Objectives

This study aims to evaluate the relationship between psychiatric comorbidity (anxiety and depression), somnolence, and quality of life, using validated scales in patients with epilepsy in real-life clinical practice and clinical and demographic variables.

Methods

A cross-sectional observational study was conducted. Self-administered scales of anxiety disorders (GAD-7), depression (NDDI-E), somnolence (Epworth Sleepiness Scale (ESS)), and quality of life (QOLIE-31-P) in patients with epilepsy treated in the refractory epilepsy unit of a tertiary hospital were employed.

Results

Eighty-four patients, 44.3 ± 17.4 years, 48.2% women, epilepsy duration 21.5 ± 15.9 years, and number of antiepileptic drugs 1.9 ± 1.2 were included. Severe anxiety was present in 14.3%, depression in 20.2%, and somnolence in 14.3% of patients. QOLIE-31-P score was 62.0 ± 19.2. Depression and focal epilepsy (OR = 4.5[1.3, 20.7], p = 0.029), as well as anxiety and temporal lobe epilepsy (OR = 4.3 [1.0, 18.1], p = 0.044), were associated. Moreover, relationships between worse quality of life and higher scores from NDDI-E (β = − 1.42, adjusted p = 0.006) and GAD-7 (β = − 1.21, adjusted p = 0.006), especially in drug-resistant epilepsy (β = − 8.08, adjusted p = 0.045) and female sex (β = − 7.83, adjusted p = 0.034), were identified. Statistically significant negative associations were observed between problems to fall asleep and overall quality of life score (β = − 11.64, adjusted p = 0.022), sleep disturbance and energy (β = − 14.78, adjusted p = 0.027), and mood (β = 12.40, adjusted p = 0.027) scores.

Conclusions

The multidimensional evaluation revealed that higher levels of anxiety and depression are associated with worse quality of life in real clinical practice in patients with epilepsy, especially in females and drug-resistant epilepsy. In addition, sleep disturbances are associated with particular aspects of the quality of life. Further studies with longitudinal follow-up would be useful to adequately manage these comorbidities in patients with epilepsy.

中文翻译：

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现实生活中在难治性癫痫病房就诊的癫痫患者的生活质量 (QOLIE-31-P)、抑郁 (NDDI-E)、焦虑 (GAD-7) 和失眠

目标

本研究旨在评估精神病合并症（焦虑和抑郁）、嗜睡和生活质量之间的关系，使用真实临床实践中癫痫患者的经过验证的量表以及临床和人口统计学变量。

方法

进行了一项横断面观察研究。难治性癫痫患者的焦虑症（GAD-7）、抑郁症（NDDI-E）、嗜睡（Epworth嗜睡量表（ESS））和生活质量（QOLIE-31-P）的自我管理量表受聘于三级医院单位。

结果

纳入 84 名患者，44.3 ± 17.4 岁，48.2% 为女性，癫痫病程 21.5 ± 15.9 年，抗癫痫药物数量为 1.9 ± 1.2。14.3% 的患者出现严重的焦虑，20.2% 的患者出现抑郁，14.3% 的患者出现嗜睡。QOLIE-31-P 评分为 62.0 ± 19.2。抑郁症和局灶性癫痫（OR  = 4.5[1.3, 20.7], p  = 0.029）以及焦虑和颞叶癫痫（OR  = 4.3 [1.0, 18.1], p  = 0.044）相关。此外，较差的生活质量与 NDDI-E ( β  = - 1.42, 调整后的p  = 0.006) 和 GAD-7 ( β  = - 1.21, 调整后的p = 0.006），特别是在耐药性癫痫（β  = - 8.08，调整后的p  = 0.045）和女性（β  = - 7.83，调整后的p  = 0.034）中被确定。在入睡问题与总体生活质量评分（β  = - 11.64，调整后的p  = 0.022）、睡眠障碍和精力（β  = - 14.78，调整后的p  = 0.027）和情绪（β  = 12.40，调整后的p  = 0.027) 分数。

结论

多维评估显示，在癫痫患者的实际临床实践中，较高水平的焦虑和抑郁与较差的生活质量相关，尤其是在女性和耐药性癫痫患者中。此外，睡眠障碍与生活质量的特定方面有关。进一步的纵向随访研究将有助于充分管理癫痫患者的这些合并症。