Fear of public places linked to poor quality of life in adults with epilepsy

Agoraphobic symptoms were common and associated with poor quality of life in adults with epilepsy, while generalized anxiety symptoms were not, according to a study published in Epilepsy Research.

“Symptoms of agoraphobia do not fully overlap with generalized anxiety or depression symptoms that are often screened in routine practice,” Heidi Marie Munger Clary, MD, MPH, associate professor of neurology at Wake Forest University School of Medicine, said in a related university press release. “Providers might want to consider more robust symptom screening methods to identify and better assist these patients. This may be important to improve health equity, given other key study findings that show those with lower education and non-white race/ethnicity had increased odds of significant phobic/agoraphobic symptoms.”

Munger Clary and colleagues conducted a cross-sectional analysis of 420 adult patients with epilepsy of diverse ethnicity and a wide range of educational levels, most of whom had focal epilepsy and were treated with at least two antiseizure medications. All participants were evaluated over a 14-year period at Columbia University Medical Center in New York and recorded phobic symptoms on the Symptom Checklist 90-R, with a T-score of at least 60 considered highly phobic.

According to results, being non-white (adjusted OR = 2.34), at a lower education level (aOR = 3.38) and having generalized anxiety symptoms (aOR = 1.91) independently associated with high agoraphobic symptoms. Further, agoraphobic symptoms independently correlated with poor quality of life, older age, depression symptoms and non-white race/ethnicity.

Researchers did not, however, report a significant association between generalized anxiety and quality of life.

“Clinicians should consider using more global symptom-screening instruments with particular attention to susceptible populations, as these impactful symptoms may be overlooked using generalized-anxiety focused screening paradigms,” Munger Clary and colleagues concluded.

Reference:

• Fear of public places is common in adults with epilepsy. https://newsroom.wakehealth.edu/news-releases/2023/01/fear-of-public-places-is-common-in-adults-with-epilepsy. Published Jan. 26, 2023. Accessed Feb. 1, 2023.