Does psychiatric comorbidity influences quality of life and disability among subjects with refractory focal epilepsy- a comparative cross-sectional study

Authors

  • Vishnu Vipin Amrita Institute of Medical Sciences
  • Praveeen Arathil Amrita Institute of Medical Sciences

DOI:

https://doi.org/10.30834/KJP.34.2.2021.271

Keywords:

refractory epilepsy, psychiatric comorbidity, quality of life, disability

Abstract

Background: Refractory focal epilepsy is a disorder associated with a significant impact on quality of life and disability. Having comorbid psychiatric disorders among these subjects has been well documented. Recently studies have looked at how this impacts the quality of life and disability, but they are few in number. Methodology: Subjects were taken from the epilepsy clinic whom neurologist diagnosed as having refractory focal epilepsy. MINI International Neuropsychiatric Interview (MINI) was used to identify psychiatric comorbidity. Two groups of 25 subjects were made based on whether they had or did not have psychiatric comorbidities and further assessed with the World Health Organization Quality of Life (WHOQOL)-BREF for quality of life and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for disability. Results: Analysis of the two groups showed quality of life score lesser in the group with psychiatric comorbidities, which was significant (p<0.001). Similarly, the disability score was higher in the group with psychiatric comorbidities, which was significant (p<0.001).  The quality of life was lowest in major depressive disorder (60.80±8.47) and disability was highest in psychosis (105.33±1.53). Conclusion: Psychiatric comorbidities in subjects with refractory focal epilepsy significantly impact the quality of life and disability. It is essential to have a good team approach, and liaison between neurology and psychiatry for early detection and treatment of such symptoms will decrease healthcare costs and improve quality of life.

References

Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, Allen Hauser W, Mathern G, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010 Jun;51(6):1069–77.

Tripathi M, Padhy UP, Vibha D, Bhatia R, Padma Srivastava MV, Singh MB, Prasad K, Chandra SP. Predictors of refractory epilepsy in north India: a case-control study. Seizure. 2011 Dec;20(10):779-83

Jacob R, Tharyan P. Psychiatric Comorbidity and Quality of Life in People with Epilepsy, Ger J Psychiatry 2010(13):79-85.

Mazarati A, Sankar R. Common Mechanisms Underlying Epileptogenesis and the Comorbidities of Epilepsy. Cold Spring Harb Perspect Med. 2016 Jul 1;6(7):a022798

Silva, B., Moniz, E., Barahona-Corrêa B . 2 Psychiatric comorbidity and quality of life in drug-resistant epilepsy. J Neurol, Neurosurg Psychiatry, 2017, 88(8), A13.2–A13.

Murray, C. J. L., Vos, T, Lozano R, Naghavi M, Flaxman AD, Michaud C, Ezzati M, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet,2012, 380(9859), 2197–2223.

Sajobi TT, Jette N, Fiest KM, Patten SB, Engbers JD, Lowerison MW, Wiebe S. Correlates of disability related to seizures in persons with epilepsy, Epilepsia, 2015, 56(9):1463–9.

Ibinda F, Wagner RG, Bertram MY, Ngugi AK, Bauni E, Vos T, Sander JW, Newton CR. Burden of epilepsy in rural Kenya measured in disability-adjusted life years. Epilepsia. 2014 Oct;55(10):1626-33.

Sheehan DV, Harnett-Sheehan K, Raj BA. The measurement of disability. Int Clin Psychopharmacol, 1996 Jun;11:89.

Pearce JMS. Psychosocial factors in chronic disability. Med Sci Monit Int Med J Exp Clin Res. 2002 Dec;8(12): RA275-281.

Loughman A, Bendrups NA, D’Souza WA. A Systematic Review of Psychiatric and Psychosocial Comorbidities of Genetic Generalised Epilepsies (GGE). Neuropsychol Rev. 2016;26(4):364–75.

Kanner AM, Schachter SC, Barry JJ, Hesdorffer DC, Mula M, Trimble M, et al. depression and epilepsy: epidemiologic and neurobiologic perspectives that may explain their high comorbid occurrence. Epilepsy Behav EB. 2012 Jun;24(2):156–68.

Piazzini, A., Canevini, M. P., Maggiori, G., & Canger, R. Depression and Anxiety in Patients with Epilepsy. Epilepsy & Behav 2001, 2(5), 481–489.

