Published online Aug 19, 2026. doi: 10.5498/wjp.118857
Revised: March 10, 2026
Accepted: March 30, 2026
Published online: August 19, 2026
Processing time: 158 Days and 23.1 Hours
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.
To identify risk factors for epilepsy-related anxiety/depression and their QoL correlation.
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 mul
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).
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.