Abstracts

Research suggests that patients with epilepsy are at risk of negative psychosocial effects. This longitudinal study followed a cohort of First Seizure Clinic patients over 12 months to compare psychosocial outcomes of those patients diagnosed with seizures and those who were not. Following a suspected first seizure, adults with no known prior diagnosis of epilepsy were grouped into four broad diagnostic categories: provoked or single seizures (33.5%), epilepsy (35.5%), syncope (14.3%), or other (18.8%). Self-report questionnaires were completed at the first visit (n=245), 3 months (n=156), and 12 months (n=93). Measures included the Hospital Anxiety and Depression Scale (HADS), a perception of general health question, a satisfaction with treatment scale, and a perceived stigma scale. In 245 participants the mean age was 37 years (SD 16) and 65% were male. Anxiety and depression rates did not differ significantly between the four diagnostic groups. However, there was a strong relationship between mood and levels of perceived general health. Patients with the poorest perception of their general health had anxiety and depression levels significantly higher than patients with high levels of perceived general health at all time points (all p[lt]0.001, one way ANOVA). Satisfaction with treatment also did not vary between diagnostic groups, but was correlated with mood. Low treatment satisfaction was associated with high levels of anxiety and depression: 3 months (anxiety: r = .35, p[lt]0.001; depression: r = .29, p[lt]0.01); 12 months (anxiety: r = .27, p[lt]0.05, depression: r = .24, p[lt]0.05). There was no difference between the perceived stigma scores of the four diagnostic categories. However, perceived stigma was strongly correlated with anxiety and depression: baseline (anxiety: r = .60; depression: r = .52); 3 months (anxiety: r = .55; depression: r = .55); 12 months (anxiety: r = .47; depression: r= .43); (all p[lt]0.001). First Seizure Clinic patients diagnosed with seizures do not appear to be at higher risk of affective disturbances or perceived stigma in the first 12 months, than those who are not diagnosed with seizures. Mood is a stronger indicator of patient well-being than diagnosis and this needs to be considered in patient management. (Supported by Australian Research Council and the Epilepsy Foundation of Victoria.)