Mediating effects of anxiety and depression on the relationship between somatic symptom disorder and quality of life among adults with epilepsy

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior Pub Date : 2025-04-26 DOI:10.1016/j.yebeh.2025.110432

Xueping Ma , Sisi Shen , Jia Xu , Rong Yang , Jinmei Li , Dong Zhou

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引用次数: 0

Abstract

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.

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焦虑和抑郁在成人癫痫患者躯体症状障碍与生活质量关系中的中介作用

目的虽然躯体症状障碍（SSD）患者的生活质量（QOL）受损，但对癫痫（PWE）患者的躯体症状障碍与生活质量之间的关系及其机制知之甚少。本研究旨在确定PWE中SSD与生活质量之间的关联中介。方法于2020年7月至2022年5月在华西医院进行横断面研究。通过方便抽样的方法，连续入组了在癫痫中心就诊的成人癫痫患者749例。所有患者都完成了评估人口学和临床特征的问卷调查，躯体症状障碍- b标准量表（SSD-12），患者健康问卷-9 (PHQ-9)，广泛焦虑障碍-7 (GAD-7)，癫痫生活质量量表-31 （qole -31）和国家医院癫痫发作严重程度量表（NHS3）。采用自举法对预测因子对PWE生活质量的直接、间接和总影响进行了检验。结果成人癫痫患者中SSD发生率高达24.43%。SSD患者抑郁、焦虑水平显著增高，生活质量显著降低。相关分析和中介分析显示，抑郁和焦虑部分介导了SSD与生活质量的负相关关系（B = -10.412, 95% CI[-12.730, - 8.343]）。间接效应占总效应的66.76%，其中抑郁所占比例更大（46.37%）。结论本研究为PWE患者SSD与生活质量之间的关联机制提供了新的视角。旨在提高躯体症状患者生活质量的干预措施应考虑筛查和治疗抑郁和焦虑。

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来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.