Elsevier

Epilepsy & Behavior

Volume 7, Issue 3, November 2005, Pages 481-485
Epilepsy & Behavior

Sleep disturbances, socioeconomic status, and seizure control as main predictors of quality of life in epilepsy

https://doi.org/10.1016/j.yebeh.2005.06.010Get rights and content

Abstract

Improving quality of life is the most important goal for patients with epilepsy. To recognize the factors associated with quality of life in patients with epilepsy in Mexico, we performed a cross-sectional survey using the Quality of Life in Epilepsy 31 (QOLIE-31) inventory to assess the quality of life of 401 adult patients with epilepsy at the National Institute of Neurology and Neurosurgery of Mexico. Clinical and demographical data were collected. Multiple regression was used to determine which factors affected quality of life in our patients. The variables that most strongly predicted a lower QOLIE-31 total score after multiple regression were sleep disorders (P < 0.001), socioeconomic status (P < 0.001), female gender (P = 0.002), and high seizure frequency (P = 0.001). In our study, neither depression nor time of evolution of epilepsy had significant influence on QOLIE-31 scores.

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.

References (19)

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    Epilepsy is one of the most complex neurological disorders and has deep repercussions on the health-related quality of life (HRQOL) of the patients, which leads to increased risks of experiencing mental health problems [1,2]. Several studies have shown that people with epilepsy have lower HRQOL, especially women [3–5], and have associated it with depression, adverse effects, a greater number of anticonvulsants and a higher frequency of seizures [6–9]. The most common comorbidity in people with epilepsy is depression [10–12], which is also the strongest predictor of HRQOL in these patients [9,13,14], showing an inversely proportional relationship [15,16].

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