Abstracts

RATIONALE: While the recent introduction of quality of life and mood surveys into epilepsy patient evaluations can help screen for emotional concerns in epilepsy patients, complete reliance upon these measures may obscure important psychosocial issues. Some patients with emotional distress answer questions to minimize symptoms. Further, survey scores lend little insight into the specific issues of concern in patients lives. In contrast, an interview conducted by an experienced epilepsy social worker can establish a quick rapport with the patient, and potentially elicit information about emotional issues and stressors related to epilepsy. A skilled interviewer observes a patients affect and demeanor and uses this information to guide questions to specific areas of stress. METHODS: Four Mood surveys and the Quality of Life in Epilepsy-10 Inventory were consecutively administered to adult patients with intractable epilepsy. Blinded to these results, our epilepsy social worker conducted interviews using a uniform but open-ended format that covered topics encompassed in the QOLIE-10. Information from interviews was quantified for comparison to responses to the QOLIE-10 and mood surveys. RESULTS: Information confided to the social worker frequently contradicted patients' responses on mood and quality of life surveys, and often suggested much higher levels of distress than what was apparent from symptom scores. Interviews also revealed specific fears and concerns that could not be discovered from review of surveys. CONCLUSIONS: Complete reliance upon psychological symptom checklists may frequently miss important fears, and emotional concerns of epilepsy patients. Face-to-face psychosocial evaluations are crucial for learning about the specific issues of concern in the quality of life of epilepsy patients.