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Abstract：
BACKGROUND: Assessment of quality of life (QoL) has become an important indicator for chronic neurological diseases. While these conditions often limit personal independence and autonomy, they are also associated with treatment-related problems and reduced life expectancy. Epilepsy has a tremendous impact on the QoL of patients and their families, which is often underestimated by practitioners. The aim of this work was to identify relevant factors affecting QoL in adults with epilepsy.
METHODS: This cross-sectional, multicenter study was conducted at four specialized epilepsy centers in Germany. Patients diagnosed with epilepsy completed a standardized questionnaire focusing on QoL and aspects of healthcare in epilepsy. Univariate regression analyses and pairwise comparisons were performed to identify variables of decreased QoL represented by the overall Quality of Life in Epilepsy Inventory (QOLIE-31) score. The variables were then considered in a multivariate regression analysis after multicollinearity analysis.
RESULTS: Complete datasets for the QOLIE-31 were available for 476 patients (279 [58.6%] female, 197 [41.4%] male, mean age 40.3 years [range 18-83 years]). Multivariate regression analysis revealed significant associations between low QoL and a high score on the Liverpool Adverse Events Profile (LAEP; beta=-0.28, p < 0.001), Hospital Anxiety and Depression Scale - depression subscale (HADS-D; beta=-0.27, p < 0.001), Neurological Disorders Depression Inventory in Epilepsy (NDDI-E; beta=-0.19, p < 0.001), revised Epilepsy Stigma Scale (beta=-0.09, p = 0.027), or Seizure Worry Scale (beta=-0.18, p < 0.001) and high seizure frequency (beta = 0.14, p < 0.001).
CONCLUSIONS: Epilepsy patients had reduced QoL, with a variety of associated factors. In addition to disease severity, as measured by seizure frequency, the patient\'s tolerability of anti-seizure medications and the presence of depression, stigma, and worry about new seizures were strongly associated with poor QoL. Diagnosed comorbid depression was underrepresented in the cohort; therefore, therapeutic decisions should always consider individual psychobehavioral and disease-specific aspects. Signs of drug-related adverse events, depression, fear, or stigmatization should be actively sought to ensure that patients receive personalized and optimized treatment.
BACKGROUND: German Clinical Trials Register (DRKS00022024; Universal Trial Number: U1111-1252-5331).
METHODS: This cross-sectional, multicenter study was conducted at four specialized epilepsy centers in Germany. Patients diagnosed with epilepsy completed a standardized questionnaire focusing on QoL and aspects of healthcare in epilepsy. Univariate regression analyses and pairwise comparisons were performed to identify variables of decreased QoL represented by the overall Quality of Life in Epilepsy Inventory (QOLIE-31) score. The variables were then considered in a multivariate regression analysis after multicollinearity analysis.
RESULTS: Complete datasets for the QOLIE-31 were available for 476 patients (279 [58.6%] female, 197 [41.4%] male, mean age 40.3 years [range 18-83 years]). Multivariate regression analysis revealed significant associations between low QoL and a high score on the Liverpool Adverse Events Profile (LAEP; beta=-0.28, p < 0.001), Hospital Anxiety and Depression Scale - depression subscale (HADS-D; beta=-0.27, p < 0.001), Neurological Disorders Depression Inventory in Epilepsy (NDDI-E; beta=-0.19, p < 0.001), revised Epilepsy Stigma Scale (beta=-0.09, p = 0.027), or Seizure Worry Scale (beta=-0.18, p < 0.001) and high seizure frequency (beta = 0.14, p < 0.001).
CONCLUSIONS: Epilepsy patients had reduced QoL, with a variety of associated factors. In addition to disease severity, as measured by seizure frequency, the patient\'s tolerability of anti-seizure medications and the presence of depression, stigma, and worry about new seizures were strongly associated with poor QoL. Diagnosed comorbid depression was underrepresented in the cohort; therefore, therapeutic decisions should always consider individual psychobehavioral and disease-specific aspects. Signs of drug-related adverse events, depression, fear, or stigmatization should be actively sought to ensure that patients receive personalized and optimized treatment.
