Evaluating quality of life in epilepsy: The role of screening for adverse drug effects, depression, and anxiety.
Epilepsy & Behavior. 2017-10-01; 75: 18-24
DOI: 10.1016/j.yebeh.2017.07.016
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1. Epilepsy Behav. 2017 Oct;75:18-24. doi: 10.1016/j.yebeh.2017.07.016. Epub 2017
Aug 15.
Evaluating quality of life in epilepsy: The role of screening for adverse drug
effects, depression, and anxiety.
Micoulaud-Franchi JA(1), Bartolomei F(2), Duncan R(3), McGonigal A(4).
Author information:
(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:
.
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.
Copyright © 2017 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.yebeh.2017.07.016
PMID: 28818810 [Indexed for MEDLINE]