Rola funkcji poznawczych w związku między czynnikami biologiczno-psychospołecznymi a jakością życia u pacjentów z epilepsją
Cognitive Mediation of Biopsychosocial Determinants of Quality of Life in Epilepsy
W skrócie
Badanie wykazało, że u pacjentów z epilepsją zaburzenia funkcji poznawczych (takie jak pamięć i koncentracja) stanowią ważny łącznik między objawami choroby a jakością ich życia. Czynniki takie jak lęk, depresja, wstyd związany z chorobą i problemy społeczne negatywnie wpływają zarówno na zdolności poznawcze, jak i ogólne samopoczucie pacjentów. Autorzy badania sugerują, że leczenie epilepsji powinno uwzględniać poprawę funkcji poznawczych, aby pacjenci czuli się lepiej w codziennym życiu.
Oryginalny abstract (angielski)
PURPOSE: Epilepsy is a chronic neurological disorder with complex etiology and high recurrence rates, often leading to substantial impairment in patients' quality of life (QoL). Within the biopsychosocial (BPS) framework, multiple biological, psychological, and social factors interact to influence QoL. Cognitive dysfunction is common in epilepsy and may play a critical role in this process. This study aimed to investigate the mediating role of cognitive function in the relationship between BPS factors and QoL in patients with epilepsy. PATIENTS AND METHODS: A total of 252 patients with epilepsy treated at the First Affiliated Hospital of Anhui Medical University between 2022 and 2024 were included. Participants aged 14-66 years were included, representing late adolescents and adults with epilepsy treated in a tertiary clinical setting. Demographic and clinical characteristics were collected using a self-designed questionnaire. Anxiety, depression, stigma, and social functioning were assessed using the Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), Kilifi Stigma Scale for Epilepsy (KSSE), and Social Disability Screening Schedule (SDSS), respectively. Pearson correlation analysis was used to examine associations among BPS factors, cognitive function, and QoL. Mediation analysis was performed to evaluate the mediating effect of cognitive function. RESULTS: Disease duration, number of anti-seizure medications, anxiety, depression, perceived stigma, and social functioning impairment were all significantly negatively correlated with both cognitive function and QoL (all p < 0.001). Mediation analysis demonstrated that cognitive function partially mediated the associations between each BPS factor and QoL, with all indirect effects reaching statistical significance. CONCLUSION: Cognitive function mediates the impact of various biopsychosocial (BPS) factors on the quality of life of patients with epilepsy. This finding suggests that clinical management should place greater emphasis on improving patients' cognitive function to enhance their overall quality of life.