Influence of comorbid depression, sociodemographic and seizure-related variables on quality of life of adults with epilepsy

Abstract

Quality of life (QOL) is recognised as an important concept to better understand the distress of living with epilepsy. As it is a multidimensional construct it can be influenced by many and different factors including sociodemografic, disease-specific and psychosocial ones. AIM AND METHOD: We assessed the influence of comorbid depressive disorder, some sociodemografic and seizure-related variables on QOL of people with epilepsy (PWE). The sample included 106 adult patients with idiopathic epilepsy (41 males and 65 females). All subjects underwent clinical psychiatric examination, including evaluation on Hamilton Depression Rating Scale (HAM-D-17) and completed Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Seizure severity was measured by Seizure Severity Questionnaire (SSQ). A questionnaire for demographic and seizure-related variables was also completed. Comorbid depressive disorder was diagnosed according to ICD-10 diagnostic criteria for affective and delusional disorders and ILAE classification for epilepsies and epileptic syndromes was used. Statistical analysis included correlation analysis, t-tests and multivariation analysis. RESULTS: Employment, education and age, seizure frequency and seizure severity were associated with QOL scores. Comorbid depressive disorder was associated with QOL scores accounting for 32% of the variance in QOLIE-31 overall score and was a strong predictor for the variance in overall QOL, emotional well-being, energy/fatigue and cognitive functioning scores. Seizure severity influenced most the variance in seizure-worry score. Seizure frequency accounted most for social functioning and medication effects scores. Gender, marital status, seizure type, age at seizure onset, duration of seizures and antiepileptic medication intake had no significant association with QOLIE-31scores in this study. CONCLUSIONS: Multiple factors determine QOL of PWE. Detection and treatment of comorbid depressive disorder, being the most frequent psychiatric comorbidity in epilepsy, is a challenge for improving the QOL these patients and future research should give priority to this issue.