Factors associated with generic and disease-specific quality of life in temporal lobe epilepsy.
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.
Meldolesi
Giulio N
GN
Epilepsy Surgery Unit, Department of Neurological Sciences, IRCCS Neuromed, Pozzilli (IS), Italy.
Picardi
Angelo
A
Quarato
Pier P
PP
Grammaldo
Liliana G
LG
Esposito
Vincenzo
V
Mascia
Addolorata
A
Sparano
Antonio
A
Morosini
Pierluigi
P
Di Gennaro
Giancarlo
G
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
D000927:Anticonvulsants