Shen, Sisi;
Dong, Zaiquan;
Sander, Josemir W;
Zhou, Dong;
Li, Jinmei;
(2023)
Somatic symptoms and related disorders in a large cohort of people with epilepsy: A cohort study.
Epilepsia
, 64
(2)
pp. 320-334.
10.1111/epi.17453.
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Abstract
OBJECTIVE: To characterize somatic symptoms and related disorders (SSD) in epilepsy. METHODS: Adults with epilepsy under active follow-up at a tertiary epilepsy centre were consecutively enrolled. The diagnosis of SSD was performed by an experienced psychologist based on the structured clinical interview for DSM-5. Detailed social/demographic data, epilepsy features, psychiatric features, life quality, disability and economic burden were collected and compared between people with SSD and those without. Bodily distress syndrome checklist (BDS-checklist), Somatic Symptom Disorder-B Criteria Scale (SSD-12), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item scale (GAD-7) were used to evaluate SSD individuals' somatic symptoms, symptom-related psychological distress, depressive and anxious symptom, respectively. Quality of life and disability was assessed by Quality of Life in Epilepsy Inventory 31 (QOLIE-31) and WHO Disability Assessment Schedule V.2.0 (WHO DAS 2.0). A risk prediction nomogram was generated using least absolute shrinkage and selection operator (LASSO) analysis and validated. RESULTS: One-hundred-and-fifty of 631 participants (24%) were diagnosed with SSD. In people with SSD, the top 3 most common somatic symptoms were memory impairment, headache and dizziness (85%, 80% and 78%, respectively), and multiple systems are involved in most (82%) people with SSD. Compared with people without SSD, those with SSD had lower QOLIE-31 total scores, higher WHO DAS 2.0 scores and disease economic burdens. LASSO analysis suggested that a history of severe traumatic brain injury, hippocampal sclerosis, low seizure worry and medication effects scores of QOLIE-31, multiple systems that somatic symptoms affected, and a high GAD-7 score were risk factors of SSD. The nomogram was validated for good accuracy in the training and testing cohorts. SIGNIFICANCE: SSD is likely to be common comorbidity in epilepsy and harm epilepsy prognosis. Our risk prediction nomogram was successfully developed but needs further validation in larger cohorts.
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