Epilepsy & behavior : E&B · 2025
Mediating effects of anxiety and depression on the relationship between somatic symptom disorder and quality of life among adults with epilepsy.
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Ma Xueping, Shen Sisi, Xu Jia, Yang Rong, Li Jinmei, Zhou Dong
Аннотация
OBJECTIVE: Although quality of life (QOL) is impaired in patients with somatic symptom disorder (SSD), little is known about the relationship between SSD and QOL among patients with epilepsy (PWE) and the mechanisms underlying this association. This study aimed to identify the mediators of the association between SSD and QOL among PWE.
METHODS: A cross-sectional study was conducted at West China Hospital between July 2020 and May 2022. A total of 749 adults with epilepsy who attended the epilepsy center were consecutively enrolled via convenience sampling. All patients completed questionnaires that assessed demographic and clinical features, the Somatic Symptom Disorder-B Criteria Scale (SSD-12), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Quality of Life in Epilepsy Inventory-31 (QOLIE-31), and the National Hospital Seizure Severity Scale (NHS3). The direct, indirect, and total effects of the predictors on QOL among PWE were tested based on the bootstrap method.
RESULTS: Up to 24.43 % of the adults with epilepsy were affected by SSD. Patients with SSD had significantly higher levels of depression and anxiety and lower levels of QOL. Correlation and mediation analyses revealed that the negative relationship between SSD and QOL was partially mediated by depression and anxiety (B = -10.412, 95 % CI [-12.730, -8.343]). The indirect effect accounted for 66.76 % of the total effect, among which depression accounted for a greater proportion (46.37 %).
CONCLUSION: This study offers new insight into the mechanism underlying the association between SSD and QOL among PWE. Interventions aimed at increasing QOL in patients with somatic symptoms should consider screening and treating depression and anxiety.
METHODS: A cross-sectional study was conducted at West China Hospital between July 2020 and May 2022. A total of 749 adults with epilepsy who attended the epilepsy center were consecutively enrolled via convenience sampling. All patients completed questionnaires that assessed demographic and clinical features, the Somatic Symptom Disorder-B Criteria Scale (SSD-12), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Quality of Life in Epilepsy Inventory-31 (QOLIE-31), and the National Hospital Seizure Severity Scale (NHS3). The direct, indirect, and total effects of the predictors on QOL among PWE were tested based on the bootstrap method.
RESULTS: Up to 24.43 % of the adults with epilepsy were affected by SSD. Patients with SSD had significantly higher levels of depression and anxiety and lower levels of QOL. Correlation and mediation analyses revealed that the negative relationship between SSD and QOL was partially mediated by depression and anxiety (B = -10.412, 95 % CI [-12.730, -8.343]). The indirect effect accounted for 66.76 % of the total effect, among which depression accounted for a greater proportion (46.37 %).
CONCLUSION: This study offers new insight into the mechanism underlying the association between SSD and QOL among PWE. Interventions aimed at increasing QOL in patients with somatic symptoms should consider screening and treating depression and anxiety.