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Seizure Freedom Reduces Illness Intrusiveness and Improves Quality of Life in Epilepsy

  • Sonia Poochikian-Sarkissian (a1) (a2), Souraya Sidani (a2), Richard Wennberg (a1) and Gerald M. Devins (a3)

Abstract

Background:

Chronic illnesses are associated with multiple stressors that compromise quality of life (QOL). Implicit in many of these stressors is the concept of illness intrusiveness: the disruption of lifestyles, activities, and interests due to the constraints imposed by chronic disease and its treatment. The purpose of this study was to examine illness intrusiveness and QOL in epilepsy in patients with different levels of seizure control.

Methods:

Cross-sectional data were obtained and compared between two groups of patients categorized by presence of seizures: seizure freedom or continued seizures (N=145). Standard instruments measured the following variables: illness intrusiveness, perceived personal control, subjective well-being, and disease specific QOL.

Results:

Illness intrusiveness varied inversely and significantly with seizure control. Complete seizure freedom, whether achieved by pharmacological or surgical treatment, was associated with the lowest levels of illness intrusiveness. Seizure freedom was also associated with increased perceived control, positive affect, self-esteem and QOL in epilepsy.

Conclusions:

The most robust benefits of decreased illness intrusiveness in epilepsy occur when treatment leads to complete seizure control. Therefore every effort should be made by health care providers to achieve seizure freedom to reduce illness intrusiveness and improve QOL in epilepsy.

<span class='bold'>RÉSUMÉ:</span> <span class='bold'> <span class='italic'>Contexte:</span> </span>

: Les maladies chroniques sont associées à de multiples facteurs de stress qui compromettent la qualité de vie (QV). Le concept d’effet de perturbation de la maladie est implicite dans plusieurs de ces facteurs de stress : la perturbation du mode de vie, des activités et des intérèts à cause des contraintes imposées par une maladie chronique et son traitement. Le but de cette étude était d’examiner l’effet de perturbation de la maladie et la QV dans l’épilepsie chez des patients présentant différents niveaux de controle des crises.

<span class='bold'> <span class='italic'>Méthodes:</span> </span>

Nous avons recueilli des données transversales et nous avons séparé les patients en deux groupes, selon la présence ou l’absence de crises (N = 145). Les variables suivantes ont été mesurées au moyen d’instruments standards : l’effet de perturbation du à la maladie, le controle personnel per9u par le patient, son bien-ètre et sa QV spécifique de la maladie.

<span class='bold'> <span class='italic'>Résultats:</span> </span>

L’effet de perturbation de la maladie variait inversement et significativement selon le controle des crises. La disparition des crises, soit par un traitement pharmacologique ou chirurgical, était associée aux niveaux les plus bas d’effet de perturbation du à la maladie. La disparition des crises était également associée à une augmentation du controle per9u, l’affect positif, l’estime de soi et la QV dans l’épilepsie.

<span class='bold'> <span class='italic'>Conclusions:</span> </span>

: Les bénéfices les plus robustes de la diminution de l’effet de perturbation du à la maladie dans l’épilepsie se retrouvent quand le traitement assure le controle complet des crises. Les professionnels de la santé devraient donc viser à faire disparaìtre les crises afin de diminuer l’effet de perturbation du à la maladie et d’améliorer la QV dans l’épilepsie.

