Abstracts

Rationale: Epilepsy exerts tremendous psychosocial burden on the patient and society. Studies have addressed the relationship between demographics, socioeconomic factors, and psychological comorbidity on quality of life in persons with epilepsy . However, less focus has been placed on how these factors may differ between patients who have varying levels of seizure control. This study, conducted using data from the Centers for Disease Control and Prevention’s Managing Epilepsy Well Network (MEW Network), aimed to elucidate differences in demographic factors, depression, and quality of life (QOL) between adult persons with epilepsy (PWE). Methods: This cross-sectional analysis used data from 481 adult PWE enrolled in 6 MEW Network epilepsy self-management studies. Quality of life was measured with the Quality of Life in Epilepsy for Adults scale (QOLIE-10). Depression was quantified with The Patient Health Questionnaire (PHQ-9). Variables of interest were compared between 3 seizure frequency categories operationalized along clinically relevant groups: PWE who were seizure-free within the past 30 days (SZF); those with fair seizure control who had 1-4 seizures over the past month (FC); and those with poor seizure control who had ≥ 5 seizures over the past month (PC). Chi-square tests were used to compare the categorical variables of gender, race, ethnicity, education, income, and relationship status. Continuous variables of age, PHQ-9 score, and QOLIE-10 score were compared between seizure frequency groups using ANOVA. Results: Participants were a mean age of 42.8 years (n=481; SD=13). Gender, ethnicity, race, education, income, and relationship status were not significantly different between PWE in SZF, FC, and PC groups. Patients with worse seizure control were younger (p < 0.039), significantly more depressed (p = 0.036) and had lower QOL (p < 0.001). Average age was 44.6 (SD: 13.7) in the SZF group, 42.7 (SD: 12.8) in the FC group, and 40 (SD: 11.8) in the PC group (p = 0.039). Average PHQ-9 scores were 7.6 (SD: 5.4) in the SZF group, 9.4 (SD: 6.4) in the FC group, and 9.8 (SD: 7.0) in the PC group. QOLIE-10 scores were 2.5 (SD: 0.8) in the SZF group, 3.1 (SD: 0.9) in the FC group, and 3.2 (0.7) in the PC group. Conclusions: Generally, demographic variables did not differ significantly between PWE who have varying levels of seizure control. The results of this study show evidence of significant differences in depression and QOL in PWE, with frequent seizures associated with increased severity of depression and lower QOL. Notably, PHQ-9 and QOLIE-10 scores for the FC and PC groups were similar but significantly different from the SZF group, suggesting that having any seizures over a 30 day period is associated with greater depression and poorer QOL in PWE.  This underscores the importance of achieving complete seizure freedom in the amelioration of depression and improvement of QOL in this patient population. Funding: Centers for Disease Control & Prevention (CDC 3U48DP001935-04S3) and the CDC's Managing Epilepsy Well Network.The MEW Network is funded by the Centers for Disease Control and Prevention (CDC) and is supported by special interest project SIP 14-006 and SIP 14-007. Cooperative Agreement Numbers are: 1U48DP005002 (Arizona), 1U48DP005018 (Geisel School of Medicine at Dartmouth), 1U48DP005010 (Illinois), 1U48DP005042 (Morehouse), U48DP005008 (New York University), 1U48DP005022 (Minnesota), 1U48DP005030 (Case Western Reserve), 148DP005013 (Washington).