Abstracts

Rationale: It has been well documented that persons with epilepsy have lower quality of life (QOL) than the general population. It is important to establish factors that may be associated with QOL in persons with epilepsy, as they may also have implications for disease management. Methods: Persons with epilepsy from the only epilepsy clinic in a city of 1.2 million people completed a number of questionnaires, including the Patient Health Questionnaire (PHQ)-9, Hospital Anxiety and Depression Scale (HADS), and the Short Form (SF-12) to assess physical and mental QOL. The medical charts of all participants were reviewed to determine their epilepsy syndrome and etiology, and seizure frequency. Participants were considered depressed if they had a score of 10 or greater on the PHQ-9. Higher scores on the SF-12 indicate better QOL, with a maximum score on this scale being 100. T-tests and linear regression analyses were performed to assess mean differences on the SF-12. The level of statistical significance was set at p=.05. Results: The total number of participants with complete data on QOL was 172. The mean age of participants at study onset was 40.5 years (range 18.2-78.1) and 50.6% of participants were female. Epilepsy etiologies were as follows: 38.4% unknown, 35.5% structural/metabolic and 26.2% presumed genetic. The majority of participants had focal epilepsy (69.8%) - the remainder had either generalized epilepsy (25.6%) or unknown epilepsy (2.9%). The mean score on the mental subscale of the SF-12 was 37.1 (range 15.8-51.4) and on the physical subscale was 49.1 (range 22.4-59.5). Age was significantly associated with both mental and physical QOL: mean mental QOL scores increased with age (p=0.016), while mean physical QOL scores decreased with age (p=0.045). Participants who were depressed had significantly lower mental (p<.001) and physical (p = .003) QOL than those who were not depressed. Mental QOL was lower among those who reported symptoms of anxiety (p<.001), though physical QOL did not differ (p=.127). Those who were in a relationship has higher mental QOL (p=.028). Current smokers had lower physical QOL (p < .001) and illicit drug users had lower mental QOL (p=.013). The following variables were not associated with either physical or mental QOL: sex, epilepsy severity, seizure disability, antiseizure medication side-effects, education level, working status and current alcohol consumption. Conclusions: A number of factors are associated with both physical and mental QOL in persons with epilepsy, including age, depression, anxiety and smoking. These may be important factors that could be targeted for intervention efforts to improve QOL and other important epilepsy outcomes.