with vagus nerve stimulation to improve health-related quality of life in patients with epilepsy. Epilepsy Behav 2024; 150:109562. [PMID: 38071825 DOI: 10.1016/j.yebeh.2023.109562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/12/2023] [Accepted: 11/22/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Vagus nerve stimulation (VNS) is a non-pharmacological treatment of refractory epilepsy, which also has an antidepressive effect. The favorable combinations of VNS with specific mechanisms of action of antiseizure medication (ASM) on mood and health-related quality of life (HrQol) have not yet been studied. The objective was to identify favourable combinations of specific ASMs with VNS for the HrQoL and depression in refractory epilepsy. METHODS We performed an observational study including patients with refractory epilepsy and an implanted VNS (N = 151). In the first 24 months after VNS implantation, all patients were on stable ASM therapy. We used the standardized questionnaires QOLIE10, EQVAS and EQ5D to evaluate HrQoL as well as the Beck Depression Inventory (BDI). Multiple regression analysis was performed to evaluate the synergistic combinations of ASM with VNS for HrQoL. RESULTS At the year-two follow-up (N = 151, age 45.2 ± 17.0 years), significant improvement (p < 0.05) in BDI scores was found for combination of VNS with SV2A modulators (58.4 %) or AMPA antagonists (44.4 %). A significant increase of HrQoL by at least 30 % (p < 0.05) was measured for a combination of VNS with SV2A modulators (brivaracetam, levetiracetam) or slow sodium channel inhibitors (eslicarbazepine, lacosamide). CONCLUSION The results of our study suggests a favorable effect of the combination of SV2A modulators or slow sodium channel inhibitors with VNS on the HrQoL in comparison to other ASMs. Besides the possible synergistic effects on the seizure frequency, the amelioration of behavioral side effects of SV2A modulators by VNS is an important factor of HrQoL-improvement in these combinations.
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Affiliation(s)
- Victoria Sauer
- Mainz Comprehensive Epilepsy and Sleep Medicine Center, Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Neurology, Philipps-University Marburg, Germany
| | - Martin Glaser
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Erik Ellwardt
- Department of Neurology, Helios-HSK Wiesbaden, Wiesbaden, Germany
| | - Assel Saryyeva
- Department of Neurosurgery, Hannover Medical School, MHH, Hannover, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, MHH, Hannover, Germany
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn(2)), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Yaroslav Winter
- Mainz Comprehensive Epilepsy and Sleep Medicine Center, Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Neurology, Philipps-University Marburg, Germany.
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Takahashi K, Fujikawa M, Ueno T, Ogawa M, Nakasato N, Maeda S. Network analysis of the relationship between social support and quality of life in patients with epilepsy. Epilepsy Behav 2023; 149:109504. [PMID: 37952414 DOI: 10.1016/j.yebeh.2023.109504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Identifying important types of social support for patients with epilepsy is valuable to construct an effective system for support in daily life. However, previous studies have been inconsistent in identifying the most important types of social support for better quality of life (QOL) due to the high correlations between the social support factors. The present study employed network visualization analysis to identify the relationships between QOL and types of social support. METHODS Two hundred and eighty-three patients with epilepsy (age range: 18 to 75 years) completed questionnaires of the Medical Outcomes Study Social Support Survey (MOS-SSS) and the Quality of Life in Epilepsy Inventory-31-Problems in the epilepsy monitoring unit at Tohoku University. The MOS-SSS was established to measure the four types of social support including emotional/informational support, tangible support, affectionate support, and positive social interaction. Our network visualization analysis represented the entire structure of the interrelationships between the four functions of social support and QOL. In addition, the relative importance of each function of social support were estimated by the centrality indices using three commonly used centrality indices: strength, betweenness, and closeness. RESULTS The visualized network showed that positive social interaction and emotional/informational support were directly associated with QOL, whereas tangible support and affectionate support were not. Positive social interaction had the highest value for all three centrality indices and affectionate support had the second highest. Therefore, positive social interaction had the strongest connection to the other functions of support. DISCUSSION Our network analysis and centrality indices findings showed that positive social interaction is the most important within the network of four types of social support and QOL. The emotional informational function is also important for directly improving QOL but is less related to the other functions. The affectionate function might be an indicator of whether a patient has a foundational relationship that leads to other functions of support. CONCLUSION These results showed the importance of increasing positive social interaction in the social environment of patients with epilepsy. Therefore, practitioners need to encourage patients with epilepsy to increase their positive social interactions such as doing something enjoyable with others or someone to associate for relaxation to ensure high QOL. Connections outside the epilepsy support are important, such as having fun regardless of epilepsy, rather than only providing emotional or tangible support for epilepsy.
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Affiliation(s)
- Kento Takahashi
- Graduate School of Education, Tohoku University, Sendai, Japan
| | - Mayu Fujikawa
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Takashi Ueno
- Faculty of Comprehensive Welfare, Tohoku Fukushi University, Sendai, Japan
| | - Maimi Ogawa
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobukazu Nakasato
- Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shunta Maeda
- Graduate School of Education, Tohoku University, Sendai, Japan
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Li KY, Hsu CY, Yang YH. A review of cognitive and behavioral outcomes of Brivaracetam. Kaohsiung J Med Sci 2023; 39:104-114. [PMID: 36661137 DOI: 10.1002/kjm2.12648] [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: 07/15/2022] [Revised: 12/14/2022] [Accepted: 12/21/2022] [Indexed: 01/21/2023] Open
Abstract
Anti-seizure medications (ASMs) can cause cognitive or behavioral adverse drug reactions, which is an important consideration when selecting an appropriate ASM. Brivaracetam (BRV) is a newer synaptic vesicle protein 2A ligand, which is expected to result in fewer neuropsychiatric adverse effects due to its mechanism of action. To understand the impact of BRV on cognition and behavior compared with other ASMs, we conducted a review of the literature using the Cochrane Library, PubMed/MEDLINE, and Embase. After the screening process, a total of two animal studies, one randomized controlled trial, one pooled analysis of clinical trials, one controlled study, and nine observational studies were included. The animal studies showed that BRV did not worsen cognitive or behavioral performance in rodents. The human studies showed that BRV was associated with fewer cognitive adverse events compared with other second- or third-generation ASMs. In addition, BRV was less associated with behavioral disturbance than levetiracetam. In summary, this review revealed that BRV has a limited impact on cognition and behavior. For patients who are intolerant to levetiracetam and have levetiracetam-related behavioral side effects, switching to BRV could be beneficial. However, heterogeneity between studies resulted in low-quality of evidence, and further trials are needed to confirm the findings.
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Affiliation(s)
- Kuan-Ying Li
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chung-Yao Hsu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yuan-Han Yang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Neurology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of and Master's Program in Neurology, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Tang B, Fu Y, Liu B, Yi Q. Self-perceived burden and associated factors in Chinese adult epilepsy patients: A cross-sectional study. Front Neurol 2022; 13:994664. [PMID: 36176558 PMCID: PMC9513448 DOI: 10.3389/fneur.2022.994664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives Epilepsy requires long-term or lifelong treatment, and patients are prone to financial, emotional and psychological burdens that can cause psychological changes during the treatment process. This study aimed to describe the prevalence and associated factors of Self-Perceived Burden (SPB) in Chinese adult epilepsy patients, informing the treatment and nursing of epilepsy. Methods A total of 143 adult epilepsy patients were included in this study, and the clinical questionnaire survey was conducted at the Third Xiangya Hospital of Central South University in Hunan, China, from March 2022 to June 2022. The sociodemographic and clinical characteristics of adult epilepsy patients were collected using a self-developed questionnaire, and the data on SPB, stigma and quality of life were collected through the Self-Perceived Burden Scale (SPBS), Kilifi Stigma Scale for Epilepsy (KSSE) and Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Multiple linear regression analysis was used to determine the associated factors influencing SPB in adult epilepsy patients. Results The average score of SPBS for the 143 adult epilepsy patients was 30.77 (SD = 9.06), and 89.5% of them had obvious SPB. The results of the univariate analysis showed that residence, monthly household income, duration of epilepsy, type of medication and electroencephalogram finding were associated with SPB (P < 0.05). In Spearman correlation analysis indicated that SPBS score were positively correlated with KSSE score (r = 0.510, P < 0.05) while negatively correlated with QOLIE-31 score (r = −0.506, P < 0.05). Multiple linear regression analysis revealed that factors such as KSSE, type of medication, residence and electroencephalogram finding accounted for 32.8% of the factors influencing SPB in adult epilepsy patients. Conclusion 89.5% of adult epilepsy patients have varying degrees of SPB, which is associated with high stigma and poor quality of life. Therefore, during the treatment and nursing of adult epilepsy patients, clinical staff should pay attention to the psychological status of patients, help them reduce their psychological burden, and guide them to develop a healthy lifestyle.
