Evaluation of social inclusion in Brazilian adult women with epilepsy: Perception of stigma and quality of life.

Epilepsy is a chronic disease characterized by recurrent epileptic seizures that can affect the perception of stigma and compromise the quality of life of those living with it. In addition, sociodemographic factors such as employment and maintaining a job, education, and the autonomy to drive vehicles are often impaired. OBJECTIVE: To assess the social inclusion of adult women with epilepsy in relation to the perception of stigma and quality of life, and the clinical aspects of the disease. METHODOLOGY: Data from 70 adult Brazilian women with epilepsy regarding aspects related to their social inclusion were verified. Such data were linked to clinical aspects and scores from the questionnaires: Quality of Life in Epilepsy Inventory 31 (QOLIE-31) and the Epilepsy Stigma Scale (ESS), with a significance level of p < 0.05. RESULTS: Average age of 45.5 years, 40 (57.1 %) women were divorced/single/widowed, 31 (44.3 %) women had less than 10 years of formal education, 32 (45.7 %) women had no income, and 57 (81.4 %) did not have a driver's license. The age at the time of the first seizure was 18 years, the seizures were focal in 46 (65.7 %) cases, and 26 (37.1 %) cases were seizure-free in the last year. A high number of women reported that the diagnosis of epilepsy negatively influenced aspects of autonomy such as the possession of a driver's license and going out alone. Longer duration of epilepsy was associated with lower education, not having children, and lower scores on the QOLIE-31. Higher scores on the QOLIE-31 were correlated with lower frequency of seizures and with the age at the time of the first seizure. Values in the dimension - energy and fatigue of the QOLIE-31 were significantly lower in the group with less independence compared to the other two groups with more independence, in latent class analyses (ANOVA, adjusted for age 42.1 ± 35.6 vs 57.2 ± 28.4 vs 73.9 ± 23.8, p = 0.0295). DISCUSSION: Clinical aspects of epilepsy and having a partner, autonomy, and independence such as driving vehicles are factors that contribute to social inclusion and to the perception of a better quality of life for adult women with epilepsy. CONCLUSION: It was observed that having a partner, autonomy, and independence such as driving vehicles are factors that contribute to social inclusion and to the perception of a better quality of life for adult women with epilepsy.

Cognition and obesity in adults with epilepsy / Cognición y obesidad en adultos con epilepsia

Objective: to assess the occurrence of overweight/obesity in patient with epilepsy (PWEs) and to relate it to cognitive aspects and clinical variables.Methodology: the measurements of waist circumference, calf circumference, arm circumference, and the body mass index were related tothe scores of the Mini-Mental State Examination and the Brief Cognitive Battery-Edu, as well as to the clinical variables of 164 PWEs, with asignificance level of p < 0.05. Data were compared to a similar control group (CG) comprising 71 cases. Linear and multiple logistic regressionmodels were used to assess factors related to cognitive aspects. Results: the mean age of the PWEs was 49.8 ± 16.6 years with a mean length of epilepsy of 22 ± 15.9 years. Overweight/obesity occurred in106 (64.6 %) PWEs and in 42 (59.1 %) CG subjects. The PWEs had a worse performance in several cognitive functions when compared to CG subjects. In the PWEs, overweight/obesity was associated with lower educational level, older age, and cognitive impairment. Greater waist circumference, overweight, age at the first seizure, and use of polytherapy with antiseizure medications were predictive factors of memory impairmentin multiple linear regression. Greater arm and calf circumference values were associated with better performance in several cognitive areas. Conclusion: the occurrence of overweight/obesity in PWEs and CG subjects was high. Cognitive impairment occurred in a high number of PWE sand was associated with overweight, greater waist circumference values, and clinical aspects of epilepsy. Better cognitive performance was associated with greater arm and calf circumference. (AU)