Perini GI, Tosin C, Carraro C, Bernasconi G, Canevini MP, Canger R, Pellegrini A, Testa G. Interictal mood and personality disorders in temporal lobe epilepsy and juvenile myoclonic epilepsy. J Neurol Neurosurg Psychiatry. 1996 Dec;61(6):601-5.

Miller JM, Kustra RP, Vuong A, Hammer AE, Messenheimer JA. Depressive symptoms in epilepsy: prevalence, impact, aetiology, biological correlates and effect of treatment with antiepileptic drugs. Drugs. 2008;68(11):1493–509.

Scévola, L., Sarudiansky, M., Lanzillotti A, Oddo S, Kochen S, D'Alessio L. To what extent does depression influence quality of life of people with pharmacoresistant epilepsy in Argentina? Epilepsy & Behav,2017, 69, 133–138.

Üstün, T. B., Chatterji, S., Kostanjsek N, Rehm J, Kennedy C, Epping-Jordan J, et al. Developing the World Health Organization Disability Assessment Schedule 2.0. Bulletin of the World Health Organization,2010, 88(11), 815–823.

Anu M, Suresh K, Basavanna PL. A Cross-Sectional Study of Quality of Life among Subjects with Epilepsy Attending a Tertiary Care Hospital. J Clin Diagn Res. 2016;10(12): OC13–OC15.

Leiderman EA, Lolich M, Vázquez GH, Baldessarini RJ. Depression: point-prevalence and sociodemographic correlates in a Buenos Aires community sample. J Affect Disord. 2012 Feb;136(3):1154–8.

Dalmagro, C. L., Velasco, TR, Bianchin MM, Martins AP, Guarnieri R, Cescato MP, et al. Psychiatric comorbidity in refractory focal epilepsy: A study of 490 patients. Epilepsy & Behav,2012 25(4), 593–597.

Brodie MJ, Barry SJE, Bamagous GA, Norrie JD, Kwan P. Patterns of treatment response in newly diagnosed epilepsy. Neurology. 2012 May 15;78(20):1548–54.

Boro A, Haut S. Medical comorbidities in the treatment of epilepsy. Epilepsy Behav, 2003;4:2–12.

Gülpek, D., Bolat, E., Mete L, Arici S, Celebisoy M. Psychiatric comorbidity, quality of life and social support in epileptic patients. Nordi J Psychiat,2011, 65(6), 373–380.

Garcia ME, Garcia-Morales I, Gil-Nagel A. Prevalence of depressive symptoms and their impact on quality of life in patients with drug-resistant focal epilepsy (IMDYVA study). Epilepsy Res. 2015 Feb;110:157-65.

Wiebe S, Bellhouse DR, Fallahay C, Eliasziw M. Burden of epilepsy: The Ontario Health Survey. Can J Neurol Sci J Can Sci Neurol. 1999 Nov;26(4):263–70.

Ormel J, VonKorff M, Ustun TB, Pini S, Korten A, Oldehinkel T. Common mental disorders and disability across cultures. Results from the WHO Collaborative Study on Psychological Problems in General Health Care. JAMA. 1994 Dec 14;272(22):1741–8.

Ehrlich T, Reyes A, Paul BM, Uttarwar V, Hartman S, Mathur K, et al. Beyond depression: The impact of executive functioning on quality of life in patients with temporal lobe epilepsy. Epilepsy Res. 2019 Jan;149:30-36.

Antunes A, Frasquilho D, Azeredo-Lopes S, Neto D, Silva M, Cardoso G, Caldas-de-Almeida JM. Disability and common mental disorders: Results from the World Mental Health Survey Initiative Portugal. Eur Psychiatry J Assoc Eur Psychiatr. 2018; 49:56–61.

Lasebikan VO, Ayinde O. Profile and Determinants of Disability in Psychotic Disorders in Nigeria. Community Ment Health J. 2017;53(8):936–50.

Downloads

Published

2021-09-07

How to Cite

Vipin, V., and P. Arathil. “Does Psychiatric Comorbidity Influences Quality of Life and Disability Among Subjects With Refractory Focal Epilepsy- a Comparative Cross-Sectional Study”. Kerala Journal of Psychiatry, vol. 34, no. 2, Sept. 2021, pp. 96-104, doi:10.30834/KJP.34.2.2021.271.

Issue

Section

Research Report