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Affiliation(s)
- Binmi Tang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Yaqian Fu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Birong Liu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Qifeng Yi
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Qifeng Yi
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Kishi Y, Takumi I, Yamamoto H, Ishimaru T, Thurber S. Patient complexity, depression, and quality of life in patients with epilepsy at an epilepsy center in Japan. Epilepsia Open 2022; 7:414-421. [PMID: 35603460 PMCID: PMC9436305 DOI: 10.1002/epi4.12614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/19/2022] [Indexed: 12/04/2022] Open
Abstract
Objective The relationship between care complexity and quality of life among patients with epilepsy has not been assessed, especially in Japan. The aim of this study is to test the hypothesis that care complexity is associated with health‐related quality of life (HRQOL) and mood disturbance. Method This was an observational cross‐sectional study. The study included a consecutive series of 49 patients who newly visited an epilepsy center. Study participants were administered standardized quantitative measures of HRQOL, case complexity, and depression. Results Patient complexity predicted lower HRQL scores. Data on the social and psychological complexity domains predicted patient HRQOL findings more accurately than data from the biological domain of the case complexity scale. Seizure frequency was unrelated to HRQOL findings in this study. Additionally, depression scores were also associated with lower HRQOL. Significance A patient complexity assessment, including psychological and social domains, may be one of the key tools in epilepsy treatment settings. Further studies using larger random selection from patients with epilepsy are necessary to generalize the findings to patients in other epilepsy programs.
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Affiliation(s)
- Yasuiro Kishi
- Department of Psychiatry Nippon Medical School Musashikosugi Hospital Japan
| | - Ichiro Takumi
- Department of Neurosurgery, St. Marianna University Japan
- Epilepsy Center, St. Marianna University Japan
| | - Hitoshi Yamamoto
- Department of Pediatrics, St. Marianna University Japan
- Epilepsy Center, St. Marianna University Japan
| | | | - Steven Thurber
- Department of Psychiatry and Behavioral Sciences University of Minnesota USA
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Deegbe DA, Tshabalala AM, Aziato L, Casteleijn D. Meanings of quality of life among people living with epilepsy in Ghana; a qualitative exploratory study. Epilepsy Behav 2022; 129:108527. [PMID: 35168123 DOI: 10.1016/j.yebeh.2021.108527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to explore the meanings of quality of life among people living with epilepsy (PLWE) in Ghana. METHODS An exploratory-qualitative study design was adopted. Face-to-face in-depth interviews, using a semi-structured interview guide, were conducted on 15 PLWE who were purposively selected for the study. The interviews were audio recorded and transcribed verbatim. The content analysis approach was then used to analyze the data. RESULTS Four themes - "acceptance", "support", "seizure control", and "self-reliance" emerged from the study as meanings of Quality of life (QoL). Quality of life meant unconditional acceptance from family, friends, acquaintances at home, school, and work, and by the public despite epilepsy. Receiving support in the form of protection from injury during a seizure, financial assistance to meet individual and family demands, emotional warmth, and spiritual support through prayers and encouragement, was QoL for PLWE. Achievement of control over seizures and being self-reliant in terms of selfcare and daily activities in addition to having some form of financial independence meant QoL. CONCLUSION Meanings of quality of life among PLWE is associated with being accepted and supported by family and friends as well as being in control of seizures and attaining a status of independence.
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Affiliation(s)
- David Atsu Deegbe
- Department of Mental Health Nursing, School of Nursing and Midwifery, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana.
| | - Amme Mardulate Tshabalala
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa.
| | - Lydia Aziato
- Department of Adult Health, School of Nursing and Midwifery, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana.
| | - Daleen Casteleijn
- Department of Occupational Therapy, School of Therapeutic Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193 Johannesburg, South Africa.
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BAŞARAN Ş. Gender differences in health-related quality of life of patients with active epilepsy and clinical factors that are signs of their associations: a retrospective cross-sectional study. FAMILY PRACTICE AND PALLIATIVE CARE 2022. [DOI: 10.22391/fppc.1028627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Minwuyelet F, Mulugeta H, Tsegaye D, lake B, Getie A, Tsegaye B, Mullu G. Quality of life and associated factors among patients with epilepsy at specialized hospitals, Northwest Ethiopia; 2019. PLoS One 2022; 17:e0262814. [PMID: 35085331 PMCID: PMC8794165 DOI: 10.1371/journal.pone.0262814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/06/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Epilepsy is a chronic non-communicable brain disorder and the second most burdensome disease in terms of disability-adjusted life years which is characterized by recurrent epileptic seizures, and a constant threat to the quality of life of the patient. Nearly 80% of people with epilepsy live in low- and middle-income countries and the risk of premature death in people with epilepsy is up to three times higher than for the general population. In many parts of the world, people with epilepsy and their families suffer from stigma and discrimination. This study was aimed to assess the quality of life and associated factors among adult people living with epilepsy using the world health organization quality of life assessment tool. METHODS Institution-based cross-sectional study design was conducted on 419 epileptic patients using a systematic random sampling technique. The data were collected using the WHOQOL-BREF questionnaire. The data were entered into EpiData version 3.1 and exported to SPSS version 25 software for further analysis and bivariate and multivariable binary logistic regression analyses were done to identify factors associated with the dependent variable. The level of significance was declared as P value <0.05. RESULT A total of 402 epileptic patients with a median age of 28 years were involved in the study. The result of this study was revealed that 47.8% (95% CI: 42%, 52%) of the respondents had poor quality of life. Respondents who were in the middle age group (AOR = 0.36, 95% CI: 0.19, 0.70), lower educational level (AOR = 3.11, 95%CI: 1.35, 7.15), those who had low drug adherence (AOR = 8.36, 95%CI: (2.41, 28.98) comorbid anxiety, (AOR = 3.63, 95% CI: 2.55, 8.42) and depression (AOR = 3.85, 95% CI: 2.16, 6.82) were found to be significantly associated with poor quality of life of epilepsy patients. CONCLUSION This study revealed that almost one in two epileptic patients had poor quality of life. Age of the respondents, lower educational level, comorbid anxiety and depression, and lower adherence to drugs were significantly associated with poor quality of life. Therefore, health institutions and clinicians should not focus only on the treatment of the disease itself rather they should address diseases' impact on the quality of life of patients.