Objetivo: evaluar la ocurrencia de sobrepeso/obesidad en pacientes con epilepsia y relacionarla con aspectos cognitivos y variables clínicas.Metodología: las medidas de circunferencia de cintura, circunferencia de pantorrilla, circunferencia de brazo e índice de masa corporal serelacionaron con los puntajes del Mini-Mental State Exam y de la Batería Cognitiva Breve-Edu, así como con las variables clínicas de 164 pacientes con epilepsia, con un nivel de significación de p < 0,05. Los datos se compararon con un grupo de control similar (GC) compuesto por 71 casos. Se utilizaron modelos de regresión logística lineal y múltiple para evaluar factores relacionados con aspectos cognitivos. Resultados: la edad media de las pacientes con epilepsia fue de 49,8 ± 16,6 años con una duración media de la epilepsia de 22 ± 15,9 años. Presentaron sobrepeso/obesidad 106 (64,6 %) pacientes con epilepsia y 42 (59,1 %) sujetos del GC. Los pacientes con epilepsia tuvieron un peor desempeño en varias funciones cognitivas en comparación con los sujetos del GC. En las pacientes con epilepsia, el sobrepeso/obesidad se asoció con menor nivel educativo, mayor edad y deterioro cognitivo. La mayor circunferencia de la cintura, el sobrepeso, la edad de la primera convulsión y el uso de politerapia con medicamentos anticonvulsivos fueron factores predictivos del deterioro de la memoria en la regresión lineal múltiple. Los valores mayores de circunferencia del brazo y la pantorrilla se asociaron con un mejor rendimiento en varias áreas cognitivas. Conclusión: la incidencia de sobrepeso/obesidad en sujetos pacientes con epilepsia y GC fue alta. El deterioro cognitivo ocurrió en un alto número de pacientes con epilepsia y se asoció con sobrepeso, mayores valores de circunferencia de la cintura y aspectos clínicos de la epilepsia. Un mejor rendimiento cognitivo se asoció con una mayor circunferencia del brazo y la pantorrilla. (AU)

Physical activity in adults with epilepsy: clinical aspects and relationship with cognition and quality of life.

There are several factors associated with lower participation in regular physical activity (PA) in adult patients with epilepsy (PWEs). Objective: To assess the relationship between the regular practice of PA with clinical and cognitive variables and quality of life (QoL) in PWEs. Methods: Habitual Physical Activity Questionnaire (HPAQ) was related to clinical variables, scores on the Mini-Mental State Examination (MMSE), on the Brief Cognitive Battery-Edu (BCB-Edu), on the Satisfaction Scale for Physical Activity (SSPA), and on the Quality of Life in Epilepsy Inventory (QOLIE)-31 in 60 PWEs, with a significance level of p<0.05. Results: The PWEs had a mean age of 42.4±13.6 years, 50% of whom were female. Longer length of epilepsy correlated with lower PA in leisure time (Pearson correlation [r]= -0.276; p-value [p]=0.036). The occupational physical activity scores of the HPAQ correlated positively with perception (r=0.300; p=0.021), memory (r=0.381; p=0.003), semantic verbal fluency test (SVF) (r=0.427; p=0.001), and with the total score in the MMSE (r=0.327; p=0.012). The total HPAQ score correlated with the SVF (r=0.336; p=0.009) and with the MMSE (r=0.254; p=0.049). There was no correlation among the QOLIE-31, the HPAQ, and the SSPA. Conclusions: Longer duration of epilepsy was associated with the lower practice of PA. Physical activity was associated with better performance in aspects of cognition. There was no relationship between QoL and practice and satisfaction with PA, suggesting different psychosocial aspects involved.

Existem vários fatores associados à menor participação em atividade física regular (AF) em pacientes adultos com epilepsia (PCE). Objetivo: Avaliar em PCEs a relação entre a prática regular de AF com as variáveis clínicas e cognitivas e com a qualidade de vida (QV). Métodos: Foi relacionado o Habitual Physical Activity Questionnaire (HPAQ) com as variáveis clínicas, escores no Mini-Mental State Examination (MMSE), no Brief Cognitive Battery-Edu (BCB-Edu), Satisfaction Scale for Physical Activity (SSPA) e no Quality of Life in Epilepsy Inventory (QOLIE­31) de 60 PCE, com nível de significância p<0,05. Resultados: Idade média 42,4±13,6 anos, 50% do sexo feminino. O maior tempo de epilepsia correlacionou-se com a menor prática de AF no lazer (Correlação de Person, r= -0,276; p=0,036). Escores da AF ocupacional do HPAQ correlacionaram-se positivamente com a percepção (r=0,300; p=0,021) e a memória (r=0,381; p=0,003) no teste de fluência verbal (SVF); (r=0,427; p=0,001) e com o escore total no MMSE (r=0,327; p=0,012). O escore total do HPAQ correlacionou-se com o SVF (r=0,336; p=0,009) e com o MMSE (r=0,254; p=0,049). Não houve correlação entre o QOLIE­31 com o HPAQ e a SSPA. Conclusão: A maior duração da epilepsia associou-se com a menor prática de AF. A AF associou-se com o melhor desempenho em aspectos da cognição. Não houve relação entre QV com a prática e a satisfação e a AF, sugerindo diferentes aspectos psicossociais envolvidos.

The number of antiseizure medications taken and not the lipid profile was associated with seizure control in adult patients with epilepsy.

