Affective symptoms and determinants of health-related quality of life in Mexican people with epilepsy

Abstract

Epilepsy is known to be associated with multiple psychiatric comorbidities, such as depression, sleep-disorders, and anxiety. The objective of this study was to determine the prevalence and impact of affective symptoms over health-related quality of life (QOL) in Mexican people with epilepsy (PWE). We performed a cross-sectional observational study on 73 consecutive PWE and corresponding age- and sex-matched controls. HrQOL was assessed using the QOLIE-10 (QOL in Epilepsy-10) instrument. Clinical and demographic characteristics were recorded, and instruments evaluating depressive/anxiety symptoms, sleep quality, and insomnia were completed. PWE had more depressive/anxiety symptoms when compared with controls. QOLIE-10 scores were significantly inversely correlated with poor sleep quality, insomnia symptoms, depressive/anxiety symptoms, and number of anti-epileptic drugs used, but not with seizure type or number of seizures per month. A poor QOL was independently associated only with anti-epileptic drug polytherapy. PWE are burdened with depressive/anxiety symptoms at alarming rates. The presence of depressive symptoms along with sleep disturbances and more significantly, anti-epileptic drug polytherapy, appears to negatively impact QOL, to a greater degree than short-term seizure control.

Depression and quality of life in patients with epilepsy in Northwest Greece

“…Furthermore, the adverse effects of AEDs play a major negative role in QoL modulation [14,45,54,55]. The strong association between the presence of depression and the QoL in patients with epilepsy has already been established [12,13,16,42,44,45,56]. Previous studies have indicated that psychological factors, especially depression were more important predictors of a patients' quality of life, compared to epilepsy characteristics [30,31,57].…”

“…With regards to epilepsy characteristics, the duration of epilepsy has been reported to be both related [51] and unrelated [12] to quality of life. However, it is widely accepted that seizure frequency considerably affects patients' QoL [31,41,52,53], as long as polypharmacy has been found to be associated with poorer QoL [13,16,52,53]. Furthermore, the adverse effects of AEDs play a major negative role in QoL modulation [14,45,54,55].…”

“…The early recognition and treatment of depression in patients with epilepsy is of high importance since patients with epilepsy suffering from depression tend to use health care services more frequently [10] and have a poorer quality of life (QoL) compared to patients without depression [11][12][13][14]. Furthermore, suicide ideation, which is higher in patients with epilepsy compared to the general population, may be connected to depression [15].…”

“…Depression has been established as one of the stronger predictors of poor QOL in patients with epilepsy [11,13,14]. Regarding the characteristics of epilepsy, the frequency of seizures and the adverse effects of antiepileptic drugs (AEDs) are also important parameters that may determine QoL [16,17].…”

Situación de la epilepsia en México y América Latina

“…45 El segundo publicado en 2005 mostró una calificación promedio de QOLIE-31 para los PCE de 55 puntos y detectó que los trastornos del sueño, un estado socioeconómico bajo, el género femenino y un mal control de crisis se asociaron a reducción de la CV. 46 Otro estudio en población mexicana de PCE adultos de casos y controles reveló una relación en pérdida de CV por QOLIE-31 y la presencia de depresión/ansiedad, y mala calidad de sueño 47 acentuado por el conocimiento previo de prevalencias altas de trastornos de ansiedad y depresión (hasta 25%) en PCE adultos mexicanos. 48 La CV también se ve afectada en los cuidadores de PCE mexicanos, lo cual fue demostrado en un estudio realizado en un centro hospitalario de tercer nivel, donde se encontró un nivel de desgaste (ND) moderado en los cuidadores y una calidad de vida con puntajes de 47-55 en la escala WHOQOL-BREF (puntuación de 0 a 100, con peor CV con menor puntaje).…”