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Affiliation(s)
- Fentahun Minwuyelet
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Henok Mulugeta
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Dejene Tsegaye
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Benalfew lake
- Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Asmare Getie
- School of Nursing, Arba Minch University, Arba Minch, Ethiopia
| | - Baye Tsegaye
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Getachew Mullu
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Tan JK, Khoo CS, Beh HC, Hod R, Baharudin A, Yahya WNNW, Tan HJ. Prevalence and associated risk factors of undiagnosed depression among people with epilepsy in a multiethnic society. Epilepsy Res 2021; 178:106772. [PMID: 34763265 DOI: 10.1016/j.eplepsyres.2021.106772] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/17/2021] [Accepted: 09/19/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Depression is the most frequent psychiatric comorbidity of epilepsy. However, clinicians often neglect to screen for depressive symptoms among patients with epilepsy and, therefore, fail to detect depression. Many studies have described the risks associated with depression in patients with epilepsy, but few studies have elaborated whether these risks are similar in those with undiagnosed depression, especially in a multiethnic community. METHODS In the present cross-sectional study conducted at a tertiary teaching hospital, we aimed to investigate the prevalence and associated risk factors of undiagnosed depression in patients with epilepsy. We recruited patients with epilepsy aged 18-65 years after excluding those with background illnesses that may have contributed to the depressive symptoms. In total, 129 participants were recruited. We collected their demographic and clinical details before interviewing them using two questionnaires-the Neurological Disorders Depression Inventory for Epilepsy and Beck's Depression Inventory-II. Subsequently, if a participant screened positive for depression, the diagnosis was confirmed using the Diagnostic and Statistical Manual of Mental Disorders questionnaire, and a psychiatric clinic referral was offered. RESULTS Among the 129 participants, 9.3 % had undiagnosed major depressive disorder, and there was a female preponderance (66.7 %). The risk factors for undiagnosed depression among patients with epilepsy included low socioeconomic background (p = 0.026), generalized epilepsy (p = 0.036), and temporal lobe epilepsy (p = 0.010). Other variables such as being underweight and unmarried were more common among patients diagnosed with depression than without but no statistically significant relationship was found. CONCLUSION The prevalence of undiagnosed depression among patients with epilepsy was higher than that in population-based studies conducted in Western countries. Although questionnaires to screen for depression are widely available, some clinicians rarely use them and, therefore, fail to identify patients who may benefit from psychosocial support and treatment that would improve their disease outcomes and quality of life. The present study indicated that clinicians should use screening questionnaires to identify undiagnosed depression in people with epilepsy.
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Affiliation(s)
- Juen Kiem Tan
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Ching Soong Khoo
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hui Chien Beh
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Azlin Baharudin
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Wan Nur Nafisah Wan Yahya
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hui Jan Tan
- Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
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Lee SA, Kim SJ, No SK, Park HK, Kim OJ. Gender differences in seizure recurrence and antiepileptic drug polytherapy predicting health-related quality of life of persons 1 year after diagnosis of epilepsy. Epilepsy Behav 2021; 120:107984. [PMID: 33962251 DOI: 10.1016/j.yebeh.2021.107984] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of this study was to determine whether gender influences the prediction of health-related quality of life (HRQoL) in persons with newly diagnosed epilepsy (NDE). METHODS This was a 1-year longitudinal study. Persons with NDE were assessed with the Quality of Life in Epilepsy Inventory-31 (QOLIE-31), the Hospital Anxiety Depression Scale (HADS), the Stigma Scale, and the Rosenberg Self-esteem Scale. An analysis of covariance (ANCOVA) with interaction terms was used. RESULTS Among 134 adults with NDE, there were no gender differences in the scores of the QOLIE-31 and its subscales. A multivariate linear regression analysis showed that the HADS-anxiety scores at diagnosis (p = 0.005) and seizure recurrence after diagnosis (p = 0.050) negatively predicted QOLIE-31 scores in persons with NDE. There were significant effects of the gender interaction with seizure recurrence (F = 8.745, p = 0.004, partial eta2 = 0.066) and antiepileptic drug (AED) polytherapy (F = 6.320, p = 0.013, partial eta2 = 0.049) in the adjusted model. Specifically, seizure recurrence negatively predicted the QOLIE-31 scores only in men. By contrast, AED polytherapy negatively predicted the QOLIE-31 scores only in women. CONCLUSIONS There are gender differences in certain epilepsy-related factors predicting HRQoL at 1 year in persons with NDE.
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Affiliation(s)
- Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Soo Jeong Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Soon-Kee No
- Department of Neurology, On Hospital, Pusan, Republic of Korea
| | - Hyung-Kook Park
- Department of Neurology, SoonChunHyang University College of Medicine, Cheonan, Republic of Korea
| | - Ok-Joon Kim
- Department of Neurology, CHA University, Seongnam, Republic of Korea
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Chen HF, Tsai YF, Fan JY, Chen MC, Hsi MS, Hua MS. Evaluation of a self-management intervention for adults with epilepsy in Taiwan: A longitudinal randomized controlled trial. Epilepsy Behav 2021; 117:107845. [PMID: 33621815 DOI: 10.1016/j.yebeh.2021.107845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Epilepsy is a neurological disease that causes recurrent seizures and can have a significant impact on a person's quality of life (QOL). A self-management intervention (SMI) can allow adults with epilepsy to modify behaviors in order to manage their seizures and evaluate the impact of medication and treatments on their daily lives. The purpose of this study was to investigate the effects of a SMI for adults with epilepsy. METHODS This was a longitudinal randomized controlled trial. Adults with epilepsy between the age of 20 and 65 years were recruited from a medical center in northern Taiwan. Participants were assigned to an intervention group (IG) or control group (CG) through simple randomization. Data regarding demographic and clinical characteristics were collected at baseline (T0). In addition, participants answered nine validated self-report questionnaires, which were used as outcome measures. Following collection of baseline data, the CG received routine monthly counseling over the next 3 months. The IG received the routine monthly counseling, as well as individual face-to-face health counseling on self-management 1 h/month and remote counseling via the phone or computer network at least twice per month. After the first month (T1) and at the end of the third (T2) and sixth months (T3) participants answered the nine questionnaires again. Differences in outcomes between the IGs and CGs were analyzed by comparing scores for the nine outcome variables at T0 with scores at T1, T2, and T3 with generalized estimating equations. RESULTS A total of 210 adults agreed to participate in the study; however, only 155 participants completed the questionnaires for all three time points: 75 in the CG and 80 in the IG. The mean age of the 155 participants was 39.6 years (SD = 10.9). There was no significant difference between demographic or clinical variables between the two groups. The only difference in baseline scores (T0) among the nine self-report questionnaires was in epilepsy knowledge, measured with the Epilepsy Knowledge Profile questionnaire, which were significantly higher for the CG (mean = 32.28, SD = 3.92) than the IG (mean = 23.01, SD = 2.79) (p < 0.001). Generalized estimating equations (GEE) analysis showed scores decreased significantly at T3 from baseline for the CG for epilepsy knowledge and QOL (p < 0.001). Improvements in scores for sleep quality, anxiety, depression, self-efficacy, coping, and social support did not differ between groups. Classification of the IG by gender showed a significantly greater increase for males compared with females from baseline to T3 for epilepsy knowledge (p < 0.001). If we further classified the IGs by seizure frequency, participants with a seizure frequency of ≥1 per year had a more significant increase in epilepsy knowledge and increase in QOL compared with participants with a seizure frequency of <1 per year at T3 compared with T0. CONCLUSION The lack of improvement in health-related quality of life (HRQoL) following the SMI may indicate that additional time is required to change behaviors that impact this variable for patients with epilepsy. Additional research should focus on variables associated with medication compliance, epilepsy knowledge, medicine symptom distress, self-efficacy, anxiety, and HRQoL.