Previous studies show changes in lipid metabolism in epilepsy. The aim of this study was to investigate the association between lipid profile and clinical variables in adult patients with epilepsy (APE). Seventy-two APE participated in this pilot study at an outpatient neurology service. The lipid profile (total cholesterol, low-density lipoprotein (LDL) cholesterol, very-low-density lipoproteins (VLDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides), age at disease onset, disease duration, seizures frequency, and the number of antiseizure medications (ASM) used were investigated. Data were analyzed using the Chi-square, Fisher, Mann-Whitney, Spearman coefficient, and logistic regression tests. There were significant differences in HDL (p = 0.0023) and total cholesterol (p = 0.0452) levels in connection with the number of ASM used. There was a significant difference in seizure control among the different numbers of ASM used (p = 0.0382). Higher HDL values were found in females (p = 0.0170). The logistic regression showed that only the number of ASM used was associated with seizure control (p = 0.0408; OR = 2.800; 95% CI = 1.044; 7.509). The number of ASM taken and not the lipid profile was associated with seizure control in APE.

Physical activity in adults with epilepsy: clinical aspects and relationship with cognition and quality of life / Atividade física em pessoas adultas com epilepsia: aspectos clínicos e as relações com a cognição e a qualidade de vida

ABSTRACT There are several factors associated with lower participation in regular physical activity (PA) in adult patients with epilepsy (PWEs). Objective: To assess the relationship between the regular practice of PA with clinical and cognitive variables and quality of life (QoL) in PWEs. Methods: Habitual Physical Activity Questionnaire (HPAQ) was related to clinical variables, scores on the Mini-Mental State Examination (MMSE), on the Brief Cognitive Battery-Edu (BCB-Edu), on the Satisfaction Scale for Physical Activity (SSPA), and on the Quality of Life in Epilepsy Inventory (QOLIE)-31 in 60 PWEs, with a significance level of p<0.05. Results: The PWEs had a mean age of 42.4±13.6 years, 50% of whom were female. Longer length of epilepsy correlated with lower PA in leisure time (Pearson correlation [r]= -0.276; p-value [p]=0.036). The occupational physical activity scores of the HPAQ correlated positively with perception (r=0.300; p=0.021), memory (r=0.381; p=0.003), semantic verbal fluency test (SVF) (r=0.427; p=0.001), and with the total score in the MMSE (r=0.327; p=0.012). The total HPAQ score correlated with the SVF (r=0.336; p=0.009) and with the MMSE (r=0.254; p=0.049). There was no correlation among the QOLIE-31, the HPAQ, and the SSPA. Conclusions: Longer duration of epilepsy was associated with the lower practice of PA. Physical activity was associated with better performance in aspects of cognition. There was no relationship between QoL and practice and satisfaction with PA, suggesting different psychosocial aspects involved.

RESUMO Existem vários fatores associados à menor participação em atividade física regular (AF) em pacientes adultos com epilepsia (PCE). Objetivo: Avaliar em PCEs a relação entre a prática regular de AF com as variáveis clínicas e cognitivas e com a qualidade de vida (QV). Métodos: Foi relacionado o Habitual Physical Activity Questionnaire (HPAQ) com as variáveis clínicas, escores no Mini-Mental State Examination (MMSE), no Brief Cognitive Battery-Edu (BCB-Edu), Satisfaction Scale for Physical Activity (SSPA) e no Quality of Life in Epilepsy Inventory (QOLIE-31) de 60 PCE, com nível de significância p<0,05. Resultados: Idade média 42,4±13,6 anos, 50% do sexo feminino. O maior tempo de epilepsia correlacionou-se com a menor prática de AF no lazer (Correlação de Person, r= -0,276; p=0,036). Escores da AF ocupacional do HPAQ correlacionaram-se positivamente com a percepção (r=0,300; p=0,021) e a memória (r=0,381; p=0,003) no teste de fluência verbal (SVF); (r=0,427; p=0,001) e com o escore total no MMSE (r=0,327; p=0,012). O escore total do HPAQ correlacionou-se com o SVF (r=0,336; p=0,009) e com o MMSE (r=0,254; p=0,049). Não houve correlação entre o QOLIE-31 com o HPAQ e a SSPA. Conclusão: A maior duração da epilepsia associou-se com a menor prática de AF. A AF associou-se com o melhor desempenho em aspectos da cognição. Não houve relação entre QV com a prática e a satisfação e a AF, sugerindo diferentes aspectos psicossociais envolvidos.

I would be better off dead: investigating suicidal ideation in people with epilepsy.

