Abstracts

Rationale: Quality of Life (QOL) is increasingly seen as a relevant indicator of outcomes in the treatment of chronic illness. Studies have shown that QOL in people with epilepsy is worse compared to people with chronic illnesses for example, asthma and diabetes. But the actual determinants of this poor QOL are rather poorly understood. This study of people with epilepsy who were admitted to video EEG monitoring (VEM) unit aimed to determine the predictors of QOL. Methods: Patients who underwent VEM unit at the Royal Melbourne Hospital since 2005 were invited to participate in the study. Participants were asked to complete the Quality of Life in Epilepsy Inventory (QOLIE-89), the psychiatric Symptom Checklist-90-Revised (SCL-90-R), and the Hospital Anxiety and Depression Scale (HADS) questionnaires. QOLIE-89 is a measure of QOL and SCL-90-R and HADS are well-validated tools for assessment of psychiatric well-being. Final diagnosis of epilepsy syndrome was made by a general consensus of three epileptologists based on clinical history, neuroimaging, and the VEM findings. Results: The subgroups compared were focal epilepsy (n=69) and primary generalised epilepsy (n=20). Focal epilepsy group comprised of temporal lobe epilepsy (n=49) and extra-temporal lobe epilepsy (n=20). There were no significant differences in overall quality of life and the level of psychological distress between any of the subgroups of epilepsy. On multiple logistic regression, the measures of psychological distress and seizure frequency were better predictors of QOL (all p<0.05) than the type of epilepsy syndrome. Conclusions: In this cohort of people with epilepsy admitted to VEM, psychological well-being and seizure frequency were significant predictors of QOL. In contrast, QOL was not dependent on the type of epilepsy. This study indicates that besides improving seizure control, addressing the psychiatric distress is an essential part of improving QOL in patients with epilepsy.