Employment and seizure frequency as important predictors of health-related quality of life in people with functional/dissociative seizures

Abstract

Background

There are inconsistent results on health-related quality of life (HRQoL) in patients with functional/dissociative seizures (FDS), particularly in relation to the predictors. The aim of the present study was to investigate variables predicting HRQoL in a sample of patients with FDS who had been hospitalized for an average of 5.6 years.

Methods

People with a confirmed diagnosis of FDS who had already received inpatient treatment years ago were contacted to participate to the survey by completing a self-report questionnaire. They were asked to rate their current HRQoL and provide information on seizure frequency at onset and current, employment and other clinical and sociodemographic variables.

Results

Of the n = 443 treated inpatients over a period of 14 years, n = 63 patients could still be reached and participated in the study. Seizure frequency decreased significantly over the course of the disease. At the time of the survey, half of the participants were limited in their HRQoL. The three significant predictors of HRQoL were current seizure frequency, current employment status and seizure frequency at the onset of the disease.

Conclusions

Even years after inpatient treatment, half of the people with FDS reported limited HRQoL. The frequency of seizures (current and at the onset) and current employment status were identified as predictors of better HRQoL. These variables can be targeted in psychotherapeutic treatment, for instance on the basis of the concept of experiential avoidance.