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Affiliation(s)
- Hsiu-Fang Chen
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan; Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Yun-Fang Tsai
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan; School of Nursing, Chang Gung University, Tao-Yuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
| | - Jun-Yu Fan
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan; Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Min-Chi Chen
- Graduate Institute of Biomedical Sciences, Chang Gung University, Tao-Yuan, Taiwan
| | - Mo-Song Hsi
- Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taiwan
| | - Mau-Sun Hua
- Department of Psychology, National Taiwan University, Taipei, Taiwan
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Lee SA, Kim SJ, Han NE, Lee SM, No YJ. Gender differences in factors associated with resilience for health-related quality of life in persons with epilepsy. Epilepsy Behav 2021; 115:107710. [PMID: 33423015 DOI: 10.1016/j.yebeh.2020.107710] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/03/2020] [Accepted: 12/12/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE We determined whether resilience factors such as self-efficacy, stress coping styles, and social support were differentially associated with health-related quality of life (HRQoL) in men and women with epilepsy after controlling for depression, anxiety, and daily-life stress. METHODS This was a cross-sectional study of 129 adults with epilepsy. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31), Epilepsy Self-Efficacy Scale, Way of Stress Coping Checklist, Social Support Scale, Beck Depression Inventory (BDI), Beck Anxiety Inventory, and Daily Hassles Scale were used. Stepwise linear regression analyses were performed. RESULTS Except for medication effects, there were no gender differences in the QOLIE-31 and its subscales. The medication effects score was higher in men than in women after controlling for BDI scores. The BDI scores were independently associated with the QOLIE-31 score in men and women. Epilepsy self-efficacy was associated with the QOLIE-31 in men, whereas social support was associated with the QOLIE-31 in women. Coping strategies were associated with the QOLIE-31 in neither men nor women. Seizure frequency, daily-life stress, and anxiety were also negatively associated with the QOLIE-31, but only in men. The coefficients of determination were 0.637 and 0.587 in the men's and women's models, respectively. CONCLUSIONS The influence of self-efficacy and social support on HRQoL differed between men and women with epilepsy even after controlling for psychological distress. These findings could contribute to the development of successful gender-specific psychosocial interventions to improve HRQoL in men and women with epilepsy.
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Affiliation(s)
- Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Soo Jeong Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Noh Eul Han
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sun-Mi Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Joo No
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Stauder M, Vogel AC, Nirola DK, Tshering L, Dema U, Dorji C, Dorji L, Mateen FJ. Depression, sleep quality, and social isolation among people with epilepsy in Bhutan: A cross-sectional study. Epilepsy Behav 2020; 112:107450. [PMID: 32947250 PMCID: PMC7657980 DOI: 10.1016/j.yebeh.2020.107450] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/23/2020] [Accepted: 08/23/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE The aim of this study was to analyze the possible contributions of seizure burden, sleep quality, and social integration to depression among people with epilepsy (PWE) in Bhutan. METHODS Bhutan is a lower-middle-income country in Southeast Asia with a public healthcare system without neurologists. People with epilepsy were prospectively recruited from psychiatrist-run epilepsy clinics at the National Referral Hospital in the capital city of Thimphu. Adult participants with epilepsy were interviewed for clinical history, sleep quality using the Pittsburgh Sleep Quality Index, social networks using the Berkman-Syme Social Network Index, and depressive symptoms using the Patient Health Questionnaire - 9 (PHQ-9). A multivariable regression model was built to assess the relationship between depression as an outcome and the possible contributors of sleep quality, sex, and seizure in the prior month. RESULTS Out of 80 participants (39 women, mean age: 29.4 years old, range: 18-56 years, 58 [73%] with a seizure in the previous month), 33% had poor sleep quality, 68% were socially isolated, 30% had a mild depressive symptom burden or more, and 18% reported suicidal ideation at the time of their interview. Women had a higher average PHQ-9 score versus men, which showed a trend towards statistical significance (5.6 versus 3.3 PHQ-9 points, p = 0.07), and on average met criteria for mild depression. Social integration was not significantly associated with sleep quality and had no relationship with depressive burden. There was a small positive correlation between poorer sleep quality and depressive symptoms which showed a trend towards statistical significance (r = 0.21, p = 0.06). In a multivariable regression, poor sleep quality was associated with higher depressive symptom burden, adjusting for participant sex and having a seizure in the previous month (p = 0.01). CONCLUSIONS Our exploratory study disentangles the multilayered psychosocial burden of disease experienced by PWE in Bhutan, a lower-middle-income country with access to antiseizure medications and psychiatrists but not expert epilepsy services or human resources. Further investigation into the interrelationships among social isolation, poor sleep quality, depression, and seizure burden could identify preventable and remediable constituents of this burden.
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Affiliation(s)
- Matthew Stauder
- Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Andre C. Vogel
- Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Damber K. Nirola
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Lhab Tshering
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Ugyen Dema
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Chencho Dorji
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Lhab Dorji
- Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Farrah J. Mateen
- Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA,Corresponding author at: Neurological Clinical Research Institute, Massachusetts General Hospital, 165 Cambridge Street, Office 627, Boston, MA 02114, USA, : (F.J. Mateen)
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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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Sakthong P, Suriyapakorn B. Medication-Related Quality of Life in Thai Epilepsy Patients. J Epilepsy Res 2020; 9:139-146. [PMID: 32509550 PMCID: PMC7251341 DOI: 10.14581/jer.19016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/02/2020] [Accepted: 01/31/2020] [Indexed: 11/04/2022] Open
Abstract
Background and Purpose This study aimed to assess medication-related quality of life in Thai patients with epilepsy. The second objective was to evaluate the associations between the medication therapy-related quality of life and patient characteristics. Methods This was a cross-sectional study. A convenience sample of 173 outpatients with epilepsy was recruited from a university hospital in Bangkok, Thailand. Inclusion criteria were aged 18 or over who were continuously taking an epileptic drug for at least 3 months, understanding Thai language, and willing to participate in the study. The Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QoL) was utilized to measure the medication therapy-related quality of life. Pearson’s correlation coefficients and stepwise multiple linear regressions were employed to assess the relationships between eight PROMPT-QoL domain scores and patient demographic and clinical characteristics. Results Mean age was 36.4±9.5 years and approximately 57% were female. Among eight domains of the PROMPT-QoL, the therapeutic relationships with health care providers and psychological impacts of medication use domains yielded the highest (77.9) and lowest (61.9) mean scores, respectively. Seven out of eight PROMPT-QoL domain scores were considered as moderate-to-good. Age, gender, duration of epilepsy, seizure frequency, and treatment preference were significantly associated with PROMPT-QoL domain scores in multivariate linear regression analyses. Conclusions This study showed that Thai patients with epilepsy had moderate-to-good medication therapy-related quality of life. Healthcare providers should pay more attention to patients’ psychological impacts of antiepileptic drugs and those with characteristics related to lower medication therapy-related quality of life.
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Affiliation(s)
- Phantipa Sakthong
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Bavornpat Suriyapakorn
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
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Assessment of Quality of Life of Epileptic Patients in Ethiopia. Int J Chronic Dis 2020; 2020:8714768. [PMID: 31976314 PMCID: PMC6961609 DOI: 10.1155/2020/8714768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/26/2019] [Accepted: 10/10/2019] [Indexed: 01/26/2023] Open
Abstract
Background Patients with epilepsy are at an increased risk of poor quality of life. Purpose We aimed at assessing the quality of life and its determinants among epileptic patients at University of Gondar Referral Hospital (UoGRH), Ethiopia. Methods Institution based cross-sectional study was conducted on epileptic patients on follow up at UoGRH from January 15 to April 15, 2017. Information including socio-demographic profile and diagnosis was extracted from medical records and patients. Quality Of Life In Epilepsy-10 (QOLIE-10) tool was used to measure the quality of life. Independent t-test and one-way analysis of variance were used to look for factors associated with quality of life. The level of statistical significance was declared at P-value ≤ 0.05. Results A total of 354 patients were included in the study and mean age was 29.1 ± 11.7 years. The mean QOLIE-10 score was 19.85. One hundred ninety-four (54.8%) of participants had a good quality of life. Being illiterate, unemployment, and presence of co-morbid medical condition were associated with poorer quality of life. Conclusion Nearly half of the participants had a poor quality of life. Patients with co-morbidity, illiteracy, and unemployment should be given special emphasis in order to improve their quality of life.
