Determinants of quality of life in adults with epilepsy: a multicenter, cross-sectional study from Germany

Abstract

Background Assessment of quality of life (QoL) has become an important indicator for chronic neurological diseases. While these conditions often limit personal independence and autonomy, they are also associated with treatment-related problems and reduced life expectancy. Epilepsy has a tremendous impact on the QoL of patients and their families, which is often underestimated by practitioners. The aim of this work was to identify relevant factors affecting QoL in adults with epilepsy. Methods This cross-sectional, multicenter study was conducted at four specialized epilepsy centers in Germany. Patients diagnosed with epilepsy completed a standardized questionnaire focusing on QoL and aspects of healthcare in epilepsy. Univariate regression analyses and pairwise comparisons were performed to identify variables of decreased QoL represented by the overall Quality of Life in Epilepsy Inventory (QOLIE-31) score. The variables were then considered in a multivariate regression analysis after multicollinearity analysis. Results Complete datasets for the QOLIE-31 were available for 476 patients (279 [58.6%] female, 197 [41.4%] male, mean age 40.3 years [range 18–83 years]). Multivariate regression analysis revealed significant associations between low QoL and a high score on the Liverpool Adverse Events Profile (LAEP; beta=-0.28, p < 0.001), Hospital Anxiety and Depression Scale – depression subscale (HADS-D; beta=-0.27, p < 0.001), Neurological Disorders Depression Inventory in Epilepsy (NDDI-E; beta=-0.19, p < 0.001), revised Epilepsy Stigma Scale (beta=-0.09, p = 0.027), or Seizure Worry Scale (beta=-0.18, p < 0.001) and high seizure frequency (beta = 0.14, p < 0.001). Conclusion Epilepsy patients had reduced QoL, with a variety of associated factors. In addition to disease severity, as measured by seizure frequency, the patient’s tolerability of anti-seizure medications and the presence of depression, stigma, and worry about new seizures were strongly associated with poor QoL. Diagnosed comorbid depression was underrepresented in the cohort; therefore, therapeutic decisions should always consider individual psychobehavioral and disease-specific aspects. Signs of drug-related adverse events, depression, fear, or stigmatization should be actively sought to ensure that patients receive personalized and optimized treatment. Trial Registration German Clinical Trials Register (DRKS00022024; Universal Trial Number: U1111-1252-5331).

The impact of the comorbid seizure/epilepsy on the health related quality of life in people with multiple sclerosis: an international multicentric study

“…Furthermore, since a number of patients remain resistant to ASMs, it has been shown that the overall quality of life scores were statistically significantly higher in the group of patients who were responders as compared to nonresponders (28). In line with these findings, it has been also, recently, shown that the insufficient seizure control with high frequency of seizures is significantly related to the poor quality of life (25).…”

“…However, considering the influence of epilepsy-related factors, it has to be emphasized that some of them also affect quality of life. Thus, it was shown that high seizure frequency might be associated with poorer quality of life (23,25), although these results are not fully consistent (26). It has been also…”

Determinants of the Quality of Life in Patients with Drug-Resistant Temporal Lobe Epilepsy: A Comparison of the Results before and after Surgery

“…However, the relationship between post-operative quality of life and individual clinical variables is not clear. The literature contains studies that show a relationship between QoL and the frequency of seizures [ 42 ], age at epilepsy onset [ 23 ], and the severity of symptoms of depression and anxiety [ 42 , 43 , 44 ]; however, there are also studies in which this relationship was not demonstrated (age at epilepsy onset: [ 43 , 45 , 46 ]; seizure frequency: [ 43 ]. The present study did not show the association between post-surgical QoL and other analyzed demographical or clinical variables (which was similar to other studies) such as sex [ 46 ], age [ 47 ], education level [ 46 ], or number of prescribed antiepileptic drugs [ 43 ].…”

A multicenter, matched case–control analysis comparing burden of illness among patients with tuberous sclerosis complex related epilepsy, generalized idiopathic epilepsy, and focal epilepsy in Germany

“…Significant differences between patients with TSC and IGE were also determined for Neurological Disorder Depression Inventory for Epilepsy (TSC: 13.1; IGE: 11.2, P = 0.009) and Liverpool Adverse Events Profile scores (TSC: 42.7; IGE: 37.5, P = 0.017) with higher score and worse results for TSC patients in both questionnaires. syndrome [10,11,[18][19][20][21][22]. In the present analysis, only epilepsy patients diagnosed with either IGE or FE were included.…”