title: Factors associated with generic and disease-specific quality of life in temporal lobe epilepsy.
abstract: OBJECTIVE
  We aimed at further elucidating the association between quality of life (QOL) and sociodemographic factors, clinical seizure factors, depression and anxiety in drug-resistant temporal lobe epilepsy (TLE).
  
  
  METHODS
  We studied 106 consecutive adult right-handed patients (mean age 35.4 +/- 9.7; 50% males; IQ> or = 70) with drug-resistant unilateral (59% right) TLE (70% hippocampal sclerosis, 30% tumors or other lesions), who underwent a comprehensive non-invasive pre-surgical protocol. They completed the Beck Depression Inventory (BDI) and the State Form of the Spielberger State-Trait Anxiety Inventory (STAI). To measure QOL, we used both a generic instrument, the WHOQOL-100, and a disease-specific instrument, the 31-item quality of life in epilepsy (QOLIE-31). Multiple linear regression analysis was used to examine the relationship between each QOL domain and age, gender, education, side of TLE, duration of epilepsy, seizure frequency, and level of depression and anxiety.
  
  
  RESULTS
  Severity of depressive symptoms was significantly associated with lower scores across most QOL domains. Depression was consistently the strongest predictor of lower scores on almost all QOL domains. Also, severity of anxiety symptoms was significantly associated with lower scores across many QOL domains. Independent significant relationships between QOL and sociodemographic or clinical epilepsy variables were limited in number and strength.
  
  
  CONCLUSIONS
  Our findings suggest that QOL in TLE might be substantially affected by the presence and severity of depressive symptoms and, to a lesser degree, of anxiety symptoms. While clinical seizure variables had a weaker association with QOL, the absence of seizure-free patients might have obscured a relation between seizure frequency and QOL. Healthcare professionals should be aware of the significance of patients' emotional state and of the role it plays for their QOL. Adopting a biopsychosocial approach might be useful to address patients' needs.
authors.affiliation: Epilepsy Surgery Unit, Department of Neurological Sciences, IRCCS Neuromed, Pozzilli (IS), Italy.
authors.forename: Giulio N
authors.initials: GN
authors.lastname: Meldolesi
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
authors.forename: Pier P
authors.initials: PP
authors.lastname: Quarato
authors.forename: Liliana G
authors.initials: LG
authors.lastname: Grammaldo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Esposito
authors.forename: Addolorata
authors.initials: A
authors.lastname: Mascia
authors.forename: Antonio
authors.initials: A
authors.lastname: Sparano
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Morosini
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Di Gennaro
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology*; D004351:Drug Resistance; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011300:Preoperative Care; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires
chemical_list: D000927:Anticonvulsants