Purpose

To assess quality of life (QoL) in adult people with epilepsy (PWE) and identify the main factors affecting it.

Methods

We enrolled consecutively 122 PWE. They were interviewed for a careful collection of demographic and clinical data. Patients completed dedicated questionnaires for the assessment of the quality of life (Quality of Life in Epilepsy Scale-31) (Q31) as well as psychosocial features: depressive symptoms (DS) (Beck Depression Inventory-II/BDI-II), difficulties of emotion regulation (Difficulties of Emotion Regulation Scale/DERS), and stigma related to epilepsy (Stigma Scale of Epilepsy/SSE and Jacoby’s Stigma Scale/JSS). The results of Q31 and their subscales were correlated with clinical details of PWE, as well as the other scores. A stepwise multiple regression analysis was applied to identify the main factors affecting QoL.

Results

Quality of life is inversely correlated mostly with psychosocial features, as DS, emotion dysregulation, and stigma perception, as well as with epilepsy-related factors, as the seizure frequency and number of antiseizure medications (ASMs). The combination of DS, perceived stigma, and number of ASMs best explained the QoL. Worse features of QoL were detected in females and in patients with age of epilepsy onset in adulthood.

Conclusion

Quality of life in adult PWE is predominantly affected by psychosocial factors more than epilepsy-related ones. These findings suggest that effective epilepsy management requires more than seizure control, and early detection of psychological dysfunction and tailored interventions to improve the QoL should be considered.

中文翻译：

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癫痫病和生活质量：真正重要的是什么？

目的

评估成人癫痫病（PWE）的生活质量（QoL），并确定影响其的主要因素。

方法

我们已经连续注册了122 PWE。他们接受了采访，以仔细收集人口统计和临床数据。患者完成了专门的问卷调查，以评估生活质量（癫痫量表-31）（Q31）以及社会心理特征：抑郁症状（DS）（贝克抑郁量表-II / BDI-II），困难情绪调节（情绪调节量表/ DERS的困难）和与癫痫相关的柱头（癫痫的柱头量表/ SSE和雅可比的柱头量表/ JSS）。Q31及其子量表的结果与PWE的临床细节以及其他得分相关。应用逐步多元回归分析来确定影响生活质量的主要因素。

结果

生活质量主要与心理社会特征（如DS，情绪失调和柱头感）以及癫痫相关因素（如癫痫发作频率和抗癫痫药物（ASM））成反比。DS，感知的污名和ASM数量的组合最能说明QoL。在女性和成年癫痫发作年龄患者中发现了较差的生活质量特征。

结论

成年PWE的生活质量受癫痫相关因素的影响最大的是受社会心理因素的影响。这些发现表明，有效的癫痫治疗不仅需要控制癫痫发作，还应考虑早期发现心理功能障碍和采取有针对性的干预措施以改善生活质量。