Abstracts

Rationale: It is well established that people with epilepsy report poorer overall quality of life than their healthy peers. Although some studies have additionally shown QOL to be poorer in patients with generalized seizures relative to those with focal seizures, others have not found this pattern. We hypothesized that although overall quality of life might not consistently differ between people with generalized versus focal epilepsy, specific subcomponents of quality of life might distinguish the two groups. Using the QOLIE-89, we compared QOL subscale scores between generalized and focal (temporal lobe epilepsy "TLE") epilepsy patients. We also assessed the potential influence of mood on quality of life via standardized self-report mood evaluation. Methods: Subjects were 167 adult epilepsy patients (generalized: 36, TLE: 131, women: 150; mean age 39.4 (SD = 13.8); mean years education 15.1 (SD = 2.87)) referred for neuropsychological testing at the Columbia Comprehensive Epilepsy Center from 2003 to 2012 who completed QOLIE-89 for assessment of quality of life, and the SCL-90-R for assessment of mood. T-tests were used to compare groups. Results: Compared to the TLE group, patients with generalized epilepsy exhibited lower scores on the social support subscale (45.2 +/- 9.80 vs. 50.3 +/- 9.64, p = .008) of the QOLIE-89. However, there were no significant differences between groups on subscale scores of social functioning (48.2 +/- 10.9 vs. 46.3 +/- 11.7, p = .357), social isolation (48.2 +/- 8.38 vs. 50.6 +/- 9.48, p = .154), any other subscales, or in overall quality of life index scores (47.2 +/- 11.8 vs. 47.4 +/- 11.3, p = .920). Further, there were no differences between groups in self-reported mood (all subscale and index scores: P > .10). Conclusions: These results suggest that patients with generalized epilepsy experience reduced social support relative to patients with TLE. This finding did not extend to overall quality of life. More specifically, this was distinct from social functioning and feelings of social isolation, and appeared unrelated to mood. We speculate that this difference could potentially reflect generalized epilepsy patients' perception or experience of greater social stigma due to the dramatic nature of their events. The absence of group differences in social functioning and social isolation suggests similar self-perception of outward behavior between TLE and generalized epilepsy patients, yet different perceived responsiveness from others. Generalized epilepsy patients might benefit from clinicians' attention to issues regarding social support.