Sleep disturbances, socioeconomic status, and seizure control as main predictors of quality of life in epilepsy
Introduction
The quality of life among patients with epilepsy has been associated in several studies with different clinical, demographic, and socioeconomic variables [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]. Seizure type and frequency have been the most significant predictors of quality of life in some [1], [3], [6], [8], [9], [11] but not in all studies [7], [10]. Marital and the employment status have also been related to lower quality of life [2], [4], [11].
In recent studies, the importance of depression as a predictor of quality of life has been pointed out [7], [10]; while other studies consider socioeconomic status the most important factor associated with lower quality of life.
The goal of this study was to determine the impact of diverse clinical, epidemiological, and socioeconomic variables on the quality of life in adult patients with epilepsy attending a referral center in Mexico.
Section snippets
Methods
We conducted a cross-sectional survey to assess the quality of life of 401 consecutive patients evaluated at the National Institute of Neurology and Neurosurgery of Mexico between August 2002 and September 2004. All patients were older than 18, had been diagnosed with epilepsy for at least 1 year, and were taking antiepileptic drugs (AEDs) at the time of recruitment. Patients were excluded if they had physical or mental limitations not allowing them to complete the Quality of Life in Epilepsy
Sample characteristics
Of 401 patients included, 43.1% were female. The mean age was 32.2 ± 11.6 years. Table 1 summarizes the clinical, epidemiological, and socioeconomic characteristics. The mean global score of QOLIE-31 for the patient population was 55.68 ± 14.87.
Reliability of Mexican adaptation of QOLIE-31
The internal consistency for the QOLIE-31 overall score and dimensions was high. Cronbach’s α was 0.74 for the overall score, and between 0.61 and 0.86 for the dimensions. These values suggest minimal measurement error with the Mexican version of QOLIE-31.
Association of clinical and demographic variables with quality of life
Discussion
In our study, sleep disorders, lower socioeconomic status, female gender, poor seizure control, and unemployment were the variables most strongly associated with a lower quality of life. We did not find any association with seizure type, etiology of the epilepsy, and duration of disease. The associations of depressive symptoms, age at the time of the survey, and AED polytherapy with lower quality of life vanished after multiple regression.
One major methodological flaw of this study is biased
Acknowledgment
We thank Joyce Cramer for granting us permission to use the QOLIE-31 questionnaire in our study.
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