Abstracts

Mood and anxiety disorders are common in patients with epilepsy and many hypotheses have been proposed to understand the relationship between emotional dysfunction and seizures. Despite the recognition of this comorbidity, psychiatric disease remains under-recognized in neurology patients. This study was designed to identify the prevalence of depression and anxiety, as well as the co-existence of these symptoms, in patients with epilepsy and examine their impact and relative contribution on health related quality of life (QOL)., 110 consecutive patients in the University of Maryland Medical Center Epilepsy Outpatient Center and Inpatient Epilepsy Monitoring Unit (EMU) completed Beck Depression Inventory-II[reg] (BDI-II[reg]), Beck Anxiety Inventory[reg] (BAI[reg]) and Quality of Life in Epilepsy-31 (QOLIE-31) measures between December 1, 2005 and May 25, 2006. Patients who completed these questionnaires in the inpatient EMU did so on the day of admission before their medications were changed and prior to any seizure activity. Scores were calculated for each inventory and means were compared using standard t-test calculations., 109 patients completed the BAI and anxiety was noted to be severe in 9% of patients, moderate in 9%, mild in 26%, and minimal in 56% of patients. 98 patients completed the BDI and symptoms suggestive of depression were severe in 7% of patients, moderate in 12%, mild in 16% and minimal in 65%. 88 patients had complete BAI, BDI, and QOLIE-31 data for analysis. When anxiety and depression scores were independently compared with quality of life scores in 88 patients, it was found that lower levels of anxiety and depression were correlated with higher quality of life indices. The most significant reduction in quality of life was seen when comparing BAI and BDI scores between patient groups with minimal versus mild levels of depression and anxiety (table1) (p[lt]0.0001, 95% confidence interval).[table1], These findings are supportive of prior data which have noted increased prevalence of anxiety and depression in patients with epilepsy. The presence of even mild symptoms of anxiety and depression have a significant impact on quality of life. When the levels of anxiety and depression were simultaneously compared to QOLIE-31 scores, there was a more significant impact on QOL by depression levels than anxiety. These data also suggest the possibility that although more severe symptoms of depression and anxiety are associated with reduced QOL, that there may be a low threshold which is important with regard to the effect of depression and anxiety on quality of life in patients with epilepsy.,