Quality of life predictors in patients with epilepsy and cognitive disabilities

Abstract

Purpose We aimed to assess the QOL and its predictors in Bulgarian patients with refractory epilepsy (RE) and cognitive problems.

Methods We conducted a study based on questionnaires designed for people with intellectual disability (the stigma scale, the Glasgow Depression Scale, the Glasgow Anxiety Scale, the Glasgow Epilepsy Outcome Scale – GEOS-35) and a purposeful interview on clinical and social factors of 64 patients (50% men) with RE and cognitive problems.

Results The mean total score of the GEOS-35 was 76 ± 2.34 (an indicator of low QOL). On univariate analysis, the GEOS-35 total score was associated with seizure frequency and severity, stigma, depression, and anxiety. On multivariate regression analysis predictors of the GEOS-35 total score were anxiety, seizure severity, and stigma Р < 0.001 (F = 14.66). Regarding the GEOS-35 subscales, on multivariate regression analysis, we found that 1. Seizure severity, seizure type, and anxiety were predictors of “concerns about seizures” Р < 0.001 (F = 8.99); 2. Anxiety was the only predictor of “concerns about treatment” Р < 0.001 (F = 7.98); 3. Anxiety and seizure severity were predictors of “concerns about caring” Р < 0.001 (F = 12.12); and 4. Seizure severity and stigma were predictors of “concerns about social impact” Р < 0.001 (F = 18.31).

Conclusions We have affirmed the low QOL in patients with RE and cognitive problems and its clinical and social determinants. The results from our study prove the necessity of a multidisciplinary approach for quality of life improvement in these patients.

Keywords

Stigma - Depression - Anxiety - Seizure frequency - Severity

• References

• 1 Espie CA, Watkins J, Duncan R. et al. Development and validation of the Glasgow Epilepsy Outcome Scale (GEOS): a new instrument for measuring concerns about epilepsy in people with mental retardation. Epilepsia 42 2001; 1043-1051
• 2 Van Blarikom W, Tan IY, Aldenkamp AP, Van Gennep AT. Epilepsy, intellectual disability, and living environment: a critical review. Epilepsy Behav 9 2006; 14-18
• 3 Gil R. Neuropsychologie. L’examen neuropsychologique. 2006. Masson; Paris: 12-16
• 4 Cuthill F, Espie C, Cooper S-A. Development and psychometric properties of the Glasgow Depression Scale for people with a Learning Disability. Br J Psychiatry 182 2003; 347-353
• 5 Mindham J, Espie CA. Glasgow Anxiety Scale for people with an Intellectual Disability (GAS-ID): development and psychometric properties of a new measure for use with people with mild intellectual disability. J Intellect Disabil Res 47 2003; 22-30
• 6 Ali A, Strydom A, Hassiotis A, Williams R, King M. A measure of perceived stigma in people with intellectual disability. Br J Psychiatry 193 2008; 410-415
• 7 Baker GA, Smith DF, Dewey ME, Jacoby A, Chadwick DW. The initial development of a health-related quality of life model as an outcome measure in epilepsy. Epilepsy Res 16 1993; 65-81
• 8 Ventegodt S, Omar H, Struve F, Nielsen T, Kandel I, Merrick J. Quality of life and persons with intellectual disability: can we measure QOL in this population?. J Altern Med Res 2 2010; 459-471
• 9 Kerr MP, Turky A, Huber B. The psychosocial impact of epilepsy in adults with an intellectual disability. Epilepsy Behav 5 2009; S26-S30
• 10 Sabaz M, Cairns DR, Lawson JA, Bleasel AF, Bye AM. The health-related quality of life of children with refractory epilepsy: a comparison of those with and without intellectual disability. Epilepsia 42 2001; 621-628
• 11 Endermann M. Predictors of health-related and global quality of life among young adults with difficult-to-treat epilepsy and mild intellectual disability. Epilepsy Behav 26 2013; 188-195
• 12 Endermann M. Quality of life among people with epilepsy and mild intellectual disabilities in residential care. Epilepsy Behav 8 2006; 703-712