Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy

Elst, Ludger Tebartz van; Trimble, Michael; Boylan, Laura S.; Labovitz, Daniel L.; Flint, Lynn A.; Devinsky, Orrin

doi:10.1212/wnl.63.5.942-a

Cited by 6 publications

(5 citation statements)

References 4 publications

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“…Both drug resistance and TBI etiology were associated with incremental effects on all 6 measures of QOL, and this persisted after adjustment for age, sex, and comorbid conditions. The incremental effects were observed in both epilepsyspecific and generic QOL measures, which is in keeping with prior studies [11][12][13][14] in which comorbid conditions such as depression and anxiety were important drivers of QOL, in some cases even more so than seizure-related factors. This study demonstrated that DRE and PTE can overlap and affect QOL differences in unique ways.…”

Section: Discussionsupporting

confidence: 88%

“…Both epilepsy-specific and generic QOL measures have been used to demonstrate that more seizures, more comorbid conditions (especially depression/anxiety), more ASMs, and longer duration of epilepsy significantly lower QOL. 11-15 However, prior work has not evaluated the relative effects of PTE or DRE across generic and epilepsy/TBI–specific QOL measures, controlling for other characteristics associated with TBI, epilepsy, and common mental health comorbid conditions. Thus, research using multimodal measures of QOL may provide new insight into the impact of epilepsy, PTE, and DRE on QOL while controlling for other potential confounders.…”

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confidence: 99%

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Multimodal Quality of Life Assessment in Post-9/11 Veterans With Epilepsy

et al. 2022

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Background and Objectives:Epilepsy is defined by the occurrence of multiple unprovoked seizures, but quality of life (QOL) in people with epilepsy is determined by multiple factors, in which psychiatric comorbidities play a pivotal role. Therefore, understanding the interplay between comorbidities and QOL across epilepsy phenotypes is an important step towards improved outcomes. Here, we report the impact of QOL across distinct epilepsy phenotypes in a cohort of post-9/11 veterans with high rates of traumatic brain injury (TBI).Methods:This observational cohort study from the Veterans Health Administration included post-9/11 Veterans with epilepsy. A process integrating an epilepsy identification algorithm, chart abstraction, and self-reported measures was used to classify patients into one of four groups: 1. Epilepsy controlled with medications, 2. Drug resistant epilepsy (DRE), 3. Post-traumatic epilepsy (PTE), or 4. Drug resistant post-traumatic epilepsy (PT-DRE). Summary scores for six QOL measures were compared across the groups, adjusting for age, sex, and number of comorbidities.Results:A total of 529 survey respondents with epilepsy were included in the analysis: 249 controls (i.e., epilepsy without DRE or PTE), 124 with DRE, 86 with PTE, and 70 with PT-DRE. Drug resistant epilepsy was more common in those with PTE compared with non-traumatic epilepsy (45% vs. 33%, odds ratio 1.6 (95% CI: [1.1-2.4], p=0.01)). Patients with PTE and PT-DRE had significantly more comorbid conditions in health records than those with nontraumatic epilepsy. Those with both PTE and DRE reported the lowest QOL across all six measures, and this persisted after adjustment for comorbidities, and in further linear analyses.Discussion:Among those with PTE, DRE prevalence was significantly higher than for non-traumatic epilepsies. PTE was also associated with higher burden of comorbidity, and worse overall QOL compared to those with non-traumatic epilepsies. People with PTE are distinctly vulnerable to the comorbidities associated with TBI and epilepsy. This at-risk group should be the focus of future studies aimed at elucidating the factors associated with adverse health outcomes and developing anti-epileptogenic therapies.

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Section: Discussionsupporting

confidence: 88%

mentioning

confidence: 99%

Multimodal Quality of Life Assessment in Post-9/11 Veterans With Epilepsy

et al. 2022

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“…Consistent with the previous reports, we found that depressive symptoms emerge as the predictor of HRQOL [7,9,13,25,26,42,52,55,56,58]. An early paper by Perrine et al [36] showed that mood was a factor in HRQOL but questioned whether mood determined HRQOL or HRQOL determined mood.…”

Section: Qolie-31 Subscalessupporting

confidence: 88%

Health-related quality of life in Russian adults with epilepsy: The effect of socio-demographic and clinical factors

Melikyan

Guekht

Mil'chakova

et al. 2012

Epilepsy & Behavior

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“…Mood disorders in PWE are of great importance considering that they are associated with a lower quality of life of patients, suicidal behavior, the occurrence of adverse effects of antiseizure medications, resistance to antiseizure medications and a worse outcome of surgical treatment of epilepsy [9,10]. Timely recognition of the factors that contribute to the appearance of depressive symptoms in PWE may provide appropriate identi cation of a vulnerable category of patients within the group of PWE.…”

Section: Introductionmentioning

confidence: 99%

Clinical and sociodemographic predictors of depressive symptoms in epilepsy patients in a single tertiary epilepsy center

Hajder,

Sekulić,

Ignjatović

et al. 2024

Preprint

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Purpose The purpose of this study was to determine the frequency of depressive symptoms in patients with epilepsy (PWE) in a tertiary epilepsy center and, then analyze possible predictors of depression from several domains, including clinical characteristics of epilepsy and sociodemographic factors Methods PWE who visited our epilepsy clinic during 6th months period in 2020 and 2021 were enrolled in our study. In order to collect data, structured scales were created for the clinical characteristics of the disease and sociodemographic data. All participants completed Back Depression Inventory II (BDI-II). Univariate analysis and binary logistic regression were conducted to identify the factors associated with depressive symptoms in PWE. Results A total of 131 PWE were recruited in this study. It was determined that depressive symptoms were represented in 51.1% PWE. Of these, 49.25% manifest severe depressive symptoms. It was determined that about 18% of PWE use antidepressant medications which is significantly less in comparison to those PWE who are currently depressed. Univariate regression analysis showed that female gender (p = 0.013); severe seizure frequency in the past year (p = 0.001); antiseizure medication polytherapy (p = 0.018); presence of side effects of antiseizure medications (p = 0.001); history of febrile seizures (p = 0.015); focal impaired awareness seizures (p = 0,051), as well as a combination of focal aware seizures to focal impaired awareness seizures to bilateral tonic-clonic seizures (p = 0,006) may associate with depressive symptoms in PWE. Binary logistic regression analysis demonstrated that side effects of antiseizure medications (OR = 3.01; 95% CI:1.09–8.32), history of febrile seizures (OR = 3.75; 95% CI:1 .07–13.11), female gender (OR = 2.16; 95% CI: 0.984–4.73), as well as the combination of focal aware seizures to focal impaired awareness seizures to bilateral tonic-clonic seizures (OR = 7.32; 95% CI: 0.830–64.59) represent unique, independent predictors of depressive symptoms in patients with epilepsy. Conclusion Depressive symptoms in PWE are frequent, severe, undiagnosed, and mostly untreated. Side effects of antiseizure medications, history of febrile seizures, female gender, as well as the combination of focal aware seizures to focal impaired awareness seizures to bilateral tonic-clonic seizures represent unique, independent predictors of depressive symptoms in PWE.

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Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy

Cited by 6 publications

References 4 publications

Multimodal Quality of Life Assessment in Post-9/11 Veterans With Epilepsy

Multimodal Quality of Life Assessment in Post-9/11 Veterans With Epilepsy

Health-related quality of life in Russian adults with epilepsy: The effect of socio-demographic and clinical factors

Clinical and sociodemographic predictors of depressive symptoms in epilepsy patients in a single tertiary epilepsy center

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