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Executive Dysfunction Is a Significant Predictor of Poor Quality of Life in Children with Epilepsy
Author(s) -
Sherman Elisabeth M. S.,
Slick Daniel J.,
Eyrl Kim L.
Publication year - 2006
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2006.00816.x
Subject(s) - executive dysfunction , epilepsy , executive functions , quality of life (healthcare) , medicine , rating scale , psychiatry , cognition , severity of illness , odds ratio , pediatrics , psychology , clinical psychology , neuropsychology , developmental psychology , nursing
Summary: Purpose: Based on prior research indicating poor health‐related quality of life (HRQOL) in children with attention‐deficit/hyperactivity disorder, we investigated (1) whether executive functioning deficits were related to poor HRQOL in children with epilepsy, (2) how important these variables were in comparison to known predictors of HRQOL such as neurological factors, and (3) the extent to which clinical‐level impairments in executive dysfunction predispose children to low HRQOL. Method: Data included scores on the Behavior Rating Inventory of Executive Function (BRIEF) and HRQOL scales (The Impact of Childhood Illness Scale [ICI] and Hague Restrictions in Epilepsy Scale [HARCES]) for 121 children (mean age = 11.9, SD = 3.6) from a tertiary center serving children with severe epilepsy. Results: Correlations between the BRIEF and ICI total and subscore domains (child, parent, family, and treatment) were generally significant and moderate (e.g., r ≥ 0.30, p ≤ 0.001). BRIEF Global Executive Composite, number of antiepileptic drugs (AEDs), number of prior AEDs, and adaptive level all emerged as significant and unique predictors of HRQOL (R 2 = 0.36, adj. R 2 = 0.33, p < 0.0001). A clinically elevated BRIEF was associated with a twofold risk of low HRQOL (odds ratio = 2.21, p = 0.03). Conclusions: Executive dysfunction appears to exert a broad adverse influence on HRQOL in children with epilepsy, with clinical‐level impairments in executive dysfunction contributing to a twofold increase in the likelihood of poor HRQOL. The constellation of executive dysfunction, low adaptive level, high medication load, and a history of several failed AEDs are risk factors for poor HRQOL in children with epilepsy.