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.
NOV