{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:58:56Z","timestamp":1790675936651,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100011110","name":"UCB","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011110","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate changes in quality of life (QoL) dimensions and their relationship with seizure outcome, depression, and suicidality after the addition or substitution of an anti\u2010seizure medication (ASM) in adults with drug\u2010resistant focal epilepsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 665 consecutively enrolled patients were followed prospectively and assessed with Quality of Life in Epilepsy Inventory 31 (QOLIE\u201031) and the Neurological Disorders Depression Inventory for Epilepsy (NDDI\u2010E). QoL changes over time for the overall population and seizure outcome categories were analyzed with analysis of variance (ANOVA), whereas factors affecting QoL changes were assessed by using a linear regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seizure freedom was associated with a marked improvement across all QoL domains, ranging from 11 points for\n                      <jats:italic>Seizure worry<\/jats:italic>\n                      to 4 points for\n                      <jats:italic>Emotional well\u2010being<\/jats:italic>\n                      . The presence of depression before starting medication and its persistence during the observation period was associated with a global worsening of QoL across all domains, ranging from 10 points worse for\n                      <jats:italic>Social functioning,<\/jats:italic>\n                      almost 8 points for\n                      <jats:italic>Energy and fatigue<\/jats:italic>\n                      , 6 points for\n                      <jats:italic>Cognitive functioning,<\/jats:italic>\n                      and to nearly 5 points for\n                      <jats:italic>Seizure worry<\/jats:italic>\n                      . The new development of depression during treatment was associated with worsening in specific QoL domains such as\n                      <jats:italic>Cognitive functioning<\/jats:italic>\n                      ,\n                      <jats:italic>Social functioning<\/jats:italic>\n                      , and\n                      <jats:italic>Overall QoL<\/jats:italic>\n                      subscales. Persistent positive suicidality screening was associated with progressive worsening in the domain\n                      <jats:italic>Emotional well\u2010being<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>\n                      Seizure freedom can improve all domains of QoL, but mainly\n                      <jats:italic>Seizure worry,<\/jats:italic>\n                      although this can be negatively affected by depressed mood. Improvement in the domain of\n                      <jats:italic>Social functioning<\/jats:italic>\n                      requires a period of sustained seizure freedom longer than 6\u2009months to improve, and it is negatively influenced by persistent depressed mood. In contrast, changes in\n                      <jats:italic>Emotional well\u2010being<\/jats:italic>\n                      are negatively influenced by suicidality. Clinical and demographic variables, including duration of epilepsy and number of comorbidities or concomitant medical problems, showed no correlation with changes in QoL.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi.70356","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T17:38:13Z","timestamp":1784396293000},"page":"4561-4571","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Drug\u2010treatment changes, depression, and quality of life in adults with drug\u2010resistant focal epilepsy"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9415-3395","authenticated-orcid":false,"given":"Marco","family":"Mula","sequence":"first","affiliation":[{"name":"Department of Neurology, Atkinson Morley Regional Neuroscience Centre St George's University Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Borghs","sequence":"additional","affiliation":[{"name":"UCB  Slough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Ferro","sequence":"additional","affiliation":[{"name":"UCB  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2416-147X","authenticated-orcid":false,"given":"Gaetano","family":"Zaccara","sequence":"additional","affiliation":[{"name":"Regional Health Agency of Tuscany  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Dainese","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Unit of Neurology and Neurophysiology University Hospital of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Ferlazzo","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Magna Graecia University  Catanzaro Italy"},{"name":"Regional Epilepsy Centre Great Metropolitan Hospital BMM  Reggio Calabria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4505-2600","authenticated-orcid":false,"given":"Andrea","family":"Romigi","sequence":"additional","affiliation":[{"name":"IRCCS Neuromed Istituto Neurologico Mediterraneo Sleep Medicine Center  Pozzilli (IS) Italy"},{"name":"Psychology Faculty International Medical University Unicamillus  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7384-3074","authenticated-orcid":false,"given":"Antonio","family":"Gambardella","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Catanzaro  Catanzaro 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