TY - JOUR
T1 - Mood, anxiety, and incomplete seizure control affect quality of life after epilepsy surgery
AU - Hamid, Hamada
AU - Blackmon, Karen
AU - Cong, Xiangyu
AU - Dziura, James
AU - Atlas, Lauren Y.
AU - Vickrey, Barbara G.
AU - Berg, Anne T.
AU - Bazil, Carl W.
AU - Langfitt, John T.
AU - Walczak, Thaddeus S.
AU - Sperling, Michael R.
AU - Shinnar, Shlomo
AU - Devinsky, Orrin
PY - 2014/3/11
Y1 - 2014/3/11
N2 - Objective: We examined the complex relationship between depression, anxiety, and seizure control and quality of life (QOL) outcomes after epilepsy surgery. Methods: Seven epilepsy centers enrolled 373 patients and completed a comprehensive diagnostic workup and psychiatric and follow-up QOL evaluation. Subjects were evaluated before surgery and then at 3, 6, 12, 24, 48, and 60months after surgery. Standardized assessments included the Quality of Life in Epilepsy Inventory-89, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). A mixed-model repeated-measures analysis was used to analyze associations of depression, anxiety, seizure outcome, and seizure history with overall QOL score and QOL subscores (cognitive distress, physical health, mental health, epilepsy-targeted) prospectively. Results: The groups with excellent and good seizure control showed a significant positive effect on the overall QOL compared to the groups with fair and poor seizure control. The BDI and BAI scores were both highly and negatively associated with overall QOL; increases in BDI and BAI scores were associated with decreased overall QOL score. Conclusions: Depression and anxiety are strongly and independently associated with worse QOL after epilepsy surgery. Interestingly, even partial seizure control, controlling for depression and anxiety levels, improved QOL. Management of mood and anxiety is a critical component to postsurgical care.
AB - Objective: We examined the complex relationship between depression, anxiety, and seizure control and quality of life (QOL) outcomes after epilepsy surgery. Methods: Seven epilepsy centers enrolled 373 patients and completed a comprehensive diagnostic workup and psychiatric and follow-up QOL evaluation. Subjects were evaluated before surgery and then at 3, 6, 12, 24, 48, and 60months after surgery. Standardized assessments included the Quality of Life in Epilepsy Inventory-89, Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). A mixed-model repeated-measures analysis was used to analyze associations of depression, anxiety, seizure outcome, and seizure history with overall QOL score and QOL subscores (cognitive distress, physical health, mental health, epilepsy-targeted) prospectively. Results: The groups with excellent and good seizure control showed a significant positive effect on the overall QOL compared to the groups with fair and poor seizure control. The BDI and BAI scores were both highly and negatively associated with overall QOL; increases in BDI and BAI scores were associated with decreased overall QOL score. Conclusions: Depression and anxiety are strongly and independently associated with worse QOL after epilepsy surgery. Interestingly, even partial seizure control, controlling for depression and anxiety levels, improved QOL. Management of mood and anxiety is a critical component to postsurgical care.
UR - http://www.scopus.com/inward/record.url?scp=84898741138&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000000183
DO - 10.1212/WNL.0000000000000183
M3 - Article
C2 - 24489129
AN - SCOPUS:84898741138
SN - 0028-3878
VL - 82
SP - 887
EP - 894
JO - Neurology
JF - Neurology
IS - 10
ER -