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References

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1. Dodrill, CB, Batzel, LW, Queisser, HR, Temkin, NR. An objective method for the assessment of psychological and social problems among epileptics. Epilepsia. 1980; 21: 12335.
2. Jacoby, A, Baker, GA, Steen, N, Potts, P, Chadwick, DW. The clinical course of epilepsy and its psychosocial correlates: findings from a UK community study. Epilepsia. 1996; 37: 14861.
3. Hermann, BP, Whitman, S, Wyler, AR, Antin, MT, Vanderzwagg, R. Psychological predictors of psychopathology in epilepsy. Br J Psychiatry. 1990; 156: 98105.
4. Baker, GA, Jacoby, A, Chadwick, DW. The associations of psychopathology in epilepsy: a community study. Epilepsy Res. 1996; 25: 2939.
5. Gilliam, F. Optimizing health outcomes in active epilepsy. Neurology. 2002; 58 Suppl 5: S919.
6. Vickrey, BG, Hays, RD, Engel, J Jr, Spritzer, K, Rogers, WH, Rausch, R, et al. Outcome assessment for epilepsy surgery: the impact of measuring health-related quality of life. Ann Neurol. 1993; 37: 15866.
7. Vickrey, BG, Hays, RD, Rausch, R, Engel, J Jr, Visscher, BR, Ary, CM, et al. Outcomes in 248 patients who had diagnostic evaluations for epilepsy surgery. Lancet. 1995; 346: 14459.
8. Wiebe, S, Blume, W, Girvin, JP, Eliasziw, M. A randomized, controlled trial of surgery for temporal-lobe epilepsy. New Eng J Med. 2001; 345: 31118.
9. Leidy, NK, Elixhauser, A, Vickrey, B, Means, E, Willian, MK. Seizure frequency and the health-related quality of life of adults with epilepsy. Neurology. 1999; 53: 1626.
10. Chadwick, D. Better comparisons of antiepileptic drugs: what measures of efficacy? Pharm World Sci. 1997; 19: 2146.
11. Birbeck, GL, Hays, RD, Cui, X, Vickrey, B. Seizure reduction and quality of life improvements in people with epilepsy. Epilepsia. 2002; 43: 5358.
12. Engel, J Jr, Van Ness, PC, Rasmussen, TB, Ojemann, LM. Outcome with respect to epileptic seizures. In: Engel, J Jr, editor. Surgical treatment of epilepsies. New York: Raven Press; 1993. p. 60921.
13. Spencer, DD, Inserni, J. Temporal lobectomy. In: Luders, HO, editor. Epilepsy surgery. New York: Raven Press; 1991. p. 53345.
14. Taylor, DC, Falconer, MA. Clinical, socioeconomic, and psychological changes after temporal lobectomy for epilepsy. Br J Psychiatry. 1968; 114: 124761.
15. McLachlan, RS. The Canadian epilepsy database and registry. Can J Neurol Sci. 1998; 25 Suppl 4: S2731.
16. Dodrill, CB, Batzel, LW, Fraser, R. Psychosocial changes after surgery for epilepsy. In: Luders, HO, editor. Epilepsy surgery. New York: Raven Press; 1991. p. 6617.
17. Guldvog, B, Loyning, Y, Hauglie-Hassen, E, Flood, S, Bjornaes, H. Surgical versus medical treatment for epilepsy. Outcome related to survival, seizures, and neurologic deficit. Epilepsia. 1991; 32: 37588.
18. Rose, KJ, Derry, PA, McLachlan, RS. Patient expectations and postoperative depression, anxiety and psychosocial adjustment after temporal lobectomy: a prospective study. Int J Behav Med. 1997; 2: 2740.
19. Wass, CT, Rajala, MM, Hughes, JM, Sharbrough, FW, Offord, MS, Rademacher, DM, et al. Long-term follow-up of patients treated surgically for medically intractable epilepsy: results in 291 patients treated at Mayo Clinic Rochester between July 1972 and March 1985. Mayo Clinic Proc. 1996; 71: 110513.
20. Bishop, M, Allen, C. The impact of epilepsy on quality of life: a qualitative analysis. Epilepsy Behav. 2003; 4: 22633.
21. Devins, GM, Binik, YM, Hutchinson, TA, Hollomby, DJ, Barre, PE, Guttmann, RD. The emotional impact of end-stage renal disease: importance of patients’ perceptions of intrusiveness and control. Int J Psychiatry Med. 1983; 13: 32743.
22. Devins, GM. Illness intrusiveness and the psychosocial impact of lifestyle disruptions in chronic life-threatening disease. Adv Renal Replace Ther. 1994; 1: 25163.
23. Devins, GM, Edworthy, SM, Seland, TP, Klein, GM, Paul, LC, Mandin, H. Differences in illness intrusiveness across rheumatoid arthritis, end-stage renal disease, and multiple sclerosis. J Nerv Ment Dis. 1993; 181: 37781.
24. Devins, GM, Edworthy, SM, Guthrie, NG, Martin, L. Illness intrusiveness in rheumatoid arthritis: differential impact on depressive symptoms over the adult lifespan. J Rheumatol. 1992; 19: 70915.
25. Devins, GM, Edworthy, SM. Illness intrusiveness explains race-related quality-of-life differences among women with systemic lupus eythematosus. Lupus. 2000; 9: 53441.