BACKGROUND: It is known that the risk of suicidal behavior in adult people with epilepsy (PWEs) is high. However, the associated clinical and psychosocial factors are still being discussed. OBJECTIVE: To assess the risk of suicide in PWEs and relate it to resilience and quality of life (QoL) as well as with clinical variables. METHODS: The item "I'd be better off dead" of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was related to the resilience scale, clinical aspects, the presence of depression, and the Quality of Life in Epilepsy Inventory (QOLIE-31) scores of PWEs, with a p < 0.05. RESULTS: A total of 271 PWEs were assessed, 50.6% were female, with a mean age of 46.6 (± 15.8) years, and a mean age at 1st seizure of 24.1 (± 18.5) years. Risk for suicide occurred in 50 (19.3%) cases. In multiple logistic regression, the factors that explain the risk of suicide were female sex, depression, and lower scores on the QOLIE-31 and on the resilience scale. In the classification and regression trees, the order of importance of the variables was depression > resilience > age > QoL > age at 1st seizure. CONCLUSION: The risk of suicide was high, and it was associated with demographic aspects, clinical variables, QoL, and resilience. A higher risk of suicide was associated with lower resilience regardless of the presence or absence of depression. In the presence of depression, a higher risk of suicide was associated with the early onset of epilepsy. In the absence of depression, the risk of suicide was associated with low QoL in young adults.

ANTECEDENTES: É sabido que o risco de comportamento suicida é elevado em pessoas adultas com epilepsia (PCEs); entretanto, ainda são discutidos quais são os fatores clínicos e psicossociais associados. OBJETIVO: Avaliar o risco de suicídio em PCEs e relacioná-lo com a resiliência e a qualidade de vida (QV) e com as variáveis clínicas. MéTODOS: Foi relacionado o item ­ "Eu preferiria estar morto" do inventário de depressão em transtornos neurológicos para a epilepsia (IDTN-E) com a escala de resiliência, os aspectos clínicos, a presença de depressão e com o inventário de qualidade de vida na epilepsia (QOLIE-31) de PCEs, com p < 0.05. RESULTADOS: Foram avaliados 271 PCEs, 50.6% dos quais eram do sexo feminino. A idade média foi de 46.6 (± 15.8) anos, e idade na 1ª crise 24.1 (± 18.5) anos. O risco de suicídio ocorreu em 50 (19.3%) casos. Na regressão logística múltipla, os fatores que explicaram o maior risco de suicídio foram o sexo feminino, a depressão, e os menores escores no QOLIE­31 e na escala de resiliência. Na árvore de classificação e regressão, a ordem de importância das variáveis foi depressão > resiliência > idade > QV > idade na 1ª crise. CONCLUSãO: O risco de suicídio foi elevado e associou-se com aspectos demográficos, variáveis clínicas, a QV e a resiliência. O maior risco de suicídio associou-se à menor resiliência, independente da presença de depressão. Na presença de depressão, o maior risco de suicídio associou-se ao início precoce da epilepsia. Na ausência de depressão, o risco de suicídio associou-se à baixa QV em adultos jovens.

I would be better off dead: investigating suicidal ideation in people with epilepsy / Eu preferiria estar morto: avaliando a ideação suicida em pessoas com epilepsia

Abstract Background It is known that the risk of suicidal behavior in adult people with epilepsy (PWEs) is high. However, the associated clinical and psychosocial factors are still being discussed. Objective To assess the risk of suicide in PWEs and relate it to resilience and quality of life (QoL) as well as with clinical variables. Methods The item "I'd be better off dead" of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) was related to the resilience scale, clinical aspects, the presence of depression, and the Quality of Life in Epilepsy Inventory (QOLIE-31) scores of PWEs, with a p < 0.05. Results A total of 271 PWEs were assessed, 50.6% were female, with a mean age of 46.6 (± 15.8) years, and a mean age at 1st seizure of 24.1 (± 18.5) years. Risk for suicide occurred in 50 (19.3%) cases. In multiple logistic regression, the factors that explain the risk of suicide were female sex, depression, and lower scores on the QOLIE-31 and on the resilience scale. In the classification and regression trees, the order of importance of the variables was depression > resilience > age > QoL > age at 1st seizure. Conclusion The risk of suicide was high, and it was associated with demographic aspects, clinical variables, QoL, and resilience. A higher risk of suicide was associated with lower resilience regardless of the presence or absence of depression. In the presence of depression, a higher risk of suicide was associated with the early onset of epilepsy. In the absence of depression, the risk of suicide was associated with low QoL in young adults.

