Abstracts

Rationale: Patients with epilepsy experience not only disabling seizures, but also significant psychological and social problems in everyday life. The current study aims to describe QoL (Quality of Life) levels, psychiatric symptoms prevalence and perceived stigma levels in patients with drug-refractory focal epilepsy (DRE), or drug-sensitive epilepsy (DSE), or patients with DRE that underwent epilepsy surgery (DREES). Methods: We recruited 80 DRE, 31 DSE and 70 DREES. The following questionnaires were administered to all patients: a) QOLIE-31 (Cramer et. al 1998), an epilepsy-specific quality of life instrument; b) SCL-90 (Derogatis et al., 1976), to evaluate a broad range of psychological problems and c) the ESS (Dilorio et al., 2003) to assess how a person believes that epilepsy is perceived as negative and interferes with one's relationships with others. Results: The QoL in the three subgroups is significantly different (Kruskal-Wallis p=0.001). In particular, patients with DRE reported lower levels than both DREES and DSE (p<0.001 and p=0.01 respectively) and there are no significant differences between DREES and DSE (p=1). SCL-90 scores are significantly different in the three sub-groups as well (Kruskal-Wallis p=0,045). Post-hoc comparison shows a tendency of higher level of psychopathological symptoms in DRE compared to DSE and DREES. Also ESS is significantly different in the  three subgroups (Kruskal-Wallis p=0,029). Only DRE and DSE patients are significantly different (U-test p=0,026). DREES patients perceived stigma level is in between the two subgroups. Spearman correlations were performed‹ and strong significant negative correlations are found for SCL-90 Global Score and QoL Overall Score of QOLIE-31 (r= -.781; p<.001), suggesting that QoL levels decrease for patients reporting more severe psychiatric symptoms. Moderate significant positive correlations are found for SCL-90 Global Score and Perceived Stigma Global Score (r=.484; p<.001). Neurological outcome in patients surgically treated is not significantly associated to changes in any of the measures we performed. Conclusions: This cross-sectional study demonstrates that DREES patients, who were drug-resistant before surgery, are more similar to DSE than to DRE in terms of quality of life and prevalence of psychiatric symptoms while perceived stigma is in between the two subgroups. Our data provide further evidence that epilepsy surgery benefits goes beyond seizure control.BibliographyCramer et al.Epilepsia. 1998;39(1):81–88.Derogatis et al. Brit J Psychiatr. 1976;128(3):280–289.Dilorio et al. Epilepsy and Behavior. 4(3):259–267. Funding: We are grateful to the Paolo Zorzi Association for the Neurosciences for supporting our epilepsy surgery group.