ABSTRACT
Objective: The aim of this study was to examine seizure frequency and psychosocial outcomes in patients with epilepsy (PwE) during the COVID-19 pandemic. Methods: This cross-sectional case-control study included 319 adult PwE and 327 healthy controls (HC). The data were collected using a patient/person information form, Worry and Anxiety Questionnaire (WAQ), Beck Depression Inventory (BDI-II), and the Pittsburg Sleep Quality Index (PSQI). Results: Seventy-four (23.1%) patients had an increase in seizure frequency during the pandemic. The mean age of PWE with increased seizure frequency (ISF) was lower (32.8±9.3) than PWE with unchanged seizure frequency (USF) (37.0±11.4). When psychosocial impacts of the pandemic were compared between the groups, the ISF group was psychologically affected more than the USF and HC groups. WAQ and BDI-II scores were higher in ISF than USF and higher in USF than HC group. Also, the analysis revealed that the seizure frequency during the pandemic was almost similar before the pandemic. However, only those who had frequent seizures before the pandemic had worsened seizure frequency during the pandemic. The analysis showed that factors such as having trouble in drug supply, having more than 4-6 seizures in a year, worrying about seizure intervention, and being depressed, were related to being psychologically affected by the pandemic. Conclusion: It was observed that the psychosocial outcomes during the pandemic were worse in PwE than healthy controls, especially in those with increased seizure frequency. Therefore, it is essential to increase the medical and psychosocial support to PwE during the pandemic. © 2022, ASEAN Neurological Association. All rights reserved.
ABSTRACT
Objective: In the COVID-19 pandemic period, the effect of COVID-19 fear on quality of life was uncertain. This present study examined the effect of fear of COVID-19 on quality of life in patients with epilepsy through anxiety and depression. Methods: This single-center, cross-sectional study was conducted with a total of 319 adult patients with epilepsy. The mean age of the patients was 36.0 (+/- 11.1) years, and 53% were male. The mean duration of diagnosis was 16.0 (+/- 10.6) years, and more than half of the patients (52.4%) were using two and more antiepileptic drugs. Data were collected online between 15 December 2020 and 5 January 2021. COVID-19 Fear Scale, Beck Depression Inventory, Worry and Anxiety Questionnaire, and Epilepsy Quality of Life Scale-10 were used for data collection. Serial mediation analysis was conducted to determine the effect of COVID-19 fear on quality of life. Results: Although there was a significant correlation between them, the fear of COVID-19 did not directly affect the quality of life. The fear of COVID-19 increased anxiety and depression respectively, the increase in the mediators also decreased the quality of life. Conclusion: The fear of COVID-19 experienced by patients with epilepsy did not have a significant direct effect on the quality of life. However, it was found that it had an indirect effect on the quality of life by increasing mental health problems such as anxiety and depression, the indirect effect was mostly on anxiety.
ABSTRACT
Purpose: To identify factors associated with an increased or decreased risk of SUDEP. Method: The EpiNet study group is undertaking a prospective case-control study, aiming to recruit 200 participants from approximately 40 international centres over four years. Patients with epilepsy from a pre-defined cohort who die of definite or probable SUDEP will be included. Cases must be alive when the cohort is defined. For each case, three true controls and one proxy control will be recruited from the same cohort. A structured telephone interview with the next-of-kin of SUDEP cases will be conducted. Controls will be asked about their epilepsy and lifestyle. Proxy controls will be asked about the control patient they know. Information regarding seizure type and medication, sleeping arrangements, nocturnal supervision, use of seizure-detection devices, socio-economic factors and other health issues will be entered into the EpiNet database. Pathologists' and coroners' data regarding circumstances and cause of death will also be recorded if available. The data will be analysed to identify risk factors for SUDEP. Odds ratios will be calculated using the Mantel-Haenszel method and logistic regression to control for covariates. 200 cases and 800 controls will detect an odds ratio of 1.7 over a control exposure range of 22-65%, with 80% power and 95% confidence level (2-sided). Result: The study is now underway in 8 countries through Asia-Oceania, Europe and North America. COVID-19 has adversely affected case enrolment, and new centres are being sought. Conclusions: SUDEP is second only to stroke as the leading neurological cause of years of potential life lost. The causes remain uncertain. A large prospective case-control study is the best way to determine the extent of the association between specific variables and SUDEP, in particular, those that could be modified to prevent this tragedy. Anyone interested in participating is welcome to contact: epinetadmin@adhb.govt.nz.