Resumo Antecedentes É sabido que o risco de comportamento suicida é elevado em pessoas adultas com epilepsia (PCEs); entretanto, ainda são discutidos quais são os fatores clínicos e psicossociais associados. Objetivo Avaliar o risco de suicídio em PCEs e relacioná-lo com a resiliência e a qualidade de vida (QV) e com as variáveis clínicas. Métodos Foi relacionado o item - "Eu preferiria estar morto" do inventário de depressão em transtornos neurológicos para a epilepsia (IDTN-E) com a escala de resiliência, os aspectos clínicos, a presença de depressão e com o inventário de qualidade de vida na epilepsia (QOLIE-31) de PCEs, com p < 0.05. Resultados Foram avaliados 271 PCEs, 50.6% dos quais eram do sexo feminino. A idade média foi de 46.6 (± 15.8) anos, e idade na 1ª crise 24.1 (± 18.5) anos. O risco de suicídio ocorreu em 50 (19.3%) casos. Na regressão logística múltipla, os fatores que explicaram o maior risco de suicídio foram o sexo feminino, a depressão, e os menores escores no QOLIE-31 e na escala de resiliência. Na árvore de classificação e regressão, a ordem de importância das variáveis foi depressão > resiliência > idade > QV > idade na 1ª crise. Conclusão O risco de suicídio foi elevado e associou-se com aspectos demográficos, variáveis clínicas, a QV e a resiliência. O maior risco de suicídio associou-se à menor resiliência, independente da presença de depressão. Na presença de depressão, o maior risco de suicídio associou-se ao início precoce da epilepsia. Na ausência de depressão, o risco de suicídio associou-se à baixa QV em adultos jovens.

Brief multidimensional measure of spirituality/religiousness, self-esteem, quality of life, and epilepsy.

INTRODUCTION: The relationships between religiousness/spirituality (RS), self-esteem, and quality of life (QoL) in adult people with epilepsy (PWEs) have not been studied in detail. METHODS: This cross-sectional study assessed RS using the brief multidimensional measure of religiousness/spirituality (BMMRS) scores of 86 PWEs. These scores were compared to 58 individuals in the control group (CG). Among the PWEs, the BMMRS data were related with the QOLIE-31 and the Rosenberg self-esteem scale (RSES) scores and clinical variables. RESULTS: Among the PWEs, 48 individuals had temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) and other epilepsies in 38 cases. Higher "daily spiritual experiences," "overall self-ranking as a religious/spiritual person," and lower perception of "religious/spiritual coping" were observed in the TLE-HS group when compared to the CG. Among the PWEs, there was lower "religious/spiritual coping" and higher "overall self-ranking as a religious/spiritual person" in the TLE-HS group. There was a significant difference in the BMMRS dimensions according to the type and frequency of seizures and the number of antiseizure drugs taken. There was a low correlation between the BMMRS, the QOLIE-31, and the RSES. In the network analysis with the Fruchterman-Reingold algorithm, there was no correlation between self-esteem and RS. In the TLE-HS group, there was a correlation between the "forgiveness" dimension of the BMMRS and some dimensions of the QOLIE-31. CONCLUSION: There was a greater RS in the TLE-HS group when compared to the CG. Regarding the two epilepsy groups, there was a higher "overall self-ranking as a religious/spiritual person" and lower "religious/spiritual coping" in the TLE-HS. The clinical variables and demographic data are related to different BMMRS dimensions according to the type of epilepsy. In the TLE-HS group, a higher RS is related to a better QoL. RS is not related to self-esteem.

Memory complaints, clinical aspects, and self-esteem in adult people with epilepsy.

Memory complaints are common in adult people with epilepsy (PWEs). However, the associated clinical aspects are not yet fully understood. OBJECTIVE: This study aims to relate the occurrence of memory complaints in PWEs with clinical aspects and self-esteem. METHODS: To relate the data obtained from the Memory Complaint Questionnaire (MAC-Q) with clinical aspects, 71 PWEs were assessed using the Rosenberg Self-Esteem Scale (SES), the Mini Mental State Examination (MMSE), and the Brief Cognitive Battery-Edu. These data were compared with 55 individuals in a control group (CG). RESULTS: Memory complaints (MAC-Q≥25) were significantly higher in PWEs, when compared with individuals in the CG [35 (49.3%) vs. 15 (27.2%); Student's t-test; p=0.012]. Objective cognitive performance was lower in PWEs. Memory complaints were associated with a lower educational level, the presence of depression, SES, MMSE, incidental memory, and the clock-drawing test scores in PWEs. CONCLUSIONS: Memory complaints were more frequent in PWEs than in individuals in the CG, and there was a relationship with cognitive deficit, educational level, depression, and low self-esteem.