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Kumaraswamy Distribution in Analyzing the Health-related Quality of Life and Effective Factors in Elderly Patients with Epilepsy. ARCHIVES OF NEUROSCIENCE 2019. [DOI: 10.5812/ans.95476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Al-Eitan LN, Al-Dalalah IM, Mustafa MM, Alghamdi MA, Elshammari AK, Khreisat WH, Al-Quasmi MN, Aljamal HA. Genetic polymorphisms of CYP3A5, CHRM2, and ZNF498 and their association with epilepsy susceptibility: a pharmacogenetic and case-control study. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2019; 12:225-233. [PMID: 31564953 PMCID: PMC6732506 DOI: 10.2147/pgpm.s212433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/22/2019] [Indexed: 01/30/2023]
Abstract
Background A total of 50 million persons were diagnosed worldwide with epilepsy. One-third of them are experiencing debilitating seizures despite optimum anti-epileptic drugs (AEDs) treatment. Several studies have suggested that CYP3A5, CHRM2, and ZNF498 influence the pharmacokinetics of AEDs. Therefore, the severity of the disease as well as the degree of response to the AEDs could be affected by the genetic polymorphisms within these genes. Objectives In this study, we assessed the effect of certain single nucleotide polymorphisms (SNPs) within CYP3A5, CHRM2, and ZNF498 genes on the susceptibility to develop epilepsy and the responsiveness to AEDs treatment. Methods A case-control and pharmacogenetic study was conducted on samples of 299 healthy individuals in addition to 296 epileptic patients. Genotypic, allelic, and clinical data association were performed for the selected polymorphisms within the (rs324649, rs420817, rs15524, and rs1859690) in the Jordanian population. Results The analysis revealed no significant association of the investigated SNPs with epilepsy in general, partial and generalized epilepsy as well as drug responsiveness. CYP3A5 and ZNF498 were associated with family history (P=0.003 and P=0.002, respectively) and the classification of epilepsy for the ZNF498 variant (P=0.009). On the other hand, CHRM2 was not linked to either disease severity or treatment responsiveness. Conclusion Our results failed to confirm the association of CYP3A5, ZNF498, and CHRM2 variants with either disease development or treatment response. Clinical pharmacogenetic studies may contribute to treatment personalization, appropriate drug dose selection, minimizing drug adverse reactions, increasing drug efficacy, and reducing the costive burdens.
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Affiliation(s)
- Laith N Al-Eitan
- Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid, Jordan.,Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Islam M Al-Dalalah
- Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohamed M Mustafa
- Department of Neuroscience, Jordan University of Science and Technology, Irbid, Jordan
| | - Mansour A Alghamdi
- Anatomy Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Afrah K Elshammari
- Department of Pediatric Neurology, Queen Rania Hospital for Children, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Wael H Khreisat
- Department of Pediatric Neurology, Queen Rania Hospital for Children, King Hussein Medical Center, Royal Medical Services, Amman, Jordan
| | - Mohammed N Al-Quasmi
- Department of Medical Laboratory, King Abdullah University Hospital, Irbid, Jordan
| | - Hanan A Aljamal
- Department of Applied Biological Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Depression and quality of life in patients with epilepsy in Northwest Greece. Seizure 2019; 66:93-98. [PMID: 30818183 DOI: 10.1016/j.seizure.2019.02.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The purpose of the present study was to compare depression and QoL between patients with epilepsy and healthy controls, evaluating potentially related factors to depression and QoL in patients with epilepsy in Northwest Greece. METHODS A case study was conducted in adult patients with epilepsy followed up at the University Hospital of Ioannina and in healthy controls. The Patient Health Questionnaire (PHQ-9) for depression's severity evaluation, the WHOQOL-BREF questionnaire for the QoL estimation and the Adverse Event Profile (AEP) questionnaire for the Antiepileptic Drugs (AEDs) adverse effects assessment were used. RESULTS Seventy patients with epilepsy and 70 controls were recruited. The PHQ-9 score was higher in patients compared to controls and slightly higher than reported in patients with epilepsy. PHQ-9 was significantly associated with the AEP score. Our patients had a poorer QoL compared to controls. The level of education, the AEP and the PHQ-9 scores were associated to QoL, the last two being the most powerful predictors of QoL. CONCLUSION Patients with epilepsy in Northwest Greece had higher rates of depression than reported in patients with epilepsy and poorer QoL compared to controls. The adverse effects of AEDs were related to depression in our study, while the adverse effects of AEDs and depression were more powerful predictors of QoL compared to demographics and other characteristics of epilepsy.
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Chen YY, Huang S, Wu WY, Liu CR, Yang XY, Zhao HT, Wu LC, Tan LZ, Long LL, Xiao B. Associated and predictive factors of quality of life in patients with temporal lobe epilepsy. Epilepsy Behav 2018; 86:85-90. [PMID: 30017833 DOI: 10.1016/j.yebeh.2018.06.025] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/02/2018] [Accepted: 06/15/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Identifying the factors that are correlated with and predictive of reduced quality of life (QOL) is essential to optimize the treatment of epilepsy and the management of comorbidities. METHODS We analyzed the independent associations between the Quality of Life in Epilepsy-31 (QOLIE-31) inventory and the demographic, clinical, psychiatric, and cognitive variables of 47 consecutive patients with temporal lobe epilepsy (TLE). Predictors of the correlated variables were analyzed by multiple linear regression analysis. RESULTS The QOLIE-31 total score was positively correlated with occupational status and Mini-Mental State Examination (MMSE) scores (r = 0.290 and 0.295, respectively; P < 0.05) and negatively correlated with the duration of seizures, adverse effects of antiepileptic drugs (AEDs), and the Pittsburgh Sleep Quality Inventory (PSQI), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) scores (r = -0.357, 0.321, 0.328, -0.672, and -0.565, respectively; P < 0.05; P < 0.01 for the SAS and SDS). In the final multivariate regression model, anxiety, long durations of seizures, adverse effects of AEDs, and depression explained approximately 60.6% (adjusted R2 = 0.606, R coefficient = 0.800) of the QOLIE-31 overall score variance. CONCLUSION Anxiety, long durations of seizures, adverse effects of AEDs, and depression were significant predictors of QOL, and these variables had relatively high prediction capacities for the overall QOLIE-31 in the regression model. Comorbid anxiety is the most powerful negative determinant of the QOLIE-31.
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Affiliation(s)
- Ya-Yu Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Sha Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Wen-Yue Wu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Chao-Rong Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Xiao-Yan Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Hai-Ting Zhao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Ling-Chao Wu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Lang-Zi Tan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China
| | - Li-Li Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China.
| | - Bo Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, PR China.
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Xiao X, Si Y, Mo Q, Liu Y, Li C, Zhao J, Ma S, Si L, Xi Z, Chen L, Wu D, He Q, Hu M, Zhang C, Sun H. Development and validation of the Chinese Version of the Adult Epilepsy Self-Management Scale (C-ESMS) in Western China. Epilepsy Res 2018; 144:43-48. [DOI: 10.1016/j.eplepsyres.2018.04.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/18/2018] [Accepted: 04/29/2018] [Indexed: 01/28/2023]
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Yeni K, Tulek Z, Simsek OF, Bebek N. Relationships between knowledge, attitudes, stigma, anxiety and depression, and quality of life in epilepsy: A structural equation modeling. Epilepsy Behav 2018; 85:212-217. [PMID: 30032810 DOI: 10.1016/j.yebeh.2018.06.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Epilepsy not only is a medical disorder characterized by seizures, but is also associated with stigma and a neurological disorder that affects quality of life. Insufficient knowledge and misconceptions about epilepsy that causes the development of negative attitudes towards patients with epilepsy increase the stigmatization and psychosocial problems and impact the quality of life. The aim of this study was to examine the relationship between epilepsy knowledge, attitude, stigma, anxiety and depression, and quality of life within the framework of structural equation modeling. METHOD This research was carried out between May 2015 and May 2016 at the Epilepsy Outpatient Clinic of Istanbul University Istanbul Faculty of Medicine. The Epilepsy Knowledge Scale, Epilepsy Attitude Scale, Stigma Scale, Hospital Anxiety and Depression Scale, and Quality of Life in Epilepsy Scale-10 (QOLIE-10) were used. To determine the relationship between the concepts, research hypotheses were created, and structural equation modeling was made. RESULTS Two hundred five patients were included in the study, 53.7% were women, and the mean age was 32.5. It was found that 72.2% had generalized seizures, and 46.3% had more than one seizure per month. According to our proposed model, knowledge had a moderate relationship with attitude (including stigma) (r = 0.50) that, in turn, had a strong relationship with mental health (r = -0.62) while a moderate relationship with quality of life (r = 0.45). Our findings revealed that proposed model accounted for 20% of the variance in quality of life and 39% of the variance in mental health (anxiety and depression). CONCLUSION Mental health and quality of life of patient with epilepsy are closely related to the knowledge, attitude, and perceived stigma of the patients. Therefore, educating/supporting patients can help increase the mental health and quality of life.
