Background & Aims: Epilepsy is one of the most common chronic neurological disorders, and epileptic patients are prone to physical and psychological diseases and can experience issues such as anxiety, which affect their life quality. In general, epilepsy reduces life quality indexes and life expectancy, which has considerable economic effects on the person and the society and will ultimately lead to problems such as isolation, dependence, psychological damages and disorders, remaining single, unemployment and declining quality of life. Daily preferences and circadian rhythms are recognized as factors affecting epileptic patients’ life quality. As a mental feeling, quality of life is a psychological phenomenon that may play a role in patients’ life quality through personal traits such as daily preferences and circadian rhythms. In other words, circadian rhythms and anxiety are important issues found in epileptic patients, which can affect their quality of life. Therefore, the present study aimed to determine the relationship between life quality and circadian rhythms and anxiety in epileptic patient members of the Iranian Epilepsy Association.
Materials & Methods: This was a cross-sectional, descriptive and correlational study performed on 120 individuals who referred to the Iranian Epilepsy Association. The participants were selected by continuous sampling and based on the inclusion criteria. The sampling process continued for a period of June-August, 2020. Data were collected using a demographic characteristics questionnaire, including age, gender, level of education, marital status, occupational status, average monthly family income, and medical information related to other diseases, duration of diagnosis, and diagnosis of epilepsy in other family members. In addition, we applied the Morningness-Eveningness Questionnaire (MEQ), which comprises 19 questions about the sleep and waking times and appropriate times for physical, mental and conscious functioning after waking up. Moreover, we used the Beck Anxiety Inventory (BAI), which has 21 items about cognitive and physical signs of anxiety. Furthermore, we exploited the Quality of Life in Epilepsy (QOLIE-31-P) was exploited, which encompasses subscales of concern about epilepsy, psychological health, energy/fatigue, cognitive performance, drug effects, social performance and overall quality of life. The instruments were filled by the participants in a pre-determined location through self-report. Notably, the process took 20-30 minutes per subject. Data analysis was performed in SPSS version 16 using descriptive, inferential and correlational statistics and multiple linear regression model to determine the predictors of quality of life in patients with epilepsy.
Results: In this study, the mean age of the subjects was 4.14 years. Regarding circadian rhythms, most participants were in an intermediate position (71.7%), which had the highest frequency compared to other circadian rhythms. However, the lowest frequency was related to the complete morningness state. On the other hand, there was no significant relationship between life quality scales and circadian rhythms. Quality of life had the highest score in the dimension of seizure anxiety with an average of 57.47 and in the dimension of social functioning with an average of 45.76 had the lowest mean score among other dimensions. Moreover, the average score of quality of life was 50.32 with a standard deviation of 23.03, which was close to the median of the instrument score- i.e., 50. There was a significant negative correlation between the quality of life and all of its dimensions with anxiety, meaning that quality of life and its dimensions decreased with an increase in anxiety (r=-0.673, P<-0.001). In addition, a significant association was observed between anxiety and variables of the level of education, occupational status, income level and hospitalization frequency. Moreover, diagnosis of other diseases (P=0.001) and five-six hospitalization times (P<0.001) were the only significant variables in the regression model.
Conclusion: According to the results of the study, there was a negative significant correlation between the quality of life and all of its dimensions with anxiety. It seems that effective steps could be taken toward promoting anxiety-free behaviors, which increases the life quality of patients with epilepsy, through raising awareness, considering a minimum level of education of high school diploma as a recruitment criterion, creating jobs with suitable income levels, and eliminating organizational barriers (e.g., facilitation of staff recruitment).
