Psychological impact of illness intrusiveness in epilepsy - comparison of treatments.
Chronic illnesses are associated with multiple stressors that compromise quality of life (QOL). Implicit in many of these is the concept of illness intrusiveness, the disruption of lifestyles and activities attributable to constraints imposed by chronic disease and its treatment. This study tested the illness intrusiveness theoretical framework in epilepsy and compared the impact of pharmacological and surgical treatments on illness intrusiveness and QOL. Cross-sectional data compared three epilepsy groups (N = 145): (a) 40 patients admitted for presurgical evaluation to an Epilepsy Monitoring Unit; (b) 52 patients treated pharmacologically; and (c) 53 post-surgical patients. Illness intrusiveness differed significantly across epilepsy patients with the differences primarily related to seizure control. Illness intrusiveness varied inversely with seizure control (p < .05). Seizure freedom, whether achieved by surgical or pharmacological treatments, was associated with maximal reduction of illness intrusiveness. Increased illness intrusiveness correlated significantly with decreased QOL and increased depressive symptoms. Perceived control over diverse life domains correlated positively with QOL and psychosocial outcomes. Path analysis supported the validity of the illness intrusiveness theoretical framework in epilepsy. Illness intrusiveness is an important determinant of the psychosocial impact of epilepsy and its treatment. Effective pharmacological or surgical treatment may reduce illness intrusiveness in epilepsy. Findings also offer encouragement that QOL in epilepsy, as in other chronic conditions, may be enhanced by multidisciplinary bio-psychosocial efforts. Health care providers should consider multifaceted interventions to reduce illness intrusiveness and, thereby, improve QOL.
Poochikian-Sarkissian
Sonia
S
Division of Neurology, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada. sonia.sarkissian@uhn.on.ca
Sidani
Souraya
S
Wennberg
Richard A
RA
Devins
Gerald M
GM
D000328:Adult; D000339:Affect; D000927:Anticonvulsants / Q000627:therapeutic use*; D001294:Attitude to Health; D002908:Chronic Disease; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003710:Demography; D004827:Epilepsy / Q000188:drug therapy / Q000523:psychology / Q000601:surgery; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D011182:Postoperative Care; D011584:Psychology; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000927:Anticonvulsants