Predictors of quality of life and their interrelations in Korean people with epilepsy: A MEPSY study

PURPOSE People with epilepsy (PWE) are more likely to have impaired quality of life (QOL) than the general population. We studied predictors of QOL and their interrelations in Korean PWE. METHODS Subjects who consecutively visited outpatient clinics in four tertiary hospitals and one secondary care hospital were enrolled. These subjects completed the Korean version of the Neurological Disorders Depression Inventory for Epilepsy (K-NDDI-E), the Generalized Anxiety Disorder-7 (GAD-7), the Quality of Life in Epilepsy-10 (QOLIE-10), and the Korean version of Liverpool Adverse Event Profile (K-LAEP). We evaluated the predictors of QOL by multiple regression analyses and verified the interrelations between the variables using a structural equation model. RESULTS A total of 702 PWE were eligible for the study. The strongest predictor of the overall QOLIE-10 score was the K-LAEP score (β=-0.375, p<0.001), followed by the K-NDDI-E score (β=-0.316, p<0.001), seizure control (β=-0.152, p<0.001), household income (β=-0.375, p<0.001), and GAD-7 score (β=-0.119, p=0.005). These variables explained 68.7% of the variance in the overall QOLIE-31 score. Depression and seizure control had a bidirectional relationship and exerted direct effects on QOL. These factors also exerted indirect effects on QOL by provoking adverse effects of AEDs. Anxiety did not have a direct effect on QOL; it had only indirect effect through the adverse effects of AEDs. CONCLUSION Depression, anxiety, seizure control, and adverse effects of AEDs have complex interrelations that determine the QOL of PWE.