TY - JOUR
T1 - Determinants of disease severity in adults with epilepsy
T2 - Results from the Neurological Diseases and Depression Study
AU - Sajobi, Tolulope T.
AU - Jette, Nathalie
AU - Zhang, Yukun
AU - Patten, Scott B.
AU - Fiest, Kirsten M.
AU - Engbers, Jordan D.T.
AU - Lowerison, Mark W.
AU - Wiebe, Samuel
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Background: Epilepsy severity has been recognized as a significant predictor of health-related quality of life in patients with epilepsy. However, clinical markers of epilepsy severity such as seizure frequency often fail to capture important aspects of the disease. This study investigates the factors associated with patient-reported severity of epilepsy, assessed by the Global Assessment of Severity of Epilepsy (GASE) scale in adults with epilepsy. Methods: Data from a cohort of 250 patients consecutively enrolled in the Neurological Diseases and Depression Study (NEEDS) were used to assess the determinants of epilepsy severity as measured by the GASE scale. Multiple linear regression analyses were used to examine the mediation effect of clinical and sociodemographic characteristics on patients' ratings on the GASE scale. Results: The mean age of the study participants was 39.8 (SD. = 14.9) years, of which 44.4% were male. About 66.8% of the participants reported "not at all severe" or "a little severe" epilepsy, while 0.4% reported "extremely severe" epilepsy. One-year seizure freedom, number of antiseizure medications, medication side effects, depression, anxiety, and seizure-related disability were identified as significant determinants of patients' ratings of epilepsy severity. Seizure-related disability mediated the effects of 1-year seizure freedom, number of antiseizure medications, and medication side effects on epilepsy severity. Conclusion: Overall, patients with epilepsy who reported higher GASE scores were less likely to achieve 1-year seizure freedom and more likely to be on more antiseizure medications, experience more side effects from medication, endorse more depression and anxiety symptoms, and have increased self-reported seizure-related disability. The identified determinants of global, self-rated epilepsy severity can aid the design of appropriate interventions and support services for patients with severe epilepsy.
AB - Background: Epilepsy severity has been recognized as a significant predictor of health-related quality of life in patients with epilepsy. However, clinical markers of epilepsy severity such as seizure frequency often fail to capture important aspects of the disease. This study investigates the factors associated with patient-reported severity of epilepsy, assessed by the Global Assessment of Severity of Epilepsy (GASE) scale in adults with epilepsy. Methods: Data from a cohort of 250 patients consecutively enrolled in the Neurological Diseases and Depression Study (NEEDS) were used to assess the determinants of epilepsy severity as measured by the GASE scale. Multiple linear regression analyses were used to examine the mediation effect of clinical and sociodemographic characteristics on patients' ratings on the GASE scale. Results: The mean age of the study participants was 39.8 (SD. = 14.9) years, of which 44.4% were male. About 66.8% of the participants reported "not at all severe" or "a little severe" epilepsy, while 0.4% reported "extremely severe" epilepsy. One-year seizure freedom, number of antiseizure medications, medication side effects, depression, anxiety, and seizure-related disability were identified as significant determinants of patients' ratings of epilepsy severity. Seizure-related disability mediated the effects of 1-year seizure freedom, number of antiseizure medications, and medication side effects on epilepsy severity. Conclusion: Overall, patients with epilepsy who reported higher GASE scores were less likely to achieve 1-year seizure freedom and more likely to be on more antiseizure medications, experience more side effects from medication, endorse more depression and anxiety symptoms, and have increased self-reported seizure-related disability. The identified determinants of global, self-rated epilepsy severity can aid the design of appropriate interventions and support services for patients with severe epilepsy.
KW - Depression and anxiety
KW - Epilepsy severity
KW - Global Assessment of Severity of Epilepsy
KW - Patient-reported outcomes
KW - Seizure-related disability
UR - http://www.scopus.com/inward/record.url?scp=84939549969&partnerID=8YFLogxK
U2 - 10.1016/j.yebeh.2015.07.036
DO - 10.1016/j.yebeh.2015.07.036
M3 - Article
C2 - 26287469
AN - SCOPUS:84939549969
SN - 1525-5050
VL - 51
SP - 170
EP - 175
JO - Epilepsy and Behavior
JF - Epilepsy and Behavior
ER -