The mediating role of epileptic seizures, irritability, and depression on quality of life in people with epilepsy

Campos-Fernández, Daniel; Fonseca, Elena Zucconi Galli; Olivé‐Gadea, Marta; Quintana, Manuel; Abraira, Laura; Seijo-Raposo, Iván; Santamarina, Estevo; Toledo, Manuel

doi:10.1016/j.yebeh.2020.107511

Cited by 5 publications

(7 citation statements)

References 31 publications

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“…These include seizure types, patient-reported anxiety, disease severity, frequency of seizures, employment status, and ability to drive. [16][17][18] A few studies [19][20][21] have recently explored the interrelationship among several predictors of HRQOL via mediation analysis. However, there is a paucity of studies investigating the direct and indirect relationships between ASMs and HRQOL and factors that mediate this relationship.…”

Section: Introductionmentioning

confidence: 99%

Association between antiseizure medications and quality of life in epilepsy: A mediation analysis

et al. 2021

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Section: Introductionmentioning

confidence: 99%

Association between antiseizure medications and quality of life in epilepsy: A mediation analysis

et al. 2021

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“…Although the increase in seizure frequency with respect to baseline remained stable during follow‐up, we detected changes in the factors associated with poor control, with depression becoming the main risk factor. Psychiatric comorbidities are known to have an important role in seizure control, even in non‐pandemic times 28,29 . A recent Spanish study identified lockdown‐related emotional distress as the main risk factor for worsening seizure control in patients with epilepsy 27 .…”

Section: Discussionmentioning

confidence: 99%

“…Our study has several limitations. The pre‐pandemic baseline scores for anxiety and depression were not collected in our sample, even though prior studies performed in our population area portrayed lower rates of psychiatric pathologies before the COVID‐19 pandemic 29 . Besides psychological comorbidities and sleep disturbances were measured using validated tests, changes in seizure frequency were based on self‐reported data.…”

Section: Discussionmentioning

confidence: 99%

“…are known to have an important role in seizure control, even in nonpandemic times. 28,29 A recent Spanish study identified lockdownrelated emotional distress as the main risk factor for worsening seizure control in patients with epilepsy. 27 Insomnia remained highly prevalent in our follow-up study, supporting previous findings showing worsening of sleep disturbances among epilepsy patients during the first peak of the pandemic and an association with seizure control.…”

Section: F I G U R Ementioning

confidence: 99%

“…The pre-pandemic baseline scores for anxiety and depression were not collected in our sample, even though prior studies performed in our population area portrayed TA B L E 3 Clinical factors associated with seizure control during and after lockdown in the first wave of the coronavirus disease 2019 pandemic lower rates of psychiatric pathologies before the COVID-19 pandemic. 29 Besides psychological comorbidities and sleep disturbances were measured using validated tests, changes in seizure frequency were based on self-reported data. Our findings may also be affected by selection bias as just 50% of the patients from the initial study completed the follow-up survey.…”

Section: F I G U R Ementioning

confidence: 99%

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Medium‐term effects of COVID‐19 pandemic on epilepsy: A follow‐up study

et al. 2021

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Objective To analyze the medium‐term impact of the COVID‐19 pandemic on epilepsy patients, focusing on psychological effects and seizure control. Methods Prospective follow‐up study to evaluate the medium‐term effects of the COVID‐19 pandemic on a cohort of epilepsy patients from a tertiary hospital previously surveyed during the first peak of the pandemic. Between July 1, 2020, and August 30, 2020, the patients answered an online 19‐item questionnaire, HADS, and PSIQ scales. Short‐ and medium‐term effects of the pandemic confinement and the perception of telemedicine were compared. Results 153 patients completed the questionnaire, mean ± SD age, 47.6 ± 19.3 years; 49.7% women. Depression was reported by 43 patients, significantly more prevalent than in the short‐term analysis (29.2% vs. 19.7%; p = .038). Anxiety (38.1% vs. 36.1%; p = 0.749) and insomnia (28.9% vs. 30.9%, p = .761) remained highly prevalent. Seventeen patients reported an increase in seizure frequency (11.1% vs. 9.1%, p = .515). The three factors independently associated with an increase in seizure frequency in the medium term were drug‐resistant epilepsy (odds ratio [OR] = 8.2, 95% CI 2.06–32.52), depression (OR = 6.46, 95% CI 1.80–23.11), and a reduction in income (OR = 5.47, 95% CI 1.51–19.88). A higher proportion of patients found telemedicine unsatisfactory (11.2% vs. 2.4%), and a lower percentage (44.8% vs. 56.8%) found it very satisfactory ( p = .005). Conclusions Depression rates increased significantly after the first wave. Depression, drug‐resistant epilepsy, and a reduction in family income were independent risk factors for an increased seizure frequency. Perception of telemedicine worsened, indicating need for re‐adaptation.

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Depressive symptoms in patients with epilepsy and clinically associated features in a single tertiary center

et al. 2021

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Although depressive symptoms are the most common psychiatric comorbidity in epilepsy, they remain underestimated and untreated in a large proportion of patients. The purpose of this study was to evaluate depression severity and related clinical features in people with epilepsy using a well-reliable self-report index of mood, the Beck Depression Inventory-II (BDI-II). One-hundred seventeen adult patients with epilepsy were recruited from a tertiary epilepsy center and completed the BDI-II. A single-item analysis of the 21 questions of the BDI-II was computed and differences between women and men in each depressive symptom were evaluated. Correlation and regression analyses were used to identify clinical features associated with the severity of depression. Results showed gender differences in some items, with women reporting overall higher depression severity than men. The most common symptoms regarded domains of sleeping patterns, tiredness, and loss of energy. Regression evidence suggested that being female, having an epilepsy duration < 10 years, as well as being treated with psychotropic drugs and reporting generalized seizure, were associated with higher depression severity. Despite its cross-sectional nature, this study reinforces the importance of investigating and possibly treating depressive symptoms in adult patients with epilepsy, since they negatively impact well-being, daytime activities, and sleep. Further studies identifying pharmacological and non-pharmacological treatments for depression in epilepsy need to be planned.

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The mediating role of epileptic seizures, irritability, and depression on quality of life in people with epilepsy

Cited by 5 publications

References 31 publications

Association between antiseizure medications and quality of life in epilepsy: A mediation analysis

Association between antiseizure medications and quality of life in epilepsy: A mediation analysis

Medium‐term effects of COVID‐19 pandemic on epilepsy: A follow‐up study

Depressive symptoms in patients with epilepsy and clinically associated features in a single tertiary center

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