Does psychiatric comorbidity influences quality of life and disability among subjects with refractory focal epilepsy- a comparative cross-sectional study

Abstract

Background: Refractory focal epilepsy is a disorder associated with a significant impact on quality of life and disability. Having comorbid psychiatric disorders among these subjects has been well documented. Recently studies have looked at how this impacts the quality of life and disability, but they are few in number. Methodology: Subjects were taken from the epilepsy clinic whom neurologist diagnosed as having refractory focal epilepsy. MINI International Neuropsychiatric Interview (MINI) was used to identify psychiatric comorbidity. Two groups of 25 subjects were made based on whether they had or did not have psychiatric comorbidities and further assessed with the World Health Organization Quality of Life (WHOQOL)-BREF for quality of life and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for disability. Results: Analysis of the two groups showed quality of life score lesser in the group with psychiatric comorbidities, which was significant (p<0.001). Similarly, the disability score was higher in the group with psychiatric comorbidities, which was significant (p<0.001).  The quality of life was lowest in major depressive disorder (60.80±8.47) and disability was highest in psychosis (105.33±1.53). Conclusion: Psychiatric comorbidities in subjects with refractory focal epilepsy significantly impact the quality of life and disability. It is essential to have a good team approach, and liaison between neurology and psychiatry for early detection and treatment of such symptoms will decrease healthcare costs and improve quality of life.