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Affiliation(s)
- Kubra Yeni
- Ondokuz Mayis University, Faculty of Health Sciences, Turkey
| | - Zeliha Tulek
- Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Turkey.
| | - Omer Faruk Simsek
- Istanbul Arel University, Faculty of Science and Letters, Department of Psychology, Turkey
| | - Nerses Bebek
- Istanbul University, Istanbul Medical Faculty, Department of Neurology, Turkey
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Larsson J, Israelsson H, Eklund A, Malm J. Epilepsy, headache, and abdominal pain after shunt surgery for idiopathic normal pressure hydrocephalus: the INPH-CRasH study. J Neurosurg 2018; 128:1674-1683. [DOI: 10.3171/2017.3.jns162453] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVEAdverse events related to shunt surgery are common and might have a negative effect on outcome in patients with idiopathic normal pressure hydrocephalus (INPH). The authors’ objectives were to establish the frequencies of epilepsy, headache, and abdominal pain and determine their impact on patient quality of life (QOL), in long-term follow-up after shunt surgery for INPH.METHODSOne hundred seventy-six shunt-treated patients with INPH (mean age 74 years) and 368 age- and sex-matched controls from the population were included. The mean follow-up time after surgery was 21 months (range 6–45 months). Each participant answered a questionnaire regarding present frequency and severity of headache and abdominal pain. Confirmed diagnoses of epilepsy and all prescriptions for antiepileptic drugs (AEDs) before and after shunt surgery for INPH were gathered from national registries. Equivalent presurgical and postsurgical time periods were constructed for the controls based on the date of surgery (the division date for controls is referred to as virtual surgery). All registry data covered a mean period of 6 years (range 3–8 years) before surgery/virtual surgery and 4 years (range 2–6 years) after surgery/virtual surgery. Provoked epileptic seizures were excluded. Patient QOL was assessed with the EuroQoL 5-dimension 5-level instrument.RESULTSEpilepsy was more common in shunt-treated patients with INPH than in controls (4.5% vs 1.1%, respectively; p = 0.023), as was treatment with AEDs (14.8% vs 7.3%, respectively; p = 0.010). No difference was found between the populations before surgery/virtual surgery (epilepsy, 2.3% [INPH] vs 1.1% [control], p = 0.280; AED treatment, 8.5% [INPH] vs 5.4% [control], p = 0.235). New-onset epilepsy and new AED treatment after surgery/virtual surgery were more common in INPH (epilepsy, 2.3% [INPH] vs 0.0% [control], p = 0.011; AED, 8.5% [INPH] vs 3.3% [control], p = 0.015). At follow-up, more patients with INPH than controls experienced headache several times per month or more often (36.1% vs 11.6%, respectively; p < 0.001). Patients with INPH and unilateral headache had more right-sided headaches than controls (p = 0.038). Postural headache was experienced by 16% (n = 27 of 169) of the patients with INPH. Twenty percent (n = 35) of the patients with INPH had persistent abdominal pain. Headache was not correlated to lower QOL. The study was underpowered to draw conclusions regarding QOL in patients with INPH who had epilepsy and abdominal pain, but the finding of no net difference in mean QOL indicates that no correlation between them existed.CONCLUSIONSEpilepsy, headache, and abdominal pain are common in long-term follow-up in patients after shunt surgery for INPH and are more common among patients with INPH than in the general population. All adverse events, including mild and moderate ones, should be considered during postoperative follow-ups and in the development of new methods for shunt placement.
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Affiliation(s)
- Jenny Larsson
- Departments of 1Pharmacology and Clinical Neuroscience and
| | | | | | - Jan Malm
- Departments of 1Pharmacology and Clinical Neuroscience and
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Asadi-Pooya AA, Kanemoto K, Kwon OY, Taniguchi G, Dong Z, Chinvarun Y, Yu HY, McGonigal A, Kanner AM, Park SP. Depression in people with epilepsy: How much do Asian colleagues acknowledge it? Seizure 2018; 57:45-49. [DOI: 10.1016/j.seizure.2018.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 03/08/2018] [Accepted: 03/10/2018] [Indexed: 10/17/2022] Open
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Winter Y, Daneshkhah N, Galland N, Kotulla I, Krüger A, Groppa S. Health-related quality of life in patients with poststroke epilepsy. Epilepsy Behav 2018; 80:303-306. [PMID: 29429905 DOI: 10.1016/j.yebeh.2017.12.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 12/28/2017] [Accepted: 12/30/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Lesional epilepsy is an important long-term sequela of stroke. Data on health-related quality of life (HrQoL) in patients with poststroke epilepsy are limited. We investigated HrQoL in patients with epilepsy after ischemic stroke and identified independent HrQoL-determinants. METHODS AND PATIENTS All patients with acute ischemic stroke, who were permanent residents in the district Marburg-Biedenkopf (Hessia, Germany, reference population 240,000 inhabitants) were recruited within 12months in the population-based Marburg Stroke Register (MARSTREG). Follow-up visits were performed after 6, 12, and 24months, and patients who developed poststroke epilepsy were identified. Data on demographics, antiepileptic drugs (AEDs), stroke severity (National Institute of Heath Stroke Scale (NIHSS), Barthel-Index, modified Rankin Scale), depression (Geriatric Depression Scale), and HrQoL (EQ-5D and EQ VAS) were collected. A multiple regression analysis was performed to identify HrQoL-determinants. RESULTS Among the study participants (n=374), 23 (6.1%) developed poststroke epilepsy. The HrQoL of patients with poststroke epilepsy was reduced in comparison with patients without seizures (24-month follow-up: EuroQol Visual Analogue Scale (EuroQol-VAS): 55.3±10.7 versus 64.2±11.4, p=0.03). Seizure frequency, depression, and functional impairment (Barthel-Index) were identified as independent determinants of HrQoL. The adjustment of AEDs between 6-month and 24-month follow-ups resulted in decrease of seizure frequency by 40% and reduction of complications (dizziness by 27.8%, nausea by 52.2%, fatigue by 84.2%). CONCLUSION Lesional epilepsy is associated with decreased HrQoL in patients with stroke. We identified HrQoL-determinants, which would improve the management of patients with poststroke epilepsy. These determinants include proper adjustment of AEDs with reduction of seizure frequency, treatment of depression, and focused rehabilitation programs for poststroke epilepsy.
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Affiliation(s)
- Yaroslav Winter
- Mainz Comprehensive Epilepsy Center, Johannes Gutenberg-University, Mainz, Germany.
| | | | | | - Isabel Kotulla
- Department of Neurology, Philipps-University Marburg, Germany
| | - Anna Krüger
- Department of Neurology, Philipps-University Marburg, Germany
| | - Sergiu Groppa
- Mainz Comprehensive Epilepsy Center, Johannes Gutenberg-University, Mainz, Germany
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Micoulaud-Franchi JA, Bartolomei F, Duncan R, McGonigal A. Evaluating quality of life in epilepsy: The role of screening for adverse drug effects, depression, and anxiety. Epilepsy Behav 2017; 75:18-24. [PMID: 28818810 DOI: 10.1016/j.yebeh.2017.07.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/10/2017] [Accepted: 07/10/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the contribution of validated screening tools for antiepileptic drug (AED) adverse effects, depression, and anxiety to measure the quality of life (QoL) in people with epilepsy (PWE). METHODS Patients in a tertiary epilepsy service were screened for quality of life (using QOLIE-31), major depressive disorder (MDD) (NDDI-E), generalized anxiety disorder (GAD) (GAD-7), and AED effects (AEP). Mini International Neuropsychiatric Interview (MINI) generalized anxiety disorder module was also performed. For AEP validation in French, the internal structural validity was analyzed. Dimensional (NDDI-E and GAD-7 scores) and categorical (MDD and GAD) analyses were performed to investigate interactions between QoL and AEP. RESULTS A total of 132 (87 females) subjects were included. The French version of the AEP demonstrated satisfactory psychometric properties (Cronbach's α 0.87). Correlations between NDDI-E, GAD-7, AEP, and QOLIE-31 scores were high, and significant for all subscales of QOLIE-31; no effect of seizure-related variables was seen. Some sex differences in QOLIE-31 subscales were found, and mean AEP score was higher in females. Age, sex, NDDI-E, GAD-7, and AEP scores accounted for 61% of variance of QOLIE-31 scores. Differential effects were seen on QOLIE-31 subscales: AEP strongly correlated with all subscales; GAD-7 scores more strongly correlated with "Seizure Worry"; NDDI-E with "Energy-Fatigue"; and both NDDI-E and GAD-7 scores strongly correlated with "Emotional Well-Being". Categorical analysis of groups with MDD alone, GAD alone, MDD+GAD, and neither MDD nor GAD showed significant differences in AEP and QOLIE-31 scores, with MDD+GAD showing the most AED effects and the poorest QoL. SIGNIFICANCE The combination of screening tools for depression (NDDI-E), anxiety (GAD-7), and AED effects (AEP) has a strong power for evaluating QoL in PWE. Coexisting MMD and GAD were associated with the poorest quality of life and the highest AEP scores.
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Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Service d'explorations fonctionnelles du système nerveux, Clinique du sommeil, CHU de Bordeaux, Place Amélie Raba-Léon, 33076 Bordeaux, France; USR CNRS 3413 SANPSY, CHU Pellegrin, Université de Bordeaux, France
| | - Fabrice Bartolomei
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; Department of Clinical Neurophysiology, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Roderick Duncan
- Department of Neurology, University of Otago, Christchurch, New Zealand
| | - Aileen McGonigal
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; Department of Clinical Neurophysiology, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
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Kováts D, Császár N, Haller J, Juhos V, Sallay V, Békés J, Kelemen A, Fabó D, Rásonyi G, Folyovich A, Kurimay T. Factors affecting quality of life in Hungarian adults with epilepsy: A comparison of four psychiatric instruments. Epilepsy Behav 2017; 74:45-58. [PMID: 28686907 DOI: 10.1016/j.yebeh.2017.04.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 03/30/2017] [Accepted: 04/22/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE We investigated the impact of 19 factors on life quality in Hungarian patients with epilepsy. Wellbeing was evaluated by several inventories to investigate the impact of factors in more detail. METHODS A cross-sectional study was performed in 170 patients. Wellbeing was evaluated with the WHO-5 Well-being Index (WHOQOL-5), Diener Satisfaction with Life Scale (SwLS), and the Quality of Life in Epilepsy-31 Questionnaire (Qolie-31). We investigated their association with demographic characteristics, general health status, epilepsy, and its treatment. The impact of these factors on illness perception (Illness Perception Questionnaire, IPQ) was also studied. RESULTS The four measures correlated highly significantly. In addition, the predictive power of factors was comparable with the four inventories as evaluated by Multiple Regression. Factors explained 52%, 41%, 63% and 46% in the variance of WHOQOL-5, SwLS, Qolie-31, and IPQ scores, respectively. However, associations with particular factors were instrument-specific. The WHOQOL-5 was associated with factors indicative of general health. SwLS scores were associated with health-related and several demographic factors. Neither showed associations with epilepsy-related factors. All four categories of factors were associated with Qolie-31 and IPQ scores. Factors had an additive impact on IPQ, but not on Qolie-31. SIGNIFICANCE Our findings reveal interactions between the method of life quality assessment and the factors that are identified as influencing life quality. This appears to be the first study that analyses the factors that influence illness perception in epilepsy patients, and suggests that the IPQ may become a valuable tool in epilepsy research.
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Affiliation(s)
| | - Noémi Császár
- Károli Gáspár University, Faculty of Humanities, Institute of Psychology, Budapest, Hungary
| | - József Haller
- National University of Public Service, Budapest, Hungary; Institute of Experimental Medicine, Budapest, Hungary
| | - Vera Juhos
- Pediatric and Adult Epilepsy-Neurology Centre, Budapest, Hungary
| | - Viola Sallay
- University of Szeged, Department of Clinical and Health Psychology, Institute of Psychology, Szeged, Hungary
| | - Judit Békés
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Anna Kelemen
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - Dániel Fabó
- National Institute of Clinical Neurosciences, Budapest, Hungary
| | - György Rásonyi
- National Institute of Clinical Neurosciences, Budapest, Hungary; Neurocenter, Rigshospitalet, Copenhagen University, Denmark
| | - András Folyovich
- Szent János Hospital of the Municipality of Budapest, United Hospitals of North Buda, Department of Neurology, Budapest, Hungary
| | - Tamás Kurimay
- Szent János Hospital of the Municipality of Budapest, United Hospitals of North Buda, Department of Psychiatry and Psychiatric Rehabilitation, Budapest, Hungary
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Yu P, Zhou D, Liao W, Wang X, Wang Y, Wang T, Wu Y, Lang S, Lin W, Song Y, Zhao H, Cai M, Hong Z. An investigation of the characteristics of outpatients with epilepsy and antiepileptic drug utilization in a multicenter cross-sectional study in China. Epilepsy Behav 2017; 69:126-132. [PMID: 28242476 DOI: 10.1016/j.yebeh.2016.09.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/06/2016] [Accepted: 09/08/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This study aimed to describe the distribution of seizure types, clinical characteristics, and antiepileptic drug (AED) utilization in patients with epilepsy visiting tertiary hospitals in China. METHODS This was an observational, cross-sectional epidemiology study conducted at 11 tertiary hospitals across China from May 2014 to November 2014. A total of 1603 patients, of either sex or any age with confirmed diagnosis of epilepsy, visiting outpatient clinics at tertiary hospitals were screened and enrolled. Demographics, seizure types, frequency, etiologies, comorbidities, and current AED therapy were analyzed using descriptive statistics. RESULTS Overall, the majority (n=1201; 74.9%) of patients were adults (16-59years of age), and the mean (SD) age was 27.5 (15.9) years. A total of 989 (61.7%) patients had partial seizures, and 653 (40.7%) had generalized seizures. The majority experienced monthly (n=663) or yearly (n=625) seizures, with 2.7seizures/month or 2.9seizures/year, respectively. The most commonly reported symptomatic etiologies were traumatic brain injury, encephalitis, and stroke, whereas the most common comorbidities were sleep disorder, headache, anxiety, and depression. Overall, monotherapy was used in 54.1% of patients, while 30.6% of patients used dual therapy. The most commonly prescribed monotherapy for patients with partial seizures was oxcarbazepine (25.9%), while that for patients with generalized seizures was valproic acid (38.9%), and the most common AED combination was valproic acid and lamotrigine. Overall, valproic acid was the most commonly prescribed AED as monotherapy and combination therapy. CONCLUSION Findings from this study provide extensive information on clinical characteristics and utilization of AEDs in Chinese patients with epilepsy which may help physicians make well-informed clinical decisions.