Queixas de memória são frequentes em pessoas adultas com epilepsia (PCEs). Entretanto, os aspectos clínicos associados ainda não são totalmente compreendidos. OBJETIVO: Relacionar a ocorrência de queixas de memória em PCEs com aspectos clínicos e a autoestima. MÉTODOS: Relacionar os dados do Memory Complaint Questionnaire (MAC-Q) com aspectos clínicos, a Roserberg Self-esteem Scale (SES), o MEEM e a BCB-Edu de 71 PCEs. Os dados foram comparados aos de 55 indivíduos normais (GC). RESULTADOS: Queixa de memória (MAC-Q≥25) foi significativamente maior nos PCEs quando comparada a do GC [35 (49,3%) vs. 15 (27,2%); teste t de Student; p=0,012]. O desempenho cognitivo objetivo foi inferior nas PWEs. As queixas de memória foram associadas à menor escolaridade, presença de depressão e à SES, o MEEM, à memória incidental e o clock-drawing test nas PCEs. CONCLUSÕES: As queixas de memória foi mais frequente nas PCEs do que no GC, e houve relação com o déficit cognitivo, a escolaridade, a depressão e a baixa autoestima.

Memory complaints, clinical aspects, and self-esteem in adult people with epilepsy / Queixa de memória, aspectos clínicos e a autoestima em pessoas adultas com epilepsia

ABSTRACT Memory complaints are common in adult people with epilepsy (PWEs). However, the associated clinical aspects are not yet fully understood. Objective: This study aims to relate the occurrence of memory complaints in PWEs with clinical aspects and self-esteem. Methods: To relate the data obtained from the Memory Complaint Questionnaire (MAC-Q) with clinical aspects, 71 PWEs were assessed using the Rosenberg Self-Esteem Scale (SES), the Mini Mental State Examination (MMSE), and the Brief Cognitive Battery-Edu. These data were compared with 55 individuals in a control group (CG). Results: Memory complaints (MAC-Q≥25) were significantly higher in PWEs, when compared with individuals in the CG [35 (49.3%) vs. 15 (27.2%); Student's t-test; p=0.012]. Objective cognitive performance was lower in PWEs. Memory complaints were associated with a lower educational level, the presence of depression, SES, MMSE, incidental memory, and the clock-drawing test scores in PWEs. Conclusions: Memory complaints were more frequent in PWEs than in individuals in the CG, and there was a relationship with cognitive deficit, educational level, depression, and low self-esteem.

RESUMO Queixas de memória são frequentes em pessoas adultas com epilepsia (PCEs). Entretanto, os aspectos clínicos associados ainda não são totalmente compreendidos. Objetivo: Relacionar a ocorrência de queixas de memória em PCEs com aspectos clínicos e a autoestima. Métodos: Relacionar os dados do Memory Complaint Questionnaire (MAC-Q) com aspectos clínicos, a Roserberg Self-esteem Scale (SES), o MEEM e a BCB-Edu de 71 PCEs. Os dados foram comparados aos de 55 indivíduos normais (GC). Resultados: Queixa de memória (MAC-Q≥25) foi significativamente maior nos PCEs quando comparada a do GC [35 (49,3%) vs. 15 (27,2%); teste t de Student; p=0,012]. O desempenho cognitivo objetivo foi inferior nas PWEs. As queixas de memória foram associadas à menor escolaridade, presença de depressão e à SES, o MEEM, à memória incidental e o clock-drawing test nas PCEs. Conclusões: As queixas de memória foi mais frequente nas PCEs do que no GC, e houve relação com o déficit cognitivo, a escolaridade, a depressão e a baixa autoestima.

The impact of COVID-19 on patients with epilepsy / O impacto da COVID-19 em pacientes com epilepsia

ABSTRACT Background: The COVID-19 pandemic and social distancing can have adverse impacts on adult people with epilepsy (PWE). Objective: To investigate the seizure frequency, the perceived well-being, and the presence of anxiety symptoms in PWE during the COVID-19 pandemic period. Methods: Data from a questionnaire on the repercussions of COVID-19 were analyzed in relation to the clinical variables of 114 PWE, with a significance level of p<0.05. Results: There were 26 cases of COVID-19 in PWE and/or family members (22.8%). During the pandemic period, 11 PWE (9.6%) reported an increase in seizures, but unrelated to COVID-19. Also, the number of crises in PWE with previous depressive disorders increased, with differences between epilepsies. Symptoms of depression, impaired well-being, and concern for their lifestyle were significant in PWE with a previous diagnosis of depression. Impaired well-being, increased anxiety, nervousness, and tiredness, and the concern with being infected were mentioned by a high number of PWE in the pandemic. Conclusion: Seizure frequency increased during the pandemic period, a finding associated with clinical variables of epilepsy. PWE with depression had worse perceived well-being. Changes in well-being and increased anxiety and nervousness were frequent in the pandemic.

