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The association of mood with quality of life ratings in epilepsy

From the Department of Neurology (J.I.T., V.D., M.R.S., R.C., D.G.) and Jefferson Comprehensive Epilepsy Center (J.I.T., M.R.S., D.G.), Thomas Jefferson University Hospital, Philadelphia, PA.

Address correspondence and reprint requests to Dr. Joseph I. Tracy, Thomas Jefferson University/Jefferson Medical College, Jefferson Hospital for Neuroscience, 900 Walnut Street, Suite 206, Philadelphia, PA 19107; e-mail: joseph.i.tracy{at}jefferson.edu

Objective: To determine the relative contributions of psychological (mood and anxiety), social, and seizure-related variables to quality of life (QOL) scores in epilepsy.

Methods: Outpatients (n = 435) with epilepsy completed the Quality of Life in Epilepsy 31 Inventory (QOLIE-31), Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory, and a social survey. Stepwise linear regression and general linear model analyses determined the set of best predictors and the most unique predictors of composite QOLIE-31 score and subscale scores.

Results: A three-variable model accounted for 56% of the variance for the composite QOLIE-31 score. The BDI-II was the strongest (often by several multiples in terms of variance explained) and most consistent predictor of the composite and QOLIE subscales in both types of analytic approaches. In no case did BDI-II significantly interact with the other variables, suggesting that its effect on QOL was direct and not mediated by other factors. Throughout the results, depression had an inverse relation to scores, i.e., lower levels of depression correlated with high QOL scores. Separate correlational analyses showed that poor seizure control was associated with increased numbers of depressive symptoms.

Discussion: Quality of Life in Epilepsy (QOLIE) scores, reflecting both general and specific aspects of quality of life, are strongly influenced by mood state, such as depression. Factors such as seizure control exert a more limited effect on the QOLIE. Health-related quality of life measures are needed in which mood does not play such a dominant role.

Editorial, see page 1095

This article was previously published in electronic format as an Expedited E-Pub on September 20, 2006, at www.neurology.org.

Dr. Sperling is supported in part by grants NS4039601A1, HS09986-01, NS32375-06, and NS39466-01A1 from the NIH.

This work was presented in part at the American Academy of Neurology meeting in Denver, CO, in April 2002.

Disclosure: The authors report no conflicts of interest.

Received October 8, 2003. Accepted in final form July 7, 2006.

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