The Control Study About Mental Health And Quality Of Life In Epilepsy: Between Patients And Spouses

ObjectivesTo investigate the psychologic status and quality of life(QOL) in epileptic patients and their supouses,and evaluate the difference and related factors,Material and methods1.145 patients with post-traumatic epilepsy(PTE) and 145 condition-matched controls with essential epilepsy(EE) were recruited in the study, attaching their spouses.2.By on-the-spot performance,study and control subjects were administered the psychologic and QOL test battery,including 5 standard clinical measuring scales in Chinese language---SCL-90,HAMD,HAMA,WHOQOL-BREF,and QOLIE-31.3.Methods of statistics:T test was employed to compare the item-scores between patient and spouse of PTE and EE.The influence of related factors was analyzed by T test and ANOVA,then the general influence of entire related factors were analyzed by means of multiple step-wise regression models.Person chi-square criterion was employed to compare the constituent ratio of depression and anxiety between patient and spouse of PTE and EE.Partial-correlation means were employed to evaluate the dependability between SCL-90 and WHOQOL-BREF/QOLIE-31.Results1.The scores of SCL-90:Every item-score was significantly higher than the China norm in both patient and spouse of PTE and EE,and the major item-scores of PTE were significantly higher than EE.The scores of PTE patient were significantly higher than spouse in Obsessive-Compulsive(O-C),Hostility(HOS), and Paranoid Ideation(PAR),but lower in Somatization(SOM),Interpersonal Sensitivity(I-S),Depression(DEP),Anxiety(ANX),and Phobic Anxiety(PHOB). The scores of spouse in EE group were significantly higher than patient in SOM, O-C,I-S,DEP,ANX,and Psychoticism(PSY).The PTE patient's scores were significantly higher than EE in SOM,I-S,DEP,ANX,PHOB,and PAR.2.HAMA/HAMD:In both groups,the possible-depression constituent ratios of spouse were higher than patient,but the significant difference was none.The positive-anxiety constituent ratio of spouse was significantly higher than patient in both groups.3.WHOQOL-BREF:The scores of overall QOL(G1),PSYCH(Domain2), SOCIL(Domain3),and ENVIR(Domain4) in spouses of both groups were significantly lower than PET and EE patients.However,the scores of PET and EE patients in overall health(G4) and PHYS(Domain1) were higher than spouses. The scores of PTE patients were lower significantly than EE patients in G4, Domain1,Domain2,Domain3,and Domain4.4.QOLIE-31:The scores of PTE patients were lower significantly than EE patients in seizure worry(F1),life satisfaction(F2),emotional well-being(F3), energy/fatigue(F4),social function(F7) and overall score(F8).5.All of the SCL-90 item-scores in both patients and spouses were negatively associated with WHOQOL-BREF and QOLIE-31.In both groups,The DEP and ANX item-scores were significantly correlated with the entire fields of WHOQOL-BREF and QOLIE-31,while other item-scores were correlated with the partial fields of QOL scales significantly.6.The analysis of single related factor:In patient of both groups,the seizure category,the seizure frequency,the disease course,the quantity of AED,the educational background,the occupation type,and the economic condition,were associated with the psychologic status and quality of life,besides the PTE and EE spouses' educational background,occupation type,and economic condition.7.The analysis of multiple step-wise regression models:The most valuable related factors were the seizure frequency in patients,and the economic condition in spouses.Conclusions1.Compared with general person the patients and spouses in epilepsy showed various severe psychologic obstacles,and the obstacles of PTE patients and their spouses were severer than EE.2.The QOL of PTE patients were worse than EE,and the QOL of spouses in both groups were better than patients in G1 and PHYS,and worse in G4,PSYCH, SOCIL,ENVIR.3.The psychologic obstacles are negatively associated with QOL in patients and spouses.4.All the factors of disease and society in this study were associated with the psychologic status and QOL in epileptic patients,while the same social factors in their spouses.