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Purpose: To compare the prevalence of self-reported serious psychological distress using the Kessler 6 (K6) in persons with a history of epilepsy (PWE) to those without epilepsy from a population-based survey., Methods: Data were analyzed from adults aged >or=18 years (n = 43,020) who participated in the 2005 California Health Interview Survey (CHIS)., Results: California adults with a history of epilepsy, after controlling for demographics and comorbidities, reported higher rates of feeling nervous [odds ratio (OR) 2.22], feeling hopeless (OR 1.35), feeling restless (OR 2.07), feeling depressed (OR 3.14), and feeling worthless (OR 2.57), and reported that everything has been an effort (OR 2.28) in the last 30 days. The K6 score showed that serious psychological distress is more common in PWE (OR 2.24). After adjusting for demographics, comorbidities, and serious psychological distress, PWE are more likely to report having 14 or more physical, mental, and general unhealthy days in the last 30 days., Discussion: PWE have significantly higher rates of serious psychological distress and poor health-related quality of life after controlling for demographics, comorbidities. These comorbid conditions need to be factored into any comprehensive treatment strategy for managing PWE to achieve optimum quality of life.

Summary: The clinical literature suggests epilepsy may impact quality of life in males and females differently. Previous research on gender issues has focused primarily on biological–biomedical factors over psychological and social factors. In this study we compare subjective and objective quality of life in adults persons with epilepsy to persons without epilepsy by gender using the biopsychosocial model in the Canadian Community Health Survey (CCHS), a large epidemiological survey that covers 98% of the Canadian population. Logistic regression analyses were conducted using self-rated health status and the Health Utility Index® 3 (HUI3) as the outcomes. Quality of life was significantly moderated after controlling for the biological–biomedical variables in all analyses except the HUI3. Males with epilepsy were more likely to have HUI3 scores of 0.70 or greater than males without epilepsy (OR=1.61, 95%CI 1.32–1.96). For males with epilepsy the HUI3 was further moderated, but remained significantly better in the final model that controlled for biological, psychological and social factors (OR=1.43, 95%CI 1.17–1.76). Our findings provide support for treatment approaches that focus on the whole person. Such approaches should take into account gender differences when examining objective quality of life. [ABSTRACT FROM AUTHOR]

Summary Although seizure control is a critical goal for persons with epilepsy (PWE) from the biomedical perspective, there is growing support for approaches that take into account the effect of epilepsy on the whole person (the biopsychosocial perspective). We hypothesized that PWE who report normal activity limitations due to epilepsy and poor social/emotional support would report poor mental health regardless of whether they report having seizures in the past 3 months or currently taking medication for their epilepsy. In 2005 and 2006, twenty-two states asked about epilepsy in the Behavioral Risk Factor Surveillance System (BRFSS). A set of survey weight-adjusted logistic regression analyses were conducted to examine self-reported poor mental health. Our findings reveal that both normal activity limitations due to epilepsy and poor social/emotional support are significant predictors of reporting poor mental health. After controlling for social support, demographics, comorbidities, and health behaviors we determined that those reporting normal activity limitations due to epilepsy are more likely to report poor mental health (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.41-6.58). Similarly, after controlling for the same factors, PWE with poor social/emotional support are more likely to report poor mental health (OR 3.22, 95% CI 1.84-5.61). In contrast, reported seizures in the past 3 months (OR 1.12, 95% CI 0.56-2.25) or current use of medication (OR 0.58, 95% CI 0.30-1.10) were not significantly associated with poor mental health. These population-based findings support the need for clinical approaches that address psychosocial issues in addition to seizure control and treatment. [ABSTRACT FROM AUTHOR]