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Seizure Freedom Reduces Illness Intrusiveness and Improves Quality of Life in Epilepsy

Published online by Cambridge University Press:  02 December 2014

Sonia Poochikian-Sarkissian ,
Souraya Sidani ,
Richard Wennberg  and
Gerald M. Devins
Sonia Poochikian-Sarkissian
Affiliation:
The Divisions of Neurology, Krembil Neuroscience Program, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, ON, Canada School of Nursing, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, ON, Canada
Souraya Sidani
Affiliation:
School of Nursing, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, ON, Canada
Richard Wennberg
Affiliation:
The Divisions of Neurology, Krembil Neuroscience Program, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, ON, Canada
Gerald M. Devins
Affiliation:
Behavioural Sciences and Health, University of Toronto, University Health Network, Toronto Western Hospital, Toronto, ON, Canada
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Abstract

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Background:

Chronic illnesses are associated with multiple stressors that compromise quality of life (QOL). Implicit in many of these stressors is the concept of illness intrusiveness: the disruption of lifestyles, activities, and interests due to the constraints imposed by chronic disease and its treatment. The purpose of this study was to examine illness intrusiveness and QOL in epilepsy in patients with different levels of seizure control.

Methods:

Cross-sectional data were obtained and compared between two groups of patients categorized by presence of seizures: seizure freedom or continued seizures (N=145). Standard instruments measured the following variables: illness intrusiveness, perceived personal control, subjective well-being, and disease specific QOL.

Results:

Illness intrusiveness varied inversely and significantly with seizure control. Complete seizure freedom, whether achieved by pharmacological or surgical treatment, was associated with the lowest levels of illness intrusiveness. Seizure freedom was also associated with increased perceived control, positive affect, self-esteem and QOL in epilepsy.

Conclusions:

The most robust benefits of decreased illness intrusiveness in epilepsy occur when treatment leads to complete seizure control. Therefore every effort should be made by health care providers to achieve seizure freedom to reduce illness intrusiveness and improve QOL in epilepsy.

résumé:

<span class='bold'>RÉSUMÉ:</span> <span class='bold'> <span class='italic'>Contexte:</span></span>

: Les maladies chroniques sont associées à de multiples facteurs de stress qui compromettent la qualité de vie (QV). Le concept d’effet de perturbation de la maladie est implicite dans plusieurs de ces facteurs de stress : la perturbation du mode de vie, des activités et des intérèts à cause des contraintes imposées par une maladie chronique et son traitement. Le but de cette étude était d’examiner l’effet de perturbation de la maladie et la QV dans l’épilepsie chez des patients présentant différents niveaux de controle des crises.

<span class='bold'> <span class='italic'>Méthodes:</span></span>

Nous avons recueilli des données transversales et nous avons séparé les patients en deux groupes, selon la présence ou l’absence de crises (N = 145). Les variables suivantes ont été mesurées au moyen d’instruments standards : l’effet de perturbation du à la maladie, le controle personnel per9u par le patient, son bien-ètre et sa QV spécifique de la maladie.

<span class='bold'> <span class='italic'>Résultats:</span></span>

L’effet de perturbation de la maladie variait inversement et significativement selon le controle des crises. La disparition des crises, soit par un traitement pharmacologique ou chirurgical, était associée aux niveaux les plus bas d’effet de perturbation du à la maladie. La disparition des crises était également associée à une augmentation du controle per9u, l’affect positif, l’estime de soi et la QV dans l’épilepsie.

