Purpose

Locus of control (LOC) is the degree to which people believe that they have control over the outcome of events in their lives. A person's locus can be internal, external, or chance. A person with internal locus of control believes that one can control one's own life. A person with external locus of control believes that his life is controlled by external factors or people over which he has no influence. A person with chance locus of control believes that fate, chance, or luck controls his own life. The aim of the current study was to determine the health locus of control, anxiety, and depression levels in persons with epilepsy (PWE) and to assess whether locus of control has relation to anxiety, depression, and seizure control.

Methods

Patients aged 18 years or older with a history of epilepsy for at least 1 year were recruited from the outpatient epilepsy clinic or from the inpatient epilepsy monitoring unit at SCTIMST, Trivandrum from January 2019 to May 2020. Patients filled the questionnaire form consisting of demographic data, age of onset of seizures, present seizure control, and the current antiepileptic drugs. The Hospital Anxiety and Depression (HAD) scale was used to estimate the level of anxiety and depression in these patients. The Form-C of the Multidimensional Health Locus of Control (MHLC) scale was used to evaluate the health locus of control. Healthy controls aged 18 years or older and free of any chronic disease or psychiatric illness were also recruited. They were asked to fill the questionnaire forms with basic demographic data. HAD scale was used to estimate the level of anxiety and depression and form-C of MHLC was used to evaluate the health locus of control in the healthy controls. The mean scores of anxiety, depression, and locus of control were compared between the two groups.

Results

A total of 170 participants were recruited which consisted of 100 PWE and 70 healthy controls. The mean anxiety and depression scores were 8.13(SD = 4.23) and 5.85(SD = 3.66) in the PWE group and 6.75(SD = 3.39) and 4.14(SD = 2.96) in the control group, respectively. The mean internal, external, and chance LOC scores were 24.95(SD = 10.92), 26.94(SD = 4.96), and 24.41(SD = 6.46) in the PWE group; and 29.44(SD = 5.62), 26.53(SD = 5.79), and 19.9(SD = 7.13) in the control group, respectively.

Persons with epilepsy had higher chance LOC scores and lower internal LOC scores compared to controls (p = 0.00003, p < 0.00001 respectively). There were no differences in the external LOC scores between the two groups (p = 0.620). Persons with epilepsy with some level of anxiety had lower internal LOC scores compared to patients with no anxiety (p = 0.04). PWE with poor seizure control had higher external LOC score and lower internal LOC scores which however did not reach statistical significance. Persons with epilepsy with poor seizure control had higher anxiety and depression scores.

Conclusions

Persons with epilepsy had low perceptions of internal and strong perceptions of chance health locus of control. This means that PWE feel that luck plays an important role in their disease control. This information is important in the counseling of persons with epilepsy.

中文翻译：

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“控制点”如何影响癫痫患者？

目的

控制点 (LOC) 是人们相信他们可以控制生活中事件结果的程度。一个人的轨迹可以是内部的、外部的或偶然的。具有内部控制点的人相信一个人可以控制自己的生活。有外部控制点的人认为他的生活是由外部因素或他无法影响的人控制的。有机会控制点的人相信命运、机会或运气控制着自己的生活。本研究的目的是确定癫痫 (PWE) 患者的控制、焦虑和抑郁水平的健康轨迹，并评估控制轨迹是否与焦虑、抑郁和癫痫控制有关。

方法

2019 年 1 月至 2020 年 5 月在特里凡得琅 SCTIMST 的癫痫门诊或住院癫痫监测单位招募年龄 18 岁或以上且有至少 1 年癫痫病史的患者。 患者填写由人口统计数据组成的问卷表，癫痫发作的年龄，目前的癫痫控制，以及目前的抗癫痫药物。医院焦虑和抑郁（HAD）量表用于评估这些患者的焦虑和抑郁水平。多维健康控制点 (MHLC) 量表的 Form-C 用于评估健康控制点。还招募了 18 岁或以上且没有任何慢性疾病或精神疾病的健康对照。他们被要求用基本的人口统计数据填写问卷。HAD量表用于评估焦虑和抑郁水平，MHLC的形式-C用于评估健康对照的健康控制轨迹。比较两组的焦虑、抑郁和控制点的平均得分。

结果

总共招募了 170 名参与者，其中包括 100 名 PWE 和 70 名健康对照。PWE组的平均焦虑和抑郁评分分别为8.13（SD = 4.23）和5.85（SD = 3.66），对照组分别为6.75（SD = 3.39）和4.14（SD = 2.96）。PWE 组的平均内部、外部和机会 LOC 得分分别为 24.95（SD = 10.92）、26.94（SD = 4.96）和 24.41（SD = 6.46）；对照组分别为 29.44(SD = 5.62)、26.53(SD = 5.79) 和 19.9(SD = 7.13)。

与对照组相比，癫痫患者的机会 LOC 得分更高，内部 LOC 得分更低（ 分别为p  = 0.00003，p < 0.00001）。两组之间的外部 LOC 分数没有差异（p  = 0.620）。与没有焦虑的患者相比，患有某种程度焦虑的癫痫患者的内部 LOC 评分较低 ( p  = 0.04)。癫痫控制不佳的 PWE 具有较高的外部 LOC 评分和较低的内部 LOC 评分，但没有达到统计学意义。癫痫发作控制不佳的癫痫患者的焦虑和抑郁评分较高。

结论

癫痫患者对内在的认知度较低，而对机会健康控制点的认知度较高。这意味着 PWE 认为运气在他们的疾病控制中起着重要作用。这些信息对癫痫患者的咨询很重要。