Abstracts

RATIONALE: Previous research has shown that psychiatric disorders are more common among patients with epilepsy. While the presence of psychiatric comorbidities may have treatment implications, the effect of psychological status on quality of life has not previously been examined in a systematic manner. METHODS: In a randomized, double-blind trial comparing the effects of LAMICTAL?(LTG) to DEPAKOTE?(VPA) on weight gain, QOL assessments (QOL in Epilepsy Inventory-89, QOLIE-89) and mood assessments (Profile of Mood States, POMS; Beck Depression Inventory, BDI; Cornell Dysthymia Rating Scale-Self Report, CDRS) were added as secondary measures at screening, week 10 and week 32. Patients were randomized 1:1 to LTG or VPA for an 8-week escalation phase, followed by a 24-week maintenance phase. Data from screening were used for this analysis. Spearman correlations of QOLIE-89 overall score with POMS total mood disturbance score, BDI, CDRS, seizure frequency and body weight were examined. Ordinary least squares regression was performed to estimate the effect of psychological status to quality of life while controlling for age, seizure frequency and body weight. RESULTS: QOLIE-89 was weakly correlated with seizure frequency (r=-0.31) and body weight (r=-0.01). However, correlations between QOLIE-89 and psychological status measures were higher (r=-0.64 for POMS, -0.64 for BDI and -0.60 for CDRS). All correlations between QOLIE-89 and psychological measures were statistically significant (p<0.05). Because the three psychological measures were highly correlated with each other (r >0.8), only POMS was included as a psychological measure in the regression model. Only POMS (?=-0.31, p=0.0001) and age (?=-0.42, p=0.0005) were significant predictors of quality of life. CONCLUSIONS: Results from this analysis confirms that psychological status is an important factor in determining the quality of life of epilepsy patients. In addition to seizure frequency and side effects, clinicians should consider psychological status as a valuable contributor to multiple facets of clinical decision making.