Abstracts

Rationale: Severity of epilepsy has been recognized as a significant predictor of health-related quality of life of epilepsy patients in both pediatric and adult populations. However, commonly adopted measures of severity of epilepsy have failed to capture important aspects of the disease such as seizure frequency, number of anti-epileptic drugs, side effects, and impact on daily life activities. More recently, the global assessment of severity of epilepsy (GASE) scale, a single-item scale for assessing the symptom severity in epilepsy, was developed and validated in a pediatric population of epilepsy patients. The objective of this study is to validate the GASE scale in an adult population of epilepsy patients. Methods: The construct validity of the GASE scale was examined in an adult epilepsy population using data obtained from a cohort of 250 consecutive epilepsy patients enrolled in the NEurological diseasE and Depression Study (NEEDS), a study addressing the burden, course and impact of depressive disorders in neurological patients in Calgary, Alberta, Canada. Spearman s rank correlation coefficient and multiple linear regression analyses were used to examine the association between GASE scale and several clinical and self-reported aspects of epilepsy.Results: The age of the study participants ranged between 18.7 and 79.3 years. There were no statistically significant differences between patients with severe and less-severe seizure types on several demographic characteristics, including: age, gender, current working status, marital status, education, and duration of disease. Based on the self-reported GASE rating, 45.1% of the epilepsy patients reported experiencing a not at all severe form of the disease. Statistically significant correlations were observed between GASE scale scores and clinical and self-reported outcomes such as seizure frequency, disability due to seizures, number of anti-epileptic drugs, side effects from anti-epileptic drugs, personal health questionnaire scores, and the health anxiety and depression scores (0.31 r 0.56; p < 0.001). The GASE scale did not, however, correlate strongly with type of seizure (r = 0.10, p > 005). Conclusions: The GASE scale was significantly correlated with most clinical aspects of epilepsy in this adult population. Our study results suggest that individuals with more self-perceived severe epilepsy endorse more depression symptoms, are on more medications, and consider their epilepsy more disabling. The GASE scale s brevity and its ease of implementation make it more appealing in busy clinical settings. Future research will investigate the reliability and responsiveness of this instrument in adult patients with epilepsy.