To what extent does depression in fl uence quality of life of people with pharmacoresistant epilepsy in Argentina?

Abstract

Depression is the most frequent psychiatric co-morbidity in patients with epilepsy. Lifetime prevalence of depression is reported more frequently in temporal lobe epilepsy and is estimated at 35%. This comorbidity appears to be related with various mechanisms. The aim of this study was to determine the qualityof life (QoL) of patients with pharmacoresistant epilepsy with and without co-morbid depression in an Argentinean population.Methods: Patients admitted to the video-EEG monitoring unit during the period 2010 ?2013 went through a standardized psychiatric assessment using SCID-I (Structured Clinical Interview for Axis I diagnoses of DSM-IV), BDI II(Beck Depression Inventory) GAF (Global assessment of functioning), and Q LES Q-SF (for quality of life). Patientswere divided in two groups: with and without depression (according to DSM-IV). Sociodemographic data, BDI IIscores, GAF, and quality of life (QoL) were compared between the two groups. Comparisons were made usingStudent´s t-test and Mann ?Whitney U test. Frequency distributions were compared by Chi-square test. Spearmancorrelation coefficients were determined.Results: Seventy-seven patients with pharmacoresistant epilepsy were eligible for this study, 41 patients wereincluded in the group with depression (mean BDI II 15.93), and 36 in the group without depression (mean BDIII 3.36) (p = 0.001). The overall QoL was signi ficantly lower in the group with depression compared tothe group without depression (p b 0.01). The most affected areas were: physical health (p = 0.013), mood(p = 0.006), course activities (referring to school as well as to hobbies or classes outside of school) (p =0.003), leisure time activities (p = 0.011), social activities (p = 0.047), general activities (p = 0.042), andmedication (p = 0.022). Severity of depression according to BDI II had a negative correlation with overall QoL(r - 0.339, p b 0.01). No correlations were found between seizure frequency, QoL and BDI II.Conclusion: Patients with pharmacoresistant epilepsy and co-morbid depression reported worst QoL. Depressiondisrupts daily functioning (leisure, social functioning) and is a negative influence for subjective perception of healthand medication. Interdisciplinary treatment should be considered (neurology?psychiatry?psychotherapy).