Abstracts

Rationale: Attitudes and perceptions about wellness have been proposed as a moderating factor in chronic medical conditions (Lancet. 2015;385(9968):640-648). Epilepsy is thought to be influenced by psychosocial factors (Epilepsy Res. 2009;86(1):1-14). However, attitudes toward wellness in patients with epilepsy have not been thoroughly investigated. We predicted that healthy attitudes and perceptions toward wellness would correlate positively with better seizure control.

Methods: We developed a 21-question survey to broadly measure attitudes and perceptions toward wellness in patients with epilepsy, incorporating items from the validated Perceived Wellness Survey (Am J Health Promot. 1997;11(3):208-218) with additional questions exploring perception of physical health. Patients were divided into groups based on the presence or absence of seizures in the preceding six months, and we predicted that patients who were seizure free would have a higher composite score on our survey.

Results: Thirty patients completed the survey; 40% had been seizure free for the preceding 6 months. Groups were similar with regard to age, BMI, and substance use, but differed predictably in the number of anti-seizure medications. We found that patients who were seizure free differed significantly in their composite score from those who were not (mean composite score, 4.05 vs. 3.81, p = 0.03). Sub-scale analysis suggests that this effect was driven primarily by trends in questions related to the constructs of social support and optimism.

Conclusions: These findings suggest that patients who are seizure free have more positive attitudes and perceptions toward wellness.  While correlational in nature, the significance of these findings is highlighted by increasing recognition of the bidirectional relationship between epilepsy and psychological factors (Ann Neurol. 2012;72(2):184-191). The present study is limited by its reliance on an unvalidated survey, but provides an important foundation for future research to refine measurement of attitudes and perceptions toward health and wellness in patients with epilepsy, and should serve as a basis for future research to explore these concepts prospectively, potentially leading to a therapeutic intervention to optimize wellness attitudes and perceptions with the goal of improving seizure outcomes.

Funding: None