Often times, living with epilepsy means not only wading through seizures, various drug treatments and side effects, but other medical and psychiatric condition as well. Some of the most frequent medical conditions such as asthma, migraine, and heart disease, to name a few, are two to five times more likely to occur in adults with epilepsy. So, how do epilepsy and comorbid medical and psychiatric conditions impact the quality of life of people with these disorders? A new study examined quality of life as reported by patients with temporal lobe epilepsy and comorbid medical and psychiatric conditions and sheds light on this question (1).

Study Design

93 patients with temporal lobe epilepsy (TLE) were recruited from the Neurology Department of the University of Wisconsin Hospital as part of a larger NIH funded study examining the neurobehavioral features of TLE. Researchers gave each patient the QOLIE-89, a questionnaire designed to measure health-related quality of life for adults with epilepsy. Patients were also asked to participate in a structured interview to obtain information about the presence/absence and type of current comorbid medical conditions. During the structured interview patients were asked open-ended questions specifically focused on eight disease categories including: cerebrovascular disease, kidney disease, liver disease, endocrine disorder, asthma/respiratory disease, rheumatoid arthritis, cancer and migraine/headache. In order to asses psychiatric comorbidity researchers administered the Structured Clinical Interview for DSM-IV.

Results

“Consistent with previous literature, we found that comorbid medical and psychiatric conditions are common in patients with chronic TLE”, said Dalin T. Pulsipher, third-year doctoral student of Clinical Psychology at Rosalind Franklin University of Medicine and Science and lead author of the study. “More importantly, both the number of medical conditions and psychiatric conditions exerted an independent effect on quality of life.”  In other words, the higher the number of co-morbid medical and/or psychiatric conditions a person with epilepsy has, the higher the likelihood of reporting more dissatisfaction with their quality of their life.

Improving the Doctor-Patient Relationship

“What we know based on previous research is that doctor-patient interactions in epilepsy treatment are often focused narrowly on seizure control”, Pulsipher said. “The main issue is the limited amount of time doctors and patients have to address the most pressing problem in treating epilepsy which in many cases is seizure control. However, our study highlights the need for more concentrated efforts on the part of doctors to address the other medical and psychiatric conditions so prevalent in patients with epilepsy.” 

To learn more about the patient-doctor relationship and strategies for getting the most out of your next visit go to:

• http://www.epilepsy.com/articles/ar_1063754534.html
• http://www.epilepsy.com/epilepsy/team_10common.html
• http://www.epilepsy.com/epilepsy/team_visit.html

To learn more about quality of life and epilepsy go to:

• http://www.epilepsy.com/epilepsy/quality_of_life.html

Reference

1. Pulsipher D.T. , Seidenberg M., Jones J, Hermann B. Quality of life and comorbid medical and psychiatric conditions in temporal lobe epilepsy. Epilepsy Behav2006; in press.