<span class='bold'> <span class='italic'>Conclusions:</span></span>

: Les bénéfices les plus robustes de la diminution de l’effet de perturbation du à la maladie dans l’épilepsie se retrouvent quand le traitement assure le controle complet des crises. Les professionnels de la santé devraient donc viser à faire disparaìtre les crises afin de diminuer l’effet de perturbation du à la maladie et d’améliorer la QV dans l’épilepsie.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 35 , Issue 3 , July 2008 , pp. 280 - 286
Copyright
Copyright © The Canadian Journal of Neurological 2008

References

1. Dodrill, CB, Batzel, LW, Queisser, HR, Temkin, NR. An objective method for the assessment of psychological and social problems among epileptics. Epilepsia. 1980; 21: 123–35.Google Scholar
2. Jacoby, A, Baker, GA, Steen, N, Potts, P, Chadwick, DW. The clinical course of epilepsy and its psychosocial correlates: findings from a UK community study. Epilepsia. 1996; 37: 148–61.Google Scholar
3. Hermann, BP, Whitman, S, Wyler, AR, Antin, MT, Vanderzwagg, R. Psychological predictors of psychopathology in epilepsy. Br J Psychiatry. 1990; 156: 98–105.Google Scholar
4. Baker, GA, Jacoby, A, Chadwick, DW. The associations of psychopathology in epilepsy: a community study. Epilepsy Res. 1996; 25: 29–39.Google Scholar
5. Gilliam, F. Optimizing health outcomes in active epilepsy. Neurology. 2002; 58 Suppl 5: S9–19.Google Scholar
6. Vickrey, BG, Hays, RD, Engel, J Jr, Spritzer, K, Rogers, WH, Rausch, R, et al. Outcome assessment for epilepsy surgery: the impact of measuring health-related quality of life. Ann Neurol. 1993; 37: 158–66.Google Scholar
7. Vickrey, BG, Hays, RD, Rausch, R, Engel, J Jr, Visscher, BR, Ary, CM, et al. Outcomes in 248 patients who had diagnostic evaluations for epilepsy surgery. Lancet. 1995; 346: 1445–9.Google Scholar
8. Wiebe, S, Blume, W, Girvin, JP, Eliasziw, M. A randomized, controlled trial of surgery for temporal-lobe epilepsy. New Eng J Med. 2001; 345: 311–18.Google Scholar
9. Leidy, NK, Elixhauser, A, Vickrey, B, Means, E, Willian, MK. Seizure frequency and the health-related quality of life of adults with epilepsy. Neurology. 1999; 53: 162–6.Google Scholar
10. Chadwick, D. Better comparisons of antiepileptic drugs: what measures of efficacy? Pharm World Sci. 1997; 19: 214–6.CrossRefGoogle ScholarPubMed
11. Birbeck, GL, Hays, RD, Cui, X, Vickrey, B. Seizure reduction and quality of life improvements in people with epilepsy. Epilepsia. 2002; 43: 535–8.Google Scholar
12. Engel, J Jr, Van Ness, PC, Rasmussen, TB, Ojemann, LM. Outcome with respect to epileptic seizures. In: Engel, J Jr, editor. Surgical treatment of epilepsies. New York: Raven Press; 1993. p. 609–21.Google ScholarPubMed
13. Spencer, DD, Inserni, J. Temporal lobectomy. In: Luders, HO, editor. Epilepsy surgery. New York: Raven Press; 1991. p. 533–45.Google Scholar
14. Taylor, DC, Falconer, MA. Clinical, socioeconomic, and psychological changes after temporal lobectomy for epilepsy. Br J Psychiatry. 1968; 114: 1247–61.Google Scholar
15. McLachlan, RS. The Canadian epilepsy database and registry. Can J Neurol Sci. 1998; 25 Suppl 4: S27–31.Google Scholar
16. Dodrill, CB, Batzel, LW, Fraser, R. Psychosocial changes after surgery for epilepsy. In: Luders, HO, editor. Epilepsy surgery. New York: Raven Press; 1991. p. 661–7.Google Scholar
