Obsessive-Compulsive Symptoms and Their Impacts on Psychosocial Functioning in People with Epilepsy
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Background and Purpose Obsessive-compulsive symptoms (OCS) in people with epilepsy(PWE) have not been studied systematically. We evaluated the severity, predictors, and psychosocial impact of OCS in PWE. Methods We recruited PWE who visited our epilepsy clinic and age-, gender-, and educationmatched healthy controls. Both PWE and healthy controls completed the Maudsley Obsessional-Compulsive Inventory (MOCI), which measures OCS. PWE also completed the Beck Depression Inventory (BDI) and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31). We examinedthe severity of OCS in PWE relative to healthy controls. Predictors of OCS and the QOLIE-31score were measured by regression analyses. A path analysis model was constructed to verifyinterrelations between the variables. Results The MOCI total score was significantly higher in PWE than in healthy controls (p=0.002). OCS were found in 20% of eligible patients. The strongest predictor of the MOCI totalscore was the BDI score (β=0.417, p<0.001), followed by EEG abnormality (β=0.194, p<0.001)and etiology (β=0.107, p=0.031). Epileptic syndrome, the side of the epileptic focus, and actionmechanisms of antiepileptic drugs did not affect the MOCI total score. The strongest predictorof the QOLIE-31 overall score was the BDI score (β=-0.569, p<0.001), followed by seizure control (β=-0.163, p<0.001) and the MOCI total score (β=-0.148, p=0.001). The MOCI total scoredirectly affected the QOLIE-31 overall score and also exerted indirect effects on the QOLIE-31overall score through seizure control and the BDI score. Conclusions OCS are more likely to develop in PWE than in healthy people. The developmentof OCS appears to elicit psychosocial problems directly or indirectly by provoking depressionor uncontrolled seizures.
Abstract
Background and Purpose Obsessive-compulsive symptoms (OCS) in people with epilepsy(PWE) have not been studied systematically. We evaluated the severity, predictors, and psychosocial impact of OCS in PWE. Methods We recruited PWE who visited our epilepsy clinic and age-, gender-, and educationmatched healthy controls. Both PWE and healthy controls completed the Maudsley Obsessional-Compulsive Inventory (MOCI), which measures OCS. PWE also completed the Beck Depression Inventory (BDI) and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31). We examinedthe severity of OCS in PWE relative to healthy controls. Predictors of OCS and the QOLIE-31score were measured by regression analyses. A path analysis model was constructed to verifyinterrelations between the variables. Results The MOCI total score was significantly higher in PWE than in healthy controls (p=0.002). OCS were found in 20% of eligible patients. The strongest predictor of the MOCI totalscore was the BDI score (β=0.417, p<0.001), followed by EEG abnormality (β=0.194, p<0.001)and etiology (β=0.107, p=0.031). Epileptic syndrome, the side of the epileptic focus, and actionmechanisms of antiepileptic drugs did not affect the MOCI total score. The strongest predictorof the QOLIE-31 overall score was the BDI score (β=-0.569, p<0.001), followed by seizure control (β=-0.163, p<0.001) and the MOCI total score (β=-0.148, p=0.001). The MOCI total scoredirectly affected the QOLIE-31 overall score and also exerted indirect effects on the QOLIE-31overall score through seizure control and the BDI score. Conclusions OCS are more likely to develop in PWE than in healthy people. The developmentof OCS appears to elicit psychosocial problems directly or indirectly by provoking depressionor uncontrolled seizures.
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