Abstracts

Rationale: During routine consultations, epilepsy specialists may miss symptoms of anxiety, depression and suicidal risk among those patients with epilepsy (PWE) who do not disclose their psychological status proactively. We investigated whether relatives and partners can detect the aforementioned symptoms among PWE and thus provide additional data for the clinician.

Methods: From October 2021 to March 2022, we conducted an anonymous survey of consecutive PWE and accompanying relatives or partners at the tertiary epilepsy clinic of Vilnius University Hospital Santaros Clinics (Vilnius, Lithuania). Persons accompanying PWE were asked to complete the Generalized Anxiety Disorder scale-7 (GAD-7) and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) as if they were the patient. Accordingly, they also evaluated the patient’s suicidal risk (a non-zero score of the suicide item of the Beck depression inventory was treated as a positive results) as well as the quality of life, physical and psychological health (respective single-item scales scored from 0 [worst] to 10 [best]). Companion results were then compared with those of PWE by using the Wilcoxon test for paired samples. The study received hospital approval and was exempt from consideration by a regional bioethical committee because of the anonymous design.

Results: The study sample consisted of 114 individuals: 57 PWE (32 [56.1%] female, median age 31 years [IQR=22.50-60.00], 37 [64.9%] having focal, 16 [28.1%] – generalized, 4 [7.0%] – unknown/unclassified epilepsy) and 57 accompanying persons (42 [73.7%] female, median age 51 years, [IQR=35.00-61.50], 26 [45.6%] parents, 7 [12.3%] progeny, 17 [29.8%] spouses and 7 [12.3%] partners). PWE and their companions had a comparable perception of anxiety (GAD-7 score: Mdn=4.50, IQR=1.25-10.00 and Mdn=4.00, IQR=2.00-9.00, respectively, Z=-0.816, p=0.415) and depression (NDDI-E score: Mdn=12.00, IQR=7.75-15.25 and Mdn=11.00, IQR=8.00-15.00, Z=-0.344, p=0.730). There was also no significant difference in single item scores of quality of life (Mdn=7.00, IQR=5.00-9.00 and Mdn=7.00, IQR=5.00-8.00, Z=-0.821, p=0.412), physical (Mdn=6.00, IQR=5.00-8.00 and Mdn=7.00, IQR=5.00-8.00, Z=-1.091, p=0.275) and mental health (Mdn=7.00, IQR=5.00-9.00 and Mdn=7.00, IQR=5.00-8.00, Z=-0.843, p=0.399). Three of eight companions correctly identified suicidal risk while another six had a false-positive perception of suicidality (46 [80.7%] of observed agreements, κ=0.240, 95% confidence interval=-0.084 to 0.564).

Conclusions: Our study suggests that relatives and partners have a good understanding of the psychological state (including symptoms of depression and anxiety) of their loved ones with epilepsy. Therefore, targeted inclusion of proxies in epilepsy care pathways may prove beneficial in detecting and tackling psychological comorbidities in epilepsy.

Funding: This project has received funding from European Social Fund (project No 09.3.3-LMT-K-712-25-0202) under grant agreement with the Research Council of Lithuania (LMTLT).