17. Guldvog, B, Loyning, Y, Hauglie-Hassen, E, Flood, S, Bjornaes, H. Surgical versus medical treatment for epilepsy. Outcome related to survival, seizures, and neurologic deficit. Epilepsia. 1991; 32: 375–88.CrossRefGoogle ScholarPubMed
18. Rose, KJ, Derry, PA, McLachlan, RS. Patient expectations and postoperative depression, anxiety and psychosocial adjustment after temporal lobectomy: a prospective study. Int J Behav Med. 1997; 2: 27–40.CrossRefGoogle Scholar
19. Wass, CT, Rajala, MM, Hughes, JM, Sharbrough, FW, Offord, MS, Rademacher, DM, et al. Long-term follow-up of patients treated surgically for medically intractable epilepsy: results in 291 patients treated at Mayo Clinic Rochester between July 1972 and March 1985. Mayo Clinic Proc. 1996; 71: 1105–13.CrossRefGoogle Scholar
20. Bishop, M, Allen, C. The impact of epilepsy on quality of life: a qualitative analysis. Epilepsy Behav. 2003; 4: 226–33.CrossRefGoogle ScholarPubMed
21. Devins, GM, Binik, YM, Hutchinson, TA, Hollomby, DJ, Barre, PE, Guttmann, RD. The emotional impact of end-stage renal disease: importance of patients’ perceptions of intrusiveness and control. Int J Psychiatry Med. 1983; 13: 327–43.Google Scholar
22. Devins, GM. Illness intrusiveness and the psychosocial impact of lifestyle disruptions in chronic life-threatening disease. Adv Renal Replace Ther. 1994; 1: 251–63.Google Scholar
23. Devins, GM, Edworthy, SM, Seland, TP, Klein, GM, Paul, LC, Mandin, H. Differences in illness intrusiveness across rheumatoid arthritis, end-stage renal disease, and multiple sclerosis. J Nerv Ment Dis. 1993; 181: 377–81.Google Scholar
24. Devins, GM, Edworthy, SM, Guthrie, NG, Martin, L. Illness intrusiveness in rheumatoid arthritis: differential impact on depressive symptoms over the adult lifespan. J Rheumatol. 1992; 19: 709–15.Google Scholar
25. Devins, GM, Edworthy, SM. Illness intrusiveness explains race-related quality-of-life differences among women with systemic lupus eythematosus. Lupus. 2000; 9: 534–41.Google Scholar
26. Devins, GM, Armstrong, SJ, Mandin, H, Paul, LC, Hons, RB, Burgess, ED, et al. Recurrent pain, illness intrusiveness and quality of life in end-stage renal disease. Pain. 1990; 42: 279–85.Google Scholar
27. Devins, GM, Beanlands, H, Mandin, H, Paul, LC. Psychosocial impact of illness intrusiveness moderated by self-concept and age in end-stage renal disease. Health Psychol. 1997; 16: 529–38.Google Scholar
28. Bloom, JR, Stewart, SL, Johnston, M, Banks, P. Intrusiveness of illness and quality of life in young women with breast cancer. Psychooncology. 1998; 7: 89–100.Google Scholar
29. Antony, MM, Roth, D, Swinson, RP, Huta, V, Devins, GM. Illness intrusiveness in individuals with panic disorder, obsessive compulsive disorder or social phobia. J Nerv Ment Dis. 1998; 186: 311–5.Google Scholar
30. Robb, JC, Cooke, RG, Devins, GM, Young, LT, Joffe, RT. Quality of life and lifestyle disruption in euthymic bipolar disorder. J Psychiatr Res. 1997; 31: 509–17.Google Scholar
31. Binik, YM, Devins, GM. Transplant failure does not compromise quality of life in end-stage renal disease. Int J Psychiatry Med. 1986; 16: 281–92.Google Scholar
32. Littlefield, C, Abbey, S, Fiducia, D, Cardella, C, Greig, P, Levy, G, et al. Quality of life following transplantation of the heart, liver, and lungs. Gen Hosp Psychiatry. 1996; 18 Suppl 6: S36–47.Google Scholar
33. Devins, GM, Flanagan, M, Morehouse, R, Moscovitch, A, Plamondon, J, Reinish, L, et al. Differential illness intrusiveness associated with sleep-promoting medications. Eur Psychiatry. 1995; 10 Suppl: S153-9.Google Scholar
