Religiosity and spirituality in patients with epilepsy

ABSTRACT

Religiosity and spirituality (R/S) are widely regarded as important allies against illness and suffering in general. Findings in temporal lobe epilepsy (TLE) suggest the temporal lobe as the anatomical-functional basis of religious experiences. Both R/S are relevant in patients with epilepsy (PWE) since epilepsy can lead to psychosocial issues for a significant portion of patients and their families.

Objective: To investigate R/S in PWE, as well as the impact of different epileptic syndromes on patients' R/S.

Methods: One hundred PWE and 50 healthy volunteers matched for age, sex and educational level were submitted to an interview, as well as three previously validated questionnaires: Index of Core Spiritual Experience (INSPIRIT-R), Hospital Anxiety and Depression Scale (HADS), and the Quality of Life in Epilepsy Inventory (QOLIE-31).

Results: PWE's and control's mean ages were 35.9 ± 12.4 vs. 36.3 ± 18.1 years, mean schooling was 8.9 ± 3.7 vs. 10.1 ± 4.2 years. The mean age of epilepsy onset was 14.5 ± 12.1 and monthly frequency of seizures was 5.9 ± 12.6. INSPIRIT-R's scores were not statistically significantly different between patients and controls (3.0 ± 0.8 vs. 3.0 ± 0.8); however, INSPIRIT-R's scores were significantly higher in TLE patients when compared with other epilepsy syndromes (3.2 ± 0.7 vs. 2.8 ± 0.9; p = 0.04).

Conclusion: Temporal lobe epilepsy patients have higher levels of R/S.

Resumo

Religiosidade e espiritualidade (R/E) são geralmente consideradas importantes aliadas no enfrentamento de doenças e sofrimento. Estudos na epilepsia do lobo temporal (ELT) sugerem que o lobo temporal é a base anatçmico-funcional de experiências religiosas. Além disso, R/E têm impacto na vida de pacientes com epilepsia (PCE), uma vez que a epilepsia frequentemente está associada a distúrbios psicossociais em pacientes e seus familiares.

Objetivo: Investigar R/E em PCE, bem como o impacto de diferentes síndromes epilépticas na R/E dos pacientes.

Método: Cem PCE e 50 voluntários saudáveis pareados por idade, sexo e nível educacional foram submetidos a uma entrevista, bem como três questionários previamente validados: Index of Core Spiritual Experience (INSPIRIT-R), Hospital Anxiety and Depression Scale (HADS), e Quality of Life in Epilepsy Inventory (QOLIE-31).

Resultados: As médias de idade de PCE e controles foram de 35,9 ± 12,4 vs. 36,3 ± 18,1 anos, com escolaridade média de 8,9 ± 3,7 vs. 10,1 ± 4,2 anos. A idade média do início da epilepsia foi de 14,5 ± 12,1 e a frequência de crises mensais foi de 5,9 ± 12,6. Os escores do INSPIRIT-R não foram estatisticamente diferentes entre os pacientes e controles (3,0 ± 0,8 vs. 3,0 ± 0,8); entretanto, os escores do INSPIRIT-R foram significativamente maiores em pacientes com ELT quando comparados com outras síndromes epilépticas (3,2 ± 0,7 vs. 2,8 ± 0,9; p = 0,04).

Conclusão: Pacientes com epilepsia do lobo temporal possuem níveis mais altos de religiosidade e espiritualidade.

Keywords:

Epilepsy, temporal lobe - quality of life - spirituality

Palavras-chave:

Epilepsia do lobo temporal - qualidade de vida - espiritualidade

• References

• 1 Mishra SK, Togneri E, Tripathi B, Trikamji B. Spirituality and religiosity and its role in health and diseases. J Relig Health. 2017 Aug;56(4):1282-301. https://doi.org/10.1007/s10943-015-0100-z
• 2 Park CL, Masters KS, Salsman JM, Wachholtz A, Clements AD, Salmoirago-Blotcher E, et al. Advancing our understanding of religion and spirituality in the context of behavioral medicine. J Behav Med. 2017 Feb;40(1):39-51. https://doi.org/10.1007/s10865-016-9755-5
• 3 Fleck MP, Borges ZN, Bolognesi G, da Rocha NS. [Development of WHOQOL spirituality, religiousness and personal beliefs module]. Rev Saude Publica. 2003 Aug;37(4):446-55. Portuguese. https://doi.org/10.1590/S0034-89102003000400009
• 4 Levin JS, Chatters LM. Research on religion and mental health: an overview of empirical findings. In: Koenig HG, editor. Handbook of religion and mental health. Cambridge: Academic Press; 1998. pp. 33-50. https://doi.org/10.1016/B978-012417645-4/50070-5
• 5 Tedrus GM, Fonseca LC, Magri FP, Mendes PH. Spiritual/religious coping in patients with epilepsy: relationship with sociodemographic and clinical aspects and quality of life. Epilepsy Behav. 2013 Sep;28(3):386-90. https://doi.org/10.1016/j.yebeh.2013.05.011
• 6 Dewhurst K, Beard AW. Sudden religious conversions in temporal lobe epilepsy. Br J Psychiatry. 1970 Nov;117(540):497-507. https://doi.org/10.1192/bjp.117.540.497
• 7 Ozkara C, Sarý H, Hanoğlu L, Yeni N, Aydoğdu I, Ozyurt E. Ictal kissing and religious speech in a patient with right temporal lobe epilepsy. Epileptic Disord. 2004 Dec;6(4):241-5.
• 8 Trimble M, Freeman A. An investigation of religiosity and the Gastaut-Geschwind syndrome in patients with temporal lobe epilepsy. Epilepsy Behav. 2006 Nov;9(3):407-14. https://doi.org/10.1016/j.yebeh.2006.05.006
• 9 Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014 Apr;55(4):475-82. https://doi.org/10.1111/epi.12550
• 10 Hauser WA, Rich SS, Lee JR, Annegers JF, Anderson VE. Risk of recurrent seizures after two unprovoked seizures. N Engl J Med. 1998 Feb;338(7):429-34. https://doi.org/10.1056/NEJM199802123380704
• 11 Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000 Feb;342(5):314-9. https://doi.org/10.1056/NEJM200002033420503
• 12 Kwan P, Sander JW. The natural history of epilepsy: an epidemiological view. J Neurol Neurosurg Psychiatry. 2004 Oct;75(10):1376-81. https://doi.org/10.1136/jnnp.2004.045690
• 13 Leone MA, Giussani G, Nolan SJ, Marson AG, Beghi E. Immediate antiepileptic drug treatment, versus placebo, deferred, or no treatment for first unprovoked seizure. Cochrane Database Syst Rev. 2016 May;6(5):CD007144. https://doi.org/10.1002/14651858.CD007144.pub2
• 14 Lin CY, Saffari M, Koenig HG, Pakpour AH. Effects of religiosity and religious coping on medication adherence and quality of life among people with epilepsy. Epilepsy Behav. 2018 Jan;78(1):45-51. https://doi.org/10.1016/j.yebeh.2017.10.008
• 15 Thurman DJ, Beghi E, Begley CE, Berg AT, Buchhalter JR, Ding D, et al. Standards for epidemiologic studies and surveillance of epilepsy. Epilepsia. 2011 Sep;52 Suppl 7:2-26. https://doi.org/10.1111/j.1528-1167.2011.03121.x
• 16 Associação Brasileira de Empresas de Pesquisa – ABEP. Critério de classificação econçmica Brasil 2016 [cited 2018 Oct 5]. Available from: https://doi.org/www.abep.org/criterio-brasil
• 17 Kass JD, Friedman R, Leserman J, Caudill M, Zuttermeister PC, Benson H. An Inventory of Positive Psychological Attitudes with potential relevance to health outcomes: validation and preliminary testing. Behav Med. 1991;17(3):121-9. https://doi.org/10.1080/08964289.1991.9937555
• 18 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-70. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
• 19 Cramer JA, Perrine K, Devinsky O, Bryant-Comstock L, Meador K, Hermann B. Development and cross-cultural translations of a 31-item quality of life in epilepsy inventory. Epilepsia. 1998 Jan;39(1):81-8. https://doi.org/10.1111/j.1528-1157.1998.tb01278.x
• 20 Devinsky O. Clinical uses of the quality-of-life in epilepsy inventory. Epilepsia. 1993;34(s4 Suppl 4):S39-44. https://doi.org/10.1111/j.1528-1157.1993.tb05915.x
• 21 Veronez IS, Bicalho MA, Claudino LS, Walz R, Lin K. Cross-cultural translation of the INSPIRIT-R for Brazil and its applicability among epilepsy patients. Arq Neuropsiquiatr. 2011;69(2b 2B):310-5. https://doi.org/10.1590/S0004-282X2011000300008 PMID:21625756
• 22 Botega NJ, Bio MR, Zomignani MA, Garcia C Jr, Pereira W. Mood disorders among