RESUMO Introdução: A pandemia por COVID-19 e o isolamento social podem ter impactos adversos em pessoas adultas com epilepsia (PCE). Objetivo: Investigar a frequência das crises, a percepção de bem-estar e a presença de sintomas de ansiedade em PCE no período da pandemia da COVID-19. Métodos: Foram relacionados os dados de um questionário de repercussões da COVID-19 com as variáveis clínicas de 114 PCE, com nível de significância p<0,05. Resultados: A COVID-19 ocorreu em 26 (22,8%) PCE e/ou familiares. Durante o período da pandemia, houve aumento das crises epilépticas em 11 (9,6%) PCE, mas sem relação com o diagnóstico de COVID-19. No período da pandemia, houve aumento do número de crises nos PCE com transtorno depressivo prévio e de modo distinto entre as epilepsias. Sintomas de depressão, comprometimento do bem-estar e preocupação com o estilo de vida ocorreram significativamente nos PCE com diagnostico anterior de depressão. O comprometimento do bem-estar, o aumento da ansiedade, do nervosismo e do cansaço, e a preocupação em contrair a doença foram referidos na maior parte do tempo em elevado número de PCE na pandemia. Conclusão: Houve aumento da ocorrência de crises epilépticas durante o período pandêmico e isso foi associado a variáveis clínicas da epilepsia. Pior percepção de bem-estar ocorreu nos PCE com depressão. Alteração do bem-estar e aumento de ansiedade e de nervosismo foram frequentes na pandemia.

Older adults with epilepsy: memory complaints and objective neuropsychological performance.

INTRODUCTION: People with epilepsy frequently complain of poor memory. OBJECTIVE: To assess the occurrence of memory complaints in older adults with epilepsy (OAE) and whether it is associated with clinical variables, objective cognitive performance, and quality of life (QoL). METHODS: The Memory Complaint Questionnaire (MAC-Q) was related to objective cognitive performance, the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), the Quality of Life in Epilepsy Inventory (QOLIE-31), and the clinical characteristics of 83 OAE. RESULTS: OAE showed worse cognitive performance and higher MAC-Q scores when compared to a similar control group (n=40). Impairment in multiple cognitive domains occurred in 34 (41%) OAE and was associated with older age and lower educational level. Memory complaints (MAC-Q≥25) were reported by 45 (54.2%) OAE and associated with older age, lower educational level, onset at ≥60 years, higher NDDI-E scores, lower QOLIE-31 scores, and impairment in multiple cognitive domains. CONCLUSIONS: OAE presented worse cognitive performance and greater memory complaints. Episode onset at ≥60 years of age was associated with complaints, but not with objective cognitive deficit. We found an association between subjective and objective cognitive performance, with aspects of epilepsy and worse QoL scores.

The impact of COVID-19 on patients with epilepsy.

BACKGROUND: The COVID-19 pandemic and social distancing can have adverse impacts on adult people with epilepsy (PWE). OBJECTIVE: To investigate the seizure frequency, the perceived well-being, and the presence of anxiety symptoms in PWE during the COVID-19 pandemic period. METHODS: Data from a questionnaire on the repercussions of COVID-19 were analyzed in relation to the clinical variables of 114 PWE, with a significance level of p<0.05. RESULTS: There were 26 cases of COVID-19 in PWE and/or family members (22.8%). During the pandemic period, 11 PWE (9.6%) reported an increase in seizures, but unrelated to COVID-19. Also, the number of crises in PWE with previous depressive disorders increased, with differences between epilepsies. Symptoms of depression, impaired well-being, and concern for their lifestyle were significant in PWE with a previous diagnosis of depression. Impaired well-being, increased anxiety, nervousness, and tiredness, and the concern with being infected were mentioned by a high number of PWE in the pandemic. CONCLUSION: Seizure frequency increased during the pandemic period, a finding associated with clinical variables of epilepsy. PWE with depression had worse perceived well-being. Changes in well-being and increased anxiety and nervousness were frequent in the pandemic.

Older adults with epilepsy: memory complaints and objective neuropsychological performance / Idosos com epilepsia: queixa de memória e desempenho neuropsicológico objetivo

ABSTRACT Introduction: People with epilepsy frequently complain of poor memory. Objective: To assess the occurrence of memory complaints in older adults with epilepsy (OAE) and whether it is associated with clinical variables, objective cognitive performance, and quality of life (QoL). Methods: The Memory Complaint Questionnaire (MAC-Q) was related to objective cognitive performance, the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), the Quality of Life in Epilepsy Inventory (QOLIE-31), and the clinical characteristics of 83 OAE. Results: OAE showed worse cognitive performance and higher MAC-Q scores when compared to a similar control group (n=40). Impairment in multiple cognitive domains occurred in 34 (41%) OAE and was associated with older age and lower educational level. Memory complaints (MAC-Q≥25) were reported by 45 (54.2%) OAE and associated with older age, lower educational level, onset at ≥60 years, higher NDDI-E scores, lower QOLIE-31 scores, and impairment in multiple cognitive domains. Conclusions: OAE presented worse cognitive performance and greater memory complaints. Episode onset at ≥60 years of age was associated with complaints, but not with objective cognitive deficit. We found an association between subjective and objective cognitive performance, with aspects of epilepsy and worse QoL scores.