34. Poochikian-Sarkissian, S. Illness intrusiveness, quality of life and self-concept in epilepsy. Ph.D. Thesis, Toronto (ON): University of Toronto; 2005.Google Scholar
35. Gilliam, F, Kuzniecky, R, Meador, K. Patient-oriented outcome assessment after temporal lobectomy for refractory epilepsy. Neurology. 1999; 53: 687–94.Google Scholar
36. Lehrner, J, Kalchmay, R, Serles, W. Health-related quality of life, activity of daily living and depressive mood disorder intemporal lobe epilepsy patients. Seizure. 1999; 8: 88–92.Google Scholar
37. SPSS 7.0 Statistical algorithms [Computer Program Manual]. Chicago, (IL); 1996.Google Scholar
38. Cohen, J, Cohen, P. Applied multiple regression/correlation analysis for the behavioral sciences, 3rd ed. Mahwah: Lawrence Erlbaum Associates; 2003.Google Scholar
39. Flanagan, JC. A research approach to improving our quality of life. Am J Psychol. 1978; 33: 138–47.Google Scholar
40. McDowell, J, Newell, C. Measuring health: a guide to rating scales and questionnaires. Oxford University Press: New York; 1996.Google Scholar
41. Bradburn, NM. The structure of psychological well-being, 1st ed. Aldine: Chicago; 1969.Google Scholar
42. Atkinson, TA. The stability and validity of quality of life measures. Soc Indic Res. 1982; 10: 113–32.Google Scholar
43. Rosenberg, M. Conceiving the self. New York: Basic Books; 1979.Google Scholar
44. Robinson, JP, Shaver, PR, Wrightsman, LS. Measures of personality and psychological attitudes. San Diego: Academic Press; 1991.Google Scholar
45. Radloff, LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psych Measures. 1977; 3: 385–401.Google Scholar
46. Cramer, JA, Perrine, K, Devinsky, O, Meador, K. A brief questionnaire screen for quality of life in epilepsy: the QOLIE-10. Epilepsia. 1998; 37: 577–87.Google Scholar
47. Devinsky, O, Vickrey, BG, Cramer, J, Parrine, K, Hermann, B, Meador, K, et al. Development of the quality of life in epilepsy inventory. Epilepsia. 1995; 36: 1089–104.Google Scholar
48. Dodrill, CB, Breyer, DN, Diamond, MB, Dubinsky, BL, Geary, BB. Psychosocial problems among adults with epilepsy. Epilepsia. 1984; 25: 168–75.Google Scholar
49. Hermann, BP, Whitman, S. Behavioural and personality correlates of epilepsy: a review, methodological critique, and conceptual model. Psychol Bull. 1984; 95: 451–97.Google Scholar
50. Edworthy, SM, Dobkin, PL, Clarke, AE, Da Costa, D, Dritsa, M, Fortin, PR, et al. Group psychotherapy reduces illness intrusiveness in systemic lupus erythematosus. J Rheumatol. 2003; 30: 1011–6.Google Scholar
51. Devins, GM, Mendelssohn, DC, Barre, PE, Binik, YM. Predialysis psychoeducational intervention and coping styles influence time to dialysis in chronic kidney disease. Am J Kidney Dis. 2003; 42: 693–703.Google Scholar
52. Bodenheimer, T, Lorig, K, Holman, H, Grumbach, K. Patient self-management of chronic disease in primary care. JAMA. 2002; 288: 2469–75.CrossRefGoogle ScholarPubMed
53. Ware, JEJ, Sherbourne, CD. The MOS 36-item short-form health survey (SF-36) Conceptual framework and item selection. Med Care. 1992; 30: 473–83.Google Scholar
54. Kanner, AM, Balabanov, A. Depression in epilepsy: how closely related are these two disorders? Neurology. 2002; 58 Suppl 5: S27–39.Google Scholar
55. Brodie, MJ, Leach, JP. Success or failure with antiepileptic drug therapy: beyond empiricism? Neurology. 2003; 60: 162–3.Google Scholar