Depression and symptoms affect quality of life in psychogenic nonepileptic seizures

Abstract

Background: In patients with active epilepsy, adverse medication effects and severity of depression are correlated with health-related quality of life, but seizure frequency is not. We sought to examine if the same pattern exists in patients with psychogenic nonepileptic seizures (PNES).

Methods: We administered seizure calendars, quality of life (QOL) scales, depression scales, and symptom checklists to 49 patients with video EEG-confirmed PNES. Data analysis consisted of performing Pearson correlation coefficients, scatter plots, and t tests.

Results: Depression and symptom scores significantly increased as health-related QOL scores decreased (partial correlation coefficient r = -0.73 for both comparisons), whereas seizure count was nonsignificant (partial correlation coefficient r = -0.19).

Conclusions: As is seen in epilepsy, patients with psychogenic nonepileptic seizures demonstrate that higher depressive symptoms and somatic symptoms are independently related to worsening quality of life (QOL); however, seizure frequency is not. Seizure frequency is an important focus in patient care and treatment trials. The findings underscore the importance of, along with seizure counts, also examining QOL, depression, and somatic symptoms in patients with seizures.

Figures

Figure 1 Scatterplot of the correlation of health-related quality of life (Quality of Life in Epilepsy–31 [QOLIE-31]) with somatic symptoms (Symptom Checklist–90 [SCL-90]) (r = −0.73, p = 0.0001) QOLIE-31: the higher the score, the better the perceived quality of life. SCL-90: the higher the score, the worse the number of reported symptoms.

Figure 2 Scatterplot of the correlation of health-related quality of life (Quality of Life in Epilepsy–31 [QOLIE-31]) with depression scale scores (Beck Depression Inventory–II [BDI-II]) (r = −0.73, p = 0.0001) QOLIE-31: the higher the score, the better the perceived quality of life. BDI-II: the higher the score, the worse the number of reported depressive symptoms.

Figure 3 Scatterplot of the correlation of health-related quality of life (Quality of Life in Epilepsy [QOLIE-31]) with seizure count (r = −0.19, p = 0.21) QOLIE-31: the higher the score, the better the perceived quality of life.