26. Devins, GM, Armstrong, SJ, Mandin, H, Paul, LC, Hons, RB, Burgess, ED, et al. Recurrent pain, illness intrusiveness and quality of life in end-stage renal disease. Pain. 1990; 42: 27985.
27. Devins, GM, Beanlands, H, Mandin, H, Paul, LC. Psychosocial impact of illness intrusiveness moderated by self-concept and age in end-stage renal disease. Health Psychol. 1997; 16: 52938.
28. Bloom, JR, Stewart, SL, Johnston, M, Banks, P. Intrusiveness of illness and quality of life in young women with breast cancer. Psychooncology. 1998; 7: 89100.
29. Antony, MM, Roth, D, Swinson, RP, Huta, V, Devins, GM. Illness intrusiveness in individuals with panic disorder, obsessive compulsive disorder or social phobia. J Nerv Ment Dis. 1998; 186: 3115.
30. Robb, JC, Cooke, RG, Devins, GM, Young, LT, Joffe, RT. Quality of life and lifestyle disruption in euthymic bipolar disorder. J Psychiatr Res. 1997; 31: 50917.
31. Binik, YM, Devins, GM. Transplant failure does not compromise quality of life in end-stage renal disease. Int J Psychiatry Med. 1986; 16: 28192.
32. Littlefield, C, Abbey, S, Fiducia, D, Cardella, C, Greig, P, Levy, G, et al. Quality of life following transplantation of the heart, liver, and lungs. Gen Hosp Psychiatry. 1996; 18 Suppl 6: S3647.
33. Devins, GM, Flanagan, M, Morehouse, R, Moscovitch, A, Plamondon, J, Reinish, L, et al. Differential illness intrusiveness associated with sleep-promoting medications. Eur Psychiatry. 1995; 10 Suppl: S153-9.
34. Poochikian-Sarkissian, S. Illness intrusiveness, quality of life and self-concept in epilepsy. Ph.D. Thesis, Toronto (ON): University of Toronto; 2005.
35. Gilliam, F, Kuzniecky, R, Meador, K. Patient-oriented outcome assessment after temporal lobectomy for refractory epilepsy. Neurology. 1999; 53: 68794.
36. Lehrner, J, Kalchmay, R, Serles, W. Health-related quality of life, activity of daily living and depressive mood disorder intemporal lobe epilepsy patients. Seizure. 1999; 8: 8892.
37. SPSS 7.0 Statistical algorithms [Computer Program Manual]. Chicago, (IL); 1996.
38. Cohen, J, Cohen, P. Applied multiple regression/correlation analysis for the behavioral sciences, 3rd ed. Mahwah: Lawrence Erlbaum Associates; 2003.
39. Flanagan, JC. A research approach to improving our quality of life. Am J Psychol. 1978; 33: 13847.
40. McDowell, J, Newell, C. Measuring health: a guide to rating scales and questionnaires. Oxford University Press: New York; 1996.
41. Bradburn, NM. The structure of psychological well-being, 1st ed. Aldine: Chicago; 1969.
42. Atkinson, TA. The stability and validity of quality of life measures. Soc Indic Res. 1982; 10: 11332.
43. Rosenberg, M. Conceiving the self. New York: Basic Books; 1979.
44. Robinson, JP, Shaver, PR, Wrightsman, LS. Measures of personality and psychological attitudes. San Diego: Academic Press; 1991.
45. Radloff, LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psych Measures. 1977; 3: 385401.
46. Cramer, JA, Perrine, K, Devinsky, O, Meador, K. A brief questionnaire screen for quality of life in epilepsy: the QOLIE-10. Epilepsia. 1998; 37: 57787.
47. Devinsky, O, Vickrey, BG, Cramer, J, Parrine, K, Hermann, B, Meador, K, et al. Development of the quality of life in epilepsy inventory. Epilepsia. 1995; 36: 1089104.
48. Dodrill, CB, Breyer, DN, Diamond, MB, Dubinsky, BL, Geary, BB. Psychosocial problems among adults with epilepsy. Epilepsia. 1984; 25: 16875.
49. Hermann, BP, Whitman, S. Behavioural and personality correlates of epilepsy: a review, methodological critique, and conceptual model. Psychol Bull. 1984; 95: 45197.
50. Edworthy, SM, Dobkin, PL, Clarke, AE, Da Costa, D, Dritsa, M, Fortin, PR, et al. Group psychotherapy reduces illness intrusiveness in systemic lupus erythematosus. J Rheumatol. 2003; 30: 10116.
51. Devins, GM, Mendelssohn, DC, Barre, PE, Binik, YM. Predialysis psychoeducational intervention and coping styles influence time to dialysis in chronic kidney disease. Am J Kidney Dis. 2003; 42: 693703.
52. Bodenheimer, T, Lorig, K, Holman, H, Grumbach, K. Patient self-management of chronic disease in primary care. JAMA. 2002; 288: 246975.
53. Ware, JEJ, Sherbourne, CD. The MOS 36-item short-form health survey (SF-36) Conceptual framework and item selection. Med Care. 1992; 30: 47383.
54. Kanner, AM, Balabanov, A. Depression in epilepsy: how closely related are these two disorders? Neurology. 2002; 58 Suppl 5: S2739.
55. Brodie, MJ, Leach, JP. Success or failure with antiepileptic drug therapy: beyond empiricism? Neurology. 2003; 60: 1623.

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