J Clin Neurol.  2014 Apr;10(2):125-132. 10.3988/jcn.2014.10.2.125.

Obsessive-Compulsive Symptoms and Their Impacts on Psychosocial Functioning in People with Epilepsy

• Seo JH
• Lee WK
• Park SP

• KMID: 2287530
• DOI: http://doi.org/10.3988/jcn.2014.10.2.125

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 education-matched 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 examined the severity of OCS in PWE relative to healthy controls. Predictors of OCS and the QOLIE-31 score were measured by regression analyses. A path analysis model was constructed to verify interrelations 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 total score was the BDI score (beta=0.417, p<0.001), followed by EEG abnormality (beta=0.194, p<0.001) and etiology (beta=0.107, p=0.031). Epileptic syndrome, the side of the epileptic focus, and action mechanisms of antiepileptic drugs did not affect the MOCI total score. The strongest predictor of the QOLIE-31 overall score was the BDI score (beta=-0.569, p<0.001), followed by seizure control (beta=-0.163, p<0.001) and the MOCI total score (beta=-0.148, p=0.001). The MOCI total score directly affected the QOLIE-31 overall score and also exerted indirect effects on the QOLIE-31 overall score through seizure control and the BDI score.
CONCLUSIONS
OCS are more likely to develop in PWE than in healthy people. The development of OCS appears to elicit psychosocial problems directly or indirectly by provoking depression or uncontrolled seizures.

Keyword

obsessive-compulsive symptom; MOCI; predictor; epilepsy; quality of life; depression

MeSH Terms

Anticonvulsants
Depression
Electroencephalography
Epilepsy*
Humans
Quality of Life
Seizures
Anticonvulsants

Figure

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  Fig. 1 Interrelations between clinical variables and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31) overall score by a refined path analysis model. An arrow indicates a direct relationship from one variable to another. Numbers denote standardized regression coefficients (β weights) for each path. Negative coefficients indicate that when the predictor variable score increases by one standard deviation, the QOLIE-31 overall score decreases by the number of standard deviations equal to the value of the coefficient. BDI: Beck Depression Inventory, MOCI: Maudsley Obsessional-Compulsive Inventory.

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