Psychosocial effects and evaluation of the quality of life in patients,
suffering from epilepsy

Mental Health Examination and the Nottingham Health Profile

Introduction: The majority of patients with epilepsy (E) are diagnosed in childhood, being obliged to receive daily antiepileptic medication for a long time. Two common events, such as the overdose and the life-long duration of the antiepileptic medication administered can have a remarkable impact on the psychologigal health of patients suffering from epilepsy. Studies already published in the medical literature come up to the conclusion that the fear and stress induced by the disease, the limitation of daily physical activities and the social stigma of a person that suffers from E were rated by patients as the major factors that devaluate their quality of life (QOL).

Aim: This study was set out in order to record the impact of the disease on the psychological health of patients suffering from E. Recording and evaluating those factors that influences the QOL of those patients were also attempted.

Patients and Method: Overall 21 outpatients, 16 men and 5 women, aged from 30 to 50 years old with a definite diagnosis of (E), manifesting seizures from 2, 3 up to several times (>6-10) per year were evaluated. The patients were divided in two subgroups. The first one consisted of 15 patients experiencing simple or complex partial seizures and the second subgroup consisted of 6 patients manifesting generalized seizures with no secondary generalization. All the patients were asked to answer a questionnaire based on the Hamilton and Mandr's depression scales, the Mini Mental Health Examination and the Nottingham Health Profile.

Results: No medium or severe degree of stress and depression was found in the patients of both subgroups. According to the two depression and anxiery scales used, a milder degree of stress and depression was diagnosed in the patients of the first subgroup as compared to those of the second one. Patients belonging in the second subgroup reported a more serious deterioration of their QOL as compared to the patients of the first subgroup. That fact was mainly related to the post diagnostic alteration of their socio-economic status. The social stigma, the fear of seizure manifestation at work or during a social event led the 4/6 (66,6%) of the patients manifesting generalized seizures to social and professional isolation as well as to limitation of their activities and ambitions. The combination of the above factors brought about a clear devaluation of their QOL.

Conclusons-Discussion: In order to determine factors that influence the QOL of patients with E and then to compare our findings with the results of previous published studies we studied 21 outpatients with epilepsy.

Previous studies indicate that the etiology, the frequency of seizures and the medication side effects are factors strictly related as well with the deterioration of QOL of epileptic patients. In our study, despite the small number of the sample evaluated, we concluded that the type and the time duration of the seizures manifested have a direct impact on the psychological health of patients suffering from E.

Despite the fact that none of our patients manifested medium or severe degree of stress and depression, the influence on their QOL was visible, while remarkable devaluation was only observed in the case of patients belonging to the second subgroup. Based on the reports of the latter subgroup of patients, this difference could mainly relate to the consequent significant alteration of the socio-economic situation of patients of this subgroup as compared to the period prior to the diagnosis of the illness.

In brief, we suggest that successful medical and psychological support can relieve the burden of patients suffering from epilepsy as well as their family's burden. The ideal model of care of E stresses collaboration among patients, families, neurologists, mental health professionals and community resources.

Key words: Psychological consequences, Quality of life, Epilepsy.