Association Of Depression And Anxiety On Treatment Adherence And Quality Of Life In Adult Patients With Epilepsy

ObjectiveThe aim of this study was to investigate the association of depression and anxiety on treatment adherence and quality of life in adult patients with epilepsy.MethodsAll the adult patients with epilepsy were randomly selected from the epilepsy clinic of the Second Affiliated Hospital, Zhejiang University School of Medicine between July,2014 and March,2015,2013. Patients meeting the inclusion and exclusion criteria were enrolled to undergo a clinical evaluation Demographic variables for age, gender, employment status, marital status, years of education, and seizure factors forage of onset, types of seizure, seizure frequency, epilepsy duration, species of antiepileptic drugs were also recorded The Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) were used to evaluate depression and anxiety. Self-reported adherence was measured by the MMAS-8. Quality of life in epilepsy (QOLIE-31) was used to evaluate quality of life of patients with epilepsy. The characteristics were compared by univariate and multivariate analysis in SPSS 18.0.Results1.163 patients were included in the study, the median age was 28 years old and the average age of onset was 21.5 years old.2.31(19.0%) patients were depressive; 41(25.2%) were anxious; 67(41.1%) had low treatment adherence; the total score of quality of life was 61.9, and the lowest score was on the aspect of seizure worry, only 44.5, secondly was medication effects, 45.6.3. Univariate and multivariate analysis showed that frequency of seizure and treatment affected depression. For those patients with anxiety, univariate analysis found duration of disease was significantly different between these patients; however, multivariate analysis found the onset of age was the independent risk factor for anxiety (P=0.047).4. Univariate analysis showed that gender, depression, anxiety affected the treatment adherence of patients. What’s more, depression (P=0.011) was an independent risk factor for treatment adherence.5. Multiple regression analysis found that occupation (P=0.008), frequency of seizure (P=0.017), depression (P< 0.001), anxiety (P< 0.001) were independent risk factors for the total score of quality of life. Furthermore, frequency of seizure, depression, anxiety affected all aspect of quality of life. Occupation was independent risk factor of overall quality of life, emotional well-being, energy/fatigue, cognitive, social function, but not seizure worry and medication effect.ConclusionTreatment adherence and quality of life of patients with epilepsy were affected by many factors. Depression was an independent risk factor for treatment adherence and quality of life. Anxiety was an independent risk factor for quality of life. Clinicians should pay more attention to the symptoms of depression and anxiety of patients with epilepsy. Screening for depression and anxiety might be necessary in all patients with epilepsy in standard clinical assessment and treatment of psychiatric comorbidity of epilepsy to optimize the treatment adherence and quality of life of these patients.