Abstracts

Rationale: Patients with either epilepsy or psychogenic non-epileptic seizures (PNES) have a poorer quality of life (QoL) than the general population (Szaflarski & Szaflarski, 2004). Furthermore, patients with PNES often have significantly worse QoL than patients with epilepsy (Testa et al., 2007). This inter-group difference has been explained in part by differences in mood states and adverse medication effects (Szaflarski et al., 2003), however the role of anxiety has yet to be investigated. Methods: 38 patients with a confirmed diagnosis of epilepsy (n=18) or PNES (n=20) were assessed using the Short-Form-36 QoL measure, the State-Trait Anxiety Inventory, the Hamilton Depression Scale, the Neurological Disorders Depression Inventory for Epilepsy, and the Liverpool Adverse Events Profile (anti-epileptic drug toxicity). Multiple regression analysis was performed to determine the strongest predictors of QoL in each group. Results: Mean QoL scores were lower in PNES (42.46) than in epilepsy (53.03). State and trait anxiety, depression and drug toxicity were all higher in PNES than in epilepsy. Lower QoL was significantly associated with higher depression (p=0.023), anxiety (p=0.001) and drug toxicity (p=0.001) in PNES. In patients with epilepsy, only drug toxicity was significant (p=0.098) in predicting 11% of the variance in QoL (R squared=0.109). Drug toxicity (p=0.024) and depression (p<0.001), but not anxiety, were significant in explaining 58% of the variance in QoL for patients with PNES (R squared=0.576). Conclusions: Increased anxiety is associated with a reduced QoL in patients with PNES, but not epilepsy. However, anxiety is not an independent predictor of QoL, suggesting the association between anxiety and reduced QoL may be due to factors such as drug toxicity or depression. Further research is needed to determine the best predictors and therefore the factors which can be modified to improve QoL for patients with either disorder. Greater focus on improving patients' mood and reducing drug toxicity may be the most effective way of improving QoL for these patients.