R. Meneses

Relationship between optimism, disease variables, and health perception and quality of life in individuals with epilepsy.

Epilepsy is a relatively frequent chronic condition with an important impact on the health perception and quality of life (QOL) of patients. The aim of the present study was to identify variables related to health status perception and QOL in persons with epilepsy. Participants were 200 persons with epilepsy, 53.5% of whom were males. The mean age was 39.6; 95% had seizures, and 99% were taking antiepileptic medication. The self-report questionnaire administered assessed four types of variables: demographic, disease, epilepsy-specific optimistic attitude, and outcome variables. Results demonstrated that an optimistic orientation is related to better perception of physical and mental health status and better perception of QOL. The variables that best predict positive outcomes are optimistic orientation, perception of cognitive functioning, and perception of seizure control. These results question the importance attributed to seizure characteristics for everyday functioning and everyday life of individuals with epilepsy, and stress the importance of facilitating an epilepsy-specific optimistic orientation.

Positive Psychosocial Variables and Outcome Variables in Persons with Epilepsy

Epilepsy is a chronic disease and the world’s most common serious neurological disorder (International League Against Epilepsy uf05bILAEuf05d, 2003a; Jacoby, 2002). Epilepsy is the name for a group of functional disorders of the brain, characterised by repetitive seizures, caused by abnormal, excessive electric discharges of the nerve cells or neurones in the brain (ILAE, 2003b). Between 5% (ILAE, 2003b) and 11% of the population experience at least one seizure at some point (Hauser & Hesdorffer, 1990), but not everybody who experiences an epileptic seizure will develop epilepsy. A diagnosis of epilepsy requires that the patient has had a minimum of two unprovoked seizures (ILAE, 2003b). Nowadays, the new generation of antiepileptic drugs and treatment adherence (i.e., proper use of pharmacological agents and compliance to life style orientations) guarantee that the majority of patients do not have seizures and can maintain a normal life, with a low cognitive and aesthetic impact of the disease. Nevertheless, epilepsy therapy may be prolonged and a cure not always attainable. The prognosis for seizure control is very good, and with appropriate therapy approximately 75% of patients with epilepsy become seizure free (ILAE, 2003a). Epilepsy is, nonetheless, a chronic disease, i.e., a disorder that persists for an extended period and affects a person’s ability to function normally. Seizure control (caused by pharmacological treatment or surgery, for instance) does not necessarily mean absence of epilepsy. The impact of epilepsy may be greater than that of some other chronic conditions, partly because of the unpredictability of seizures, and partly because of the associated stigma. In fact, research indicates that seizure disorders are often associated with a variety of psychological and social problems, as well as malaise (Collings, 1990, 1995; Jacoby et al., 1996) and social and political isolation. Thus, as any other chronic illness, epilepsy has the potential to induce profound changes in a person’s life, resulting in negative effects on quality of life (QOL) and wellbeing (de Ridder et al., 2008). In this context, improvement of the psychosocial health of people with epilepsy is a relevant issue for researchers and clinicians, making it important to understand psychosocial dimensions associated with the disease that facilitate epilepsy patients’ adjustment. Psychosocial health depends on adjustment to epilepsy. It is a process that has a start and an end point: it can be assessed by the results, or as an end point, and can be viewed by its positive side (positive adjustment) and not as an adjustment disorder.