Abstracts

There is an extensive literature examining quality of life (QOL) among individuals with epilepsy. Some clinical seizure variables (eg, seizure frequency, age of onset, duration of epilepsy) have been shown to influence QOL. Psychiatric comorbidities (e.g., depression) are reliably and strongly associated with decreased QOL. Recent studies have documented high rates of medical comorbidities (e.g., hypertension, diabetes, cancer) among people with epilepsy compared to healthy controls, but their impact on QOL has yet to be examined. The purpose of this study was to determine the relationship between comorbidities (medical and psychiatric) and QOL in a sample of adults with temporal lobe epilepsy (TLE)., 93 adult patients with TLE were administered the QOLIE-89. Medical history was obtained through structured patient/collateral interviews and chart review. All subjects underwent the Structured Clinical Interview for DSM-IV which provided a current DSM-IV Axis I diagnosis. Correlation and regression analyses were performed to determine the contribution of clinical seizure variables and comorbid medical and psychiatric conditions to QOL., 49.5% (n = 46) of the TLE patients reported the presence of a medical comorbidity, psychiatric comorbidity, or both. 19 (20%) subjects had only a medical comorbidity, 16 (17%) subjects had only a current Axis I psychiatric comorbidity, and 12 (13%) subjects had both. An increased total number of comorbid conditions were significantly associated with poorer QOL. Regression analyses demonstrated that the total number of comorbidities ([szlig] = 3.79, t = 4.06, p [lt] .01) was the strongest predictor of overall QOL, followed by education ([szlig] = .95, t = 2.35, p = .02). Clinical seizure variables did not significantly predict QOL. In addition, a stepwise regression analysis showed that both psychiatric ([szlig] = 4.46, t = 2.68, t [lt] .01) and medical comorbidities ([szlig] = 2.97, t = 2.24, p = .03) were distinct and unique predictors of overall QOL., Consistent with previous reports, we found that comorbid medical and psychiatric conditions were common in patients with TLE. The total number of combined medical and psychiatric comorbid conditions significantly predicted QOL after accounting for basic demographic and clinical seizure variables. This is the first study to date to examine the impact of medical comorbidities on QOL in TLE. The high rates of medical comorbidity observed in this and other studies should alert clinicians to the potential significance of their impact on QOL., (Supported by: This project was funded by the Epilepsy Foundation.)