Evaluating quality of life in epilepsy: The role of screening for adverse drug effects, depression, and anxiety

Jean-Arthur Micoulaud-Franchi; Fabrice Bartolomei; Roderick Duncan; Aileen McGonigal

doi:10.1016/j.yebeh.2017.07.016

Evaluating quality of life in epilepsy: The role of screening for adverse drug effects, depression, and anxiety

Epilepsy Behav. 2017 Oct:75:18-24. doi: 10.1016/j.yebeh.2017.07.016. Epub 2017 Aug 15.

Authors

Jean-Arthur Micoulaud-Franchi¹, Fabrice Bartolomei², Roderick Duncan³, Aileen McGonigal⁴

Affiliations

¹ 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.
² 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.
³ Department of Neurology, University of Otago, Christchurch, New Zealand.
⁴ 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. Electronic address: aileen.mcgonigal@univ-amu.fr.

PMID: 28818810
DOI: 10.1016/j.yebeh.2017.07.016

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.

Keywords: AEP; Anxiety; Depression; GAD-7; NDDI-E; Quality of life.

MeSH terms

Adolescent
Adult
Aged
Anxiety / psychology*
Depression / psychology*
Drug-Related Side Effects and Adverse Reactions / psychology*
Epilepsy / psychology*
Female
Humans
Male
Middle Aged
Psychometrics / instrumentation*
Quality of Life / psychology*
Young Adult