Abstracts

Rationale: Depression in epilepsy reduces quality of life,^1,2 and does so more strongly than seizure frequency.¹ In their investigation of various quality of life domains, Kobau et al.³ found that adults with epilepsy were more likely than others to report dissatisfaction in the life domain of social interactions. Moreover, studies suggest that social isolation and transportation restrictions compound depression in adults with epilepsy.^4,5,6 In light of these prior findings, we designed this study to better understand the problem of social isolation in people with epilepsy. More specifically, we wanted to explore the contributions of living and social situation, seizure activity, and depression on the feelings of isolation of people with epilepsy, and to determine their relative importance. Methods: The sample was 108 adults with physician-diagnosed epilepsy, with mild-to-moderate symptoms of depression, and without Major Depressive Disorder. Participants were part of a depression prevention study of adults with epilepsy. The analyses for the present study were based upon their cross-sectional baseline responses upon entry into the study. Validated measures of isolation (i.e., seeing oneself as apart from others and different) depressive symptoms, and seizure severity^7.8,9 were used, plus items regarding number of seizures in the past 4 weeks; days in the past 30 of poor physical health; whether or not one lived alone, was employed full- or part-time, or was partnered; age; and gender. The isolation subscale of the Self Compassion Scale⁴ was regressed upon the remaining variables combined, using multiple linear regression. Results: The model including all variables (Table 1) was significant (F_10,97 = 2.52, p = 0.010) and explained 20.6% of the variance in isolation scores. There was no collinearity among the variables. Within this model, the depressive symptoms variable was the only significant variable. Depressive symptoms were positively correlated with isolation and uniquely explained 15.2% of the variance in isolation. The second strongest correlate was being female, which uniquely explained only 1.4% of the variance and was not significant. Conclusions: Results of this study suggest that feelings of isolation among people with epilepsy are not associated with their social or living situation or the severity of their epilepsy. Instead, a large part of the isolation they experience is associated with their mood state, which may affect their perceptions about the impact of their disease. This is consistent with prior findings that depression is more strongly associated with quality of life among people with epilepsy than is seizure severity.¹ These results further underline the importance of developing and disseminating self-management programs that address mood state and depression in adults with epilepsy. Future research should investigate the impact of these self-management programs upon the experience of isolation among people with epilepsy.