Abstracts

Rationale: Validated disease specific health related quality of life(HRQoL) questionnaires give a picture of the adverse effects of epilepsy, but may not reflect a global picture of the patient s quality of life(QoL) or subjective well being(SWB). Comparison with other disease groups, and healthy controls is not possible. Methods: 149 consecutive men with epilepsy(MWE) were approached in clinic, 5 declined to take part. Questionnaires were also posted on the Epilepsy Action(British Epilepsy Association) website. Each man completed the HADS(Hospital Anxiety and Depression Scale), and the WHOQOL-Bref UK (WHO Brief Quality of life questionnaire), a 26 question instrument, developed and validated across the world . In addition to questions on global quality of life and health, it has four subscales, physical, psychological, social well being, and environmental. There is bank of UK control data for WHOQOL-Bref from over 1000 people in good health available, and over 1000 UK citizens with chronic diseases The study was approved by South East Scotland Research Ethics Committee.Results: 93(61%) men mean age 40.1 years(95%CI 37.6-42.6) approached in clinic returned completed questionnaires. 112 men, mean age 38.5 years(95%CI 36.5-40.5) completed questionnaires online. There were no significant differences in duration of epilepsy, epilepsy syndrome or other variables between the two groups.16.5% of the clinic group were one year seizure free at time of recruitment, and 22% of the online group(P>0.05). The two groups were combined for further analysis. There was no significant difference between the MWE and the UK normative data in how the MWE rated their overall QoL, but they rated their overall quality of health as significantly less good. 38% of MWE reported life 'very meaningful', 41% reported enjoying life 'very much'. Analysis of the WHOQOL-Bref subscales showed MWE had significantly poorer scores on psychological, physical, and social well being compared with a group of seven other chronic conditions, including diabetes, chronic skin diseases, and arthritis. Only patients with depression has lower WHOQOL-Bref subscale scores than MWE. Multiple linear regression showed HADS score and duration of epilepsy were the two most important independent variables influencing global quality of life and subscale scores. Conclusions: Studies show complete seizure control is the best way of ensuring good HRQoL and QoL in people with epilepsy. As a significant proportion of our patients continue to have seizures, new ways of improving QoL and SWB need to be examined. This study suggests treatment of anxiety/depression may improve QoL and SWB. Our results suggest focusing on the challenges of epilepsy has prevented us exploring what is enjoyable about our patients' lives. This is reflected in the structure of our epilepsy specific HRQoL questionnaires. This oversight denies us the opportunity to use positive psychology techniques as a way of helping patients deal with the challenges of epilepsy, and as an enabling strategy to allow them to live as full lives as possible.