Zong N, Liu XY, Chen F. Risk factors for anxiety and depression in patients with epilepsy and their relationship with quality of life. World J Psychiatry 2026; 16(8): 118857 [DOI: 10.5498/wjp.118857]
Corresponding Author of This Article
Fang Chen, Associate Chief Nurse, Department of Nephrology, The Third Affiliated Hospital of Jinzhou Medical University, No. 2 Section 5, Heping Road, Linghe District, Jinzhou 121000, Liaoning Province, China. 18704162950@163.com
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Psychology, Development
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research-article
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Zong N, Liu XY, Chen F. Risk factors for anxiety and depression in patients with epilepsy and their relationship with quality of life. World J Psychiatry 2026; 16(8): 118857 [DOI: 10.5498/wjp.118857]
World J Psychiatry. Aug 19, 2026; 16(8): 118857 Published online Aug 19, 2026. doi: 10.5498/wjp.118857
Risk factors for anxiety and depression in patients with epilepsy and their relationship with quality of life
Fang Chen, Xu-Ying Liu, Ning Zong
Ning Zong, Orthopedics Ward One, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning Province, China
Xu-Ying Liu, Department of Neurology, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning Province, China
Fang Chen, Department of Nephrology, The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, Liaoning Province, China
Author contributions: Zong N performed the research and wrote the manuscript; Liu XY and Chen F reviewed and revised the manuscript; Zong N, Liu XY and Chen F designed the research study and analyzed the data; all authors have read and approved the final manuscript.
AI contribution statement: We used Grammarly and DeepL solely for English language polishing and translation assistance in this manuscript. No AI tool was used to generate any part of the main text, design the study, interpret results, or generate images.
Institutional review board statement: The research was reviewed and approved by the Medical Ethics Review Committee of the Third Affiliated Hospital of Jinzhou Medical University (approval No. JYDSY-KXYJ-IEC-2025-075).
Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.
Conflict-of-interest statement: No conflict of interest is associated with this work.
Data sharing statement: No other data available.
Corresponding author: Fang Chen, Associate Chief Nurse, Department of Nephrology, The Third Affiliated Hospital of Jinzhou Medical University, No. 2 Section 5, Heping Road, Linghe District, Jinzhou 121000, Liaoning Province, China. 18704162950@163.com
Received: February 10, 2026 Revised: March 10, 2026 Accepted: March 30, 2026 Published online: August 19, 2026 Processing time: 169 Days and 23.2 Hours
Abstract
BACKGROUND
Epilepsy is frequently complicated by anxiety and depression, which severely undermine patients’ quality of life (QoL). However, the independent risk factors for these psychiatric comorbidities and their combined effect on QoL in Chinese patients with epilepsy remain to be comprehensively elucidated.
AIM
To identify risk factors for epilepsy-related anxiety/depression and their QoL correlation.
METHODS
A single-center, retrospective study was conducted involving 106 adult patients with epilepsy. Demographic and clinical data were collected. Standardized self-rating scales were used to assess anxiety and depressive symptoms, and QoL was evaluated using the Quality of Life in Epilepsy-31 inventory. Univariate and multivariate logistic regression analyses identified independent risk factors. The performance of the predictive model for comorbidity was evaluated using receiver operating characteristic analysis, calibration, and decision curve analysis. Correlations between psychological symptoms and QoL domains were assessed using Pearson correlation.
RESULTS
The rates for anxiety, depression, and their co-occurrence were 38.68%, 34.91%, and 26.42%, respectively. Multivariate analysis identified unemployment and high seizure frequency (> 2/month) as independent risk factors for anxiety. For depression, unemployment, polytherapy (> 2 antiepileptic drugs), and high seizure frequency were significant risk factors. Incorporation of unemployment, polytherapy, high seizure frequency, and long duration of disease in the comorbidity model predicted outcome well (area under the receiver operating characteristic curve = 0.81) thereby indicating its good clinical utility. Patients who had comorbidity scored significantly lower on the Quality of Life in Epilepsy-31 across all domains. Anxiety and depression severity correlated significantly negatively with all domains of QoL (P < 0.05). The strongest correlation was found between depression and total QoL which had (r = -0.65, P < 0.001).
CONCLUSION
Anxiety and depression are highly prevalent in Chinese epilepsy patients, driven by unemployment, uncontrolled seizures, polytherapy, and chronicity, and profoundly impair QoL, underscoring the need for integrated care.
Core Tip: This study identifies unemployment, high seizure frequency, polytherapy, and longer disease duration as key risk factors for anxiety and depression in Chinese patients with epilepsy. A clinical prediction model based on these factors effectively identifies high-risk individuals. Critically, comorbid anxiety and depression severely impair quality of life across all domains. These findings underscore the necessity of integrated care, combining optimized seizure control, medication review, and mental health support, to improve the holistic well-being of people living with epilepsy.