BACKGROUND: German Clinical Trials Register (DRKS00022024; Universal Trial Number: U1111-1252-5331).
摘要：
背景：生活质量（QoL）评估已成为慢性神经系统疾病的重要指标。虽然这些条件往往限制了个人的独立性和自主性，它们还与治疗相关的问题和预期寿命缩短有关。癫痫对患者及其家属的生活质量有巨大的影响,这往往被从业者低估了。这项工作的目的是确定影响成人癫痫患者QoL的相关因素。
方法：这个横截面，多中心研究在德国4个专门的癫痫中心进行.诊断为癫痫的患者填写了一份标准化的问卷，重点是QoL和癫痫的医疗保健方面。进行了单变量回归分析和成对比较，以确定癫痫量表（QOLIE-31）评分中总体生活质量所代表的QoL降低的变量。然后在多重共线性分析后的多元回归分析中考虑变量。
结果：476例患者（279[58.6％]女性，197[41.4%]男性，平均年龄40.3岁[范围18-83岁])。多变量回归分析显示，利物浦不良事件概况的低生活质量和高得分之间存在显著关联（LAEP；β=-0.28，p<0.001），医院焦虑和抑郁量表-抑郁分量表（HADS-D;β=-0.27，p<0.001），癫痫的神经系统疾病抑郁量表（NDDI-E；β=-0.19，p<0.001），修订后的癫痫病耻感量表（β=-0.09，p=0.027），或癫痫发作忧虑量表（β=-0.18，p<0.001）和高癫痫发作频率（β=0.14，p<0.001）。
结论：癫痫患者的QoL降低，与各种相关因素。除了疾病的严重程度，以癫痫发作频率衡量，患者对抗癫痫药物的耐受性和抑郁症的存在，污名,和担心新的癫痫发作与不良的QoL密切相关。确诊的共病抑郁症在队列中代表性不足；因此，治疗决策应始终考虑个体心理行为和疾病特异性方面.药物相关不良事件的迹象，抑郁症,恐惧,应积极寻求或污名化，以确保患者接受个性化和优化的治疗。
背景：德国临床试验注册（DRKS00022024；通用试验编号：U1111-1252-5331）。
方法：这个横截面，多中心研究在德国4个专门的癫痫中心进行.诊断为癫痫的患者填写了一份标准化的问卷，重点是QoL和癫痫的医疗保健方面。进行了单变量回归分析和成对比较，以确定癫痫量表（QOLIE-31）评分中总体生活质量所代表的QoL降低的变量。然后在多重共线性分析后的多元回归分析中考虑变量。
结果：476例患者（279[58.6％]女性，197[41.4%]男性，平均年龄40.3岁[范围18-83岁])。多变量回归分析显示，利物浦不良事件概况的低生活质量和高得分之间存在显著关联（LAEP；β=-0.28，p<0.001），医院焦虑和抑郁量表-抑郁分量表（HADS-D;β=-0.27，p<0.001），癫痫的神经系统疾病抑郁量表（NDDI-E；β=-0.19，p<0.001），修订后的癫痫病耻感量表（β=-0.09，p=0.027），或癫痫发作忧虑量表（β=-0.18，p<0.001）和高癫痫发作频率（β=0.14，p<0.001）。
结论：癫痫患者的QoL降低，与各种相关因素。除了疾病的严重程度，以癫痫发作频率衡量，患者对抗癫痫药物的耐受性和抑郁症的存在，污名,和担心新的癫痫发作与不良的QoL密切相关。确诊的共病抑郁症在队列中代表性不足；因此，治疗决策应始终考虑个体心理行为和疾病特异性方面.药物相关不良事件的迹象，抑郁症,恐惧,应积极寻求或污名化，以确保患者接受个性化和优化的治疗。
背景：德国临床试验注册（DRKS00022024；通用试验编号：U1111-1252-5331）。