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Affiliation(s)
- Peimin Yu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
| | - Dong Zhou
- West China Hospital of Sichuan University, Chengdu, China.
| | - Weiping Liao
- Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangdong, Guangzhou, China.
| | - Xin Wang
- Neurology Department, Zhongshan Hospital Fudan University, Shanghai, China.
| | - Yuping Wang
- Neurology Department, Xuanwu Hospital Capital Medical University, Beijing, China.
| | - Tiancheng Wang
- Neurology, Lanzhou University Second Hospital, Gansu, Lanzhou, China.
| | - Yuan Wu
- First Affiliated Hospital of Guangxi Provincial Medical College, Nanning, China.
| | - Senyang Lang
- Neurology Department, Chinese PLA General Hospital, Beijing, China.
| | - Weihong Lin
- The First Affiliated Hospital of Jilin University, Jilin, Changchun, China.
| | - Yijun Song
- Neurology Department, Tianjin Medical University General Hospital, Tianjin, China.
| | - Heqing Zhao
- Neurology Department, The Second Affiliated Hospital of Soochow University, Jiangsu, Suzhou, China.
| | - Meng Cai
- GlaxoSmithKline (China) Investment Co., Ltd, Shanghai, China.
| | - Zhen Hong
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
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Janssen EPCJ, de Vugt M, Köhler S, Wolfs C, Kerpershoek L, Handels RLH, Orrell M, Woods B, Jelley H, Stephan A, Bieber A, Meyer G, Engedal K, Selbaek G, Wimo A, Irving K, Hopper L, Gonçalves-Pereira M, Portolani E, Zanetti O, Verhey FR. Caregiver profiles in dementia related to quality of life, depression and perseverance time in the European Actifcare study: the importance of social health. Aging Ment Health 2017; 21:49-57. [PMID: 27869480 DOI: 10.1080/13607863.2016.1255716] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To identify caregiver profiles of persons with mild to moderate dementia and to investigate differences between identified caregiver profiles, using baseline data of the international prospective cohort study Actifcare. METHODS A latent class analysis was used to discover different caregiver profiles based on disease related characteristics of 453 persons with dementia and their 453 informal caregivers. These profiles were compared with regard to quality of life (CarerQoL score), depressive symptoms (HADS-D score) and perseverance time. RESULTS A 5-class model was identified, with the best Bayesian Information Criterion value, significant likelihood ratio test (p < 0.001), high entropy score (0.88) and substantive interpretability. The classes could be differentiated on two axes: (i) caregivers' age, relationship with persons with dementia, severity of dementia, and (ii) tendency towards stress and difficulty adapting to stress. Classes showed significant differences with all dependent variables, and were labelled 'older low strain', 'older intermediate strain', 'older high strain', 'younger low strain' and 'younger high strain'. CONCLUSION Differences exist between types of caregivers that explain variability in quality of life, depressive symptoms and perseverance time. Our findings may give direction for tailored interventions for caregivers of persons with dementia, which may improve social health and reduce health care costs.
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Affiliation(s)
- Eveline P C J Janssen
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands.,b Department of Old Age Psychiatry , Mondriaan , Heerlen , The Netherlands
| | - Marjolein de Vugt
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Sebastian Köhler
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Claire Wolfs
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Liselot Kerpershoek
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Ron L H Handels
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
| | - Martin Orrell
- c Department of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences , Institute of Mental Health, University of Nottingham , Nottingham , United Kingdom
| | - Bob Woods
- d Dementia Services Development Centre Wales , Bangor University , Bango , United Kingdom
| | - Hannah Jelley
- d Dementia Services Development Centre Wales , Bangor University , Bango , United Kingdom
| | - Astrid Stephan
- e Medical Faculty , Institute for Health and Nursing Science , Halle-Wittenberg , Germany
| | - Anja Bieber
- e Medical Faculty , Institute for Health and Nursing Science , Halle-Wittenberg , Germany
| | - Gabriele Meyer
- e Medical Faculty , Institute for Health and Nursing Science , Halle-Wittenberg , Germany
| | - Knut Engedal
- f Norwegian National Advisory Unit on Ageing and Health , Vestfold Hospital Trust , Tønsberg , Norway
| | - Geir Selbaek
- f Norwegian National Advisory Unit on Ageing and Health , Vestfold Hospital Trust , Tønsberg , Norway
| | - Anders Wimo
- g Department of Neurobiology, Care sciences and Society , Karolinska Institut , Stockholm , Sweden
| | - Kate Irving
- h School of Nursing and Human Sciences, Dublin City University , Dublin , Ireland
| | - Louise Hopper
- h School of Nursing and Human Sciences, Dublin City University , Dublin , Ireland
| | - Manuel Gonçalves-Pereira
- i CEDOC - Chronic Diseases Research Center , Nova Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa , Lisbon , Portugal
| | - Elisa Portolani
- j Alzheimer Unit , IRCCS Centro San Giovanni di Dio, Fatebenefratelli , Brescia , Italy
| | - Orazio Zanetti
- j Alzheimer Unit , IRCCS Centro San Giovanni di Dio, Fatebenefratelli , Brescia , Italy
| | - Frans R Verhey
- a Department of Psychiatry and Neuropsychology , School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University Medical Center , Maastricht , The Netherlands
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Ji H, Zhang L, Li L, Gong G, Cao Z, Zhang J, Zhou N, Wang Y, Tu H, Wang K. Illness perception in Chinese adults with epilepsy. Epilepsy Res 2016; 128:94-101. [DOI: 10.1016/j.eplepsyres.2016.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/10/2016] [Accepted: 10/25/2016] [Indexed: 01/08/2023]
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Quintas R, Cerniauskaite M, Giovannetti AM, Schiavolin S, Raggi A, Covelli V, Villani F, Didato G, Deleo F, Franceschetti S, Binelli S, Canafoglia L, Casazza M, Leonardi M. PARADISE 24 instrument: An observational study on psychosocial difficulties, quality of life, and disability levels in patients with epilepsy. Epilepsy Behav 2016; 64:160-165. [PMID: 27743548 DOI: 10.1016/j.yebeh.2016.08.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/16/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022]
Abstract
AIM The aim of this observational study was to test the effectiveness of the PARADISE 24 instrument in describing the psychosocial difficulties (PSDs) reported by people with epilepsy, their relation with disability, and quality-of-life (QoL) levels and, overall, to explore a horizontal epidemiology methodology applied to a sample of patients with epilepsy. METHODS A convenience sample of 80 adult patients with epilepsy was included in this cross-sectional study. Patients were interviewed using a structured protocol composed of demographic, clinical, and patient-reported outcome measures to collect PSDs associated with epilepsy. RESULTS There were 80 patients, 40 females; mean age was 41.2years; mean disease duration was 18.7years; and mean number of AED was 2.09. Moderate severity rating according to clinicians' rating scale, low impact of comorbidities (mean: 2.36, SD: 2.97), high levels of QoL (mean: 30.00, SD: 4.4), medium levels of resilience (mean: 13.56, SD: 2.66), high levels of perceived empathy (mean: 15.05, SD: 4.74), poor or moderate perceived social support, and low levels of disability (mean: 10.85, SD: 10.05) were observed. The most frequently reported PSDs were related to tiredness (80%), emotional problems (73.75%), anxiety (68.75%), depressive mood (66.25%), and driving problems (61.25%). The EUROHIS-QOL (p=.003) had a negative significant relationship with PARADISE 24 while WHODAS-12 (p=.000) and CRS (p=.027) had a positive significant relationship with PARADISE 24. CONCLUSIONS The PARADISE 24 permits data comparison and the creation of a complete description of a person's functioning and of all of his/her PSDs and allows better and more tailored interventions.
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Affiliation(s)
- Rui Quintas
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy.
| | - Milda Cerniauskaite
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; Neurosurgery Department, Radiotherapy Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Ambra Mara Giovannetti
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; Department of Neuroimmunology and Neuromuscular Diseases, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Silvia Schiavolin
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Venusia Covelli
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy; e-Campus University, Novedrate, Como, Italy
| | - Flavio Villani
- Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Giuseppe Didato
- Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Francesco Deleo
- Division of Clinical Epileptology and Experimental Neurophysiology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Silvana Franceschetti
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Simona Binelli
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Laura Canafoglia
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Marina Casazza
- Division of Neurophysiology and Diagnostic Epileptology, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Milan, Italy
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