HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Correspondence: View responses Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Boylan, L. S. Articles by Devinsky, O. Search for Related Content PubMed PubMed Citation Articles by Boylan, L. S. Articles by Devinsky, O.

Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy

From the New York University School of Medicine (Drs. Boylan and Devinsky, L.A. Flint, S.C. Jackson, and K. Starner), Bellevue Hospital Center (Dr. Boylan), New York University Comprehensive Epilepsy Center (Dr. Devinsky, S.C. Jackson and K. Starner), and St. Luke’s-Roosevelt Hospital Center (Dr. Labovitz), New York, NY.

Address correspondence and reprint requests to Dr. L.S. Boylan, Department of Neurology, New York University School of Medicine, 462 First Ave., New York, NY 10016; e-mail: laura.boylan{at}med.nyu.edu

Background: The two-thirds of patients with epilepsy who become seizure-free have a quality of life (QOL) similar to the general population. The major treatment challenge is patients with refractory epilepsy. Whereas neurologists typically focus on seizure reduction in the treatment of these patients, results of studies relating seizure frequency to QOL are conflicting. As depression is associated with reduced QOL in epilepsy and antiepileptic medications (AEDs) can cause depression, it is important to determine the relative roles of depression and seizure frequency in QOL in refractory epilepsy.

Methods: Prospective evaluation was conducted of patients with refractory epilepsy being admitted to an inpatient video-EEG monitoring unit. The impact of clinical variables (age, sex, marital status, seizure frequency, duration and type of seizure disorder, seizure localization, number of AEDs, depression) on QOL was analyzed.

Results: Depression was a powerful predictor of QOL (n = 122, ß = -35.8, p < 0.0001). No other variable predicted QOL. Depression was common (54%), severe (19% with suicidal thoughts), underdiagnosed (37%), and largely untreated (17% on antidepressants).

Conclusions: Treatment of depression may be inadequately prioritized in the management of intractable epilepsy.

Received May 20, 2003. Accepted in final form September 24, 2003.

This article has been cited by other articles:

				M. Mula and B. Schmitz Review: Depression in epilepsy: mechanisms and therapeutic approach Therapeutic Advances in Neurological Disorders, September 1, 2009; 2(5): 337 - 344. [Abstract] [PDF]

				B. G. Bokhour, M. J. Pugh, J. K. Rao, R. Avetisyan, D. R. Berlowitz, and L. E. Kazis Improving Methods for Measuring Quality of Care: A Patient-Centered Approach in Chronic Disease Med Care Res Rev, April 1, 2009; 66(2): 147 - 166. [Abstract] [PDF]

				M. J. V. Pugh, J. E. Zeber, L. A. Copeland, J. V. Tabares, and J. A. Cramer Psychiatric Disease Burden Profiles Among Veterans With Epilepsy: The Association With Health Services Utilization Psychiatr Serv, August 1, 2008; 59(8): 925 - 928. [Abstract] [Full Text] [PDF]

				M.J.V. Pugh, D. R. Berlowitz, G. Montouris, B. Bokhour, J. A. Cramer, V. Bohm, M. Bollinger, S. Helmers, A. Ettinger, K. J. Meador, et al. What constitutes high quality of care for adults with epilepsy? Neurology, November 20, 2007; 69(21): 2020 - 2027. [Abstract] [Full Text] [PDF]

				R. S Briellmann, M. J Hopwood, and G. D Jackson Major depression in temporal lobe epilepsy with hippocampal sclerosis: clinical and imaging correlates J. Neurol. Neurosurg. Psychiatry, November 1, 2007; 78(11): 1226 - 1230. [Abstract] [Full Text] [PDF]

				F. G. Gilliam, B. M. Maton, R. C. Martin, S. M. Sawrie, R. E. Faught, J. W. Hugg, M. Viikinsalo, and R. I. Kuzniecky Hippocampal 1H-MRSI correlates with severity of depression symptoms in temporal lobe epilepsy Neurology, January 30, 2007; 68(5): 364 - 368. [Abstract] [Full Text] [PDF]

				O. Devinsky, W. B. Barr, B. G. Vickrey, A. T. Berg, C. W. Bazil, S. V. Pacia, J. T. Langfitt, T. S. Walczak, M. R. Sperling, S. Shinnar, et al. Changes in depression and anxiety after resective surgery for epilepsy Neurology, December 13, 2005; 65(11): 1744 - 1749. [Abstract] [Full Text] [PDF]

				O. Devinsky Neurologist-induced sexual dysfunction: Enzyme-inducing antiepileptic drugs Neurology, October 11, 2005; 65(7): 980 - 981. [Full Text] [PDF]

				J. Hildebrand, C. Lecaille, J. Perennes, and J.-Y. Delattre Epileptic seizures during follow-up of patients treated for primary brain tumors Neurology, July 26, 2005; 65(2): 212 - 215. [Abstract] [Full Text] [PDF]

				S. Nadkarni, J. LaJoie, and O. Devinsky Current treatments of epilepsy Neurology, June 28, 2005; 64(12_suppl_3): S2 - S11. [Abstract] [Full Text] [PDF]

				F Ovsiew Antiepileptic drugs in psychiatry J. Neurol. Neurosurg. Psychiatry, December 1, 2004; 75(12): 1655 - 1661. [Full Text] [PDF]

				L. T. van Elst, M. R. Trimble, L. S. Boylan, D. L. Labovitz, L. A. Flint, and O. Devinsky Depression but not seizure frequency predicts quality of life in treatment-resistant epilepsy Neurology, September 14, 2004; 63(5): 942 - 943. [Full Text] [PDF]

Correspondence: