Abstracts

Rationale: Several studies have verified the negative impact of epilepsy on quality of life (QOL) in patients with temporal lobe epilepsy (TLE). However, measures of QOL evaluate only the patient s personal and subjective perceptions about the disease. Despite growing evidence on the occurrence of poor psychosocial adjustment, to moment there is no formal assessment of social adjustment (SA) using a validated instrument developed and standardized for this purpose. Our first aim was to assess the SA of patients with TLE compared to results obtained by QOL scales. Secondly, we verified the influence of cognitive performance and clinical variables of epilepsy on SA and QOL. Methods: We evaluated 35 patients (15 men; mean 39.8 yrs (SD 9.0), with 9.1 yrs (SD 3.2) of schooling and an estimated IQ of 81.5 (SD 9.1)) compared to 38 controls (14 men; mean 28.6 yrs (SD 9.0) with 9.8 yrs (SD 2.3) of schooling and an estimated IQ of 94.2 (SD 8.0)). Assessment of QOL was done with Epilepsy Surgery Inventory-55 and Quality of Life in Epilepsy-31. Evaluation of SA was done with Social Adjustment Scale. All subjects underwent comprehensive neuropsychological evaluation and clinical variables of epilepsy were also considered. Statistical analysis was performed using SPSS software. The analysis of QOL was descriptive and in order to compare scores of SA, we used ANCOVA, controlled for age and estimated IQ. Neuropsychological performance was correlated with QOL and social adjustment with the correlation coefficient of Pearson or Spearman. This analysis was performed using Bonferroni correction (p<0.000). Analysis of the influence of clinical variables was performed using the Student t test or by analysis of variance. Results: Patients showed worse SA factors in work, leisure and global SA compared to controls. In the descriptive analysis, the most affected domains of QOL were fear of seizures and cognition. We also observed strong and significant correlations between SA and the following tests: Verbal Fluency, Logical Memory I and II, RAVLT-total after interference and delayed recovery, and RVDLT-total after interference, delayed recovery and recognition. There was no correlation between QOL and neuropsychological performance. Regarding clinical variables, patients with left MTS had worse SA scores. Conclusions: Social adjustment scale reflects more precisely the social insertion of patients with TLE than QOL questionnaires, since it objectively measures social adequacy of these patients in distinct domains. The lack of association between QOL and neuropsychological findings may indicate the imprecise nature of self-report scales. Clinical variables such as left TLE influenced SA, but not QOL, reinforcing the importance of distinguishing between these concepts. The association between social adjustment and cognitive performance emphasizes the importance of neuropsychological rehabilitation as part of the current concept of treating beyond seizures . Supported by CAPES.