RESUMO Introdução: A queixa de memória fraca é frequente em pessoas com epilepsia. Objetivo: Avaliar a ocorrência de queixas de memória em idosos com epilepsia (IE) e se há associação com variáveis clínicas, desempenho cognitivo objetivo e qualidade de vida (QV). Métodos: O questionário de queixa de memória (memory complaint questionnaire — MAC-Q) foi relacionado ao desempenho cognitivo objetivo, o inventário de depressão de transtornos neurológicos para epilepsia (neurological disorders depression inventory for epilepsy — NDDI-E), o QOLIE-31 e com as características clínicas de 83 IE. Resultados: Houve desempenho cognitivo inferior e maiores escores no MAC-Q em IE quando comparados aos de um grupo controle similar (n=40). Comprometimento de múltiplos domínios cognitivos ocorreu em 34 (41%) IE e associou-se a maior idade e menor escolaridade. Queixas de memória (MAC-Q≥25) foram observadas em 45 (54,2%) IE e associadas a idade mais elevada, menor escolaridade, início das crises aos ≥60 anos, maiores escores no NDDI-E, menores escores no QOLIE-31 e comprometimento de múltiplos domínios cognitivos. Conclusões: Pior desempenho cognitivo e maiores queixa de memória ocorreram em IE. Crises com início aos ≥60 anos foram associadas a queixas, mas não a déficit objetivo cognitivo. Houve associação entre desempenho cognitivo subjetivo e objetivo, com aspectos da epilepsia e pior QV.

Epilepsy characteristics and cognitive, social, and mood functions in relation to intrinsic religiosity.

PURPOSE: The purpose of the study was to relate the Intrinsic Religiosity Inventory (IRI) with clinical epilepsy variables, the occurrence of depressive symptoms, and the quality of life (QoL) of 169 adult people with epilepsy (PWEs). Data were compared with those of a similar control group (CG) without psychiatric disorders, with p < 0.05. RESULTS: A higher intrinsic religiosity (IR) was observed in PWEs when compared with the CG. Impairment in multiple cognitive domains was found in 41 (24.2%) cases, and a score >15 in the Neurological Disorders Depression Inventory for Epilepsy was observed in 44 (26%) cases. In PWE, a greater IR was associated with the use of more than one antiepileptic drug (AED), epileptiform activity (EA) in the left hemisphere, temporal lobe epilepsy with hippocampal sclerosis (TLE-HS), and the absence of depressive disorders. An early age of onset and the social functioning dimension of the Quality of Life in Epilepsy Inventory (QOLIE-31) were the predictive factors for a higher IR in the linear multivariate regression analysis. CONCLUSION: The IR was significantly higher in PWE. A higher IR was related to TLE-HS, EA in the left hemisphere, later onset of epilepsy, a better performance in the semantic verbal fluency (SVF) test, and the absence of depressive disorders, suggesting a complex neurophysiological relationship involving multiple factors.

Quality of life perception in patients with epilepsy for a period of 4 years.

The quality of life (QoL) perception over time in adult people with epilepsy (PWE) is important to define strategies of conduct. OBJECTIVE: The aim of this study was to assess the minimally important change (MIC) threshold of the Quality of Life in Epilepsy Inventory-31 (QOLIE-31) of PWE over a period of 4 years and its relationship with clinical epilepsy variables. METHODS: A total of 129 PWE (46 ±â€¯14.3 years) were included, and the clinical aspects of epilepsy and the QOLIE-31 were assessed in the initial and final assessment, with p < 0.05. RESULTS: The emotional well-being (-6.31) and social functioning (-5.36) showed clinically relevant effects between the assessments. Quality of life was compromised by increasing the number of antiepileptic drugs (AED) taken [total score (-8.53), social functioning (-14.70)] or by maintaining the use of polytherapy [social functioning (-12.89)]. Fewer seizures were associated with a better QoL [total score (7.99), social (17.88) and cognitive functioning (16.30)]. The reduction in seizures was not associated with a better QoL [total and social functioning score], and the increase in seizures did not change QoL perception (cognitive functioning). There was a reduction in the QoL perception in medication effects in temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) (8.92) and with an increase in age in one year (-0.44). CONCLUSIONS: Quality of life was compromised in the emotional well-being and social functioning during the 4-year follow-up period. The increase in the number of AED taken and age and the TLE-HS compromised QoL changes in the frequency of seizures not associated with a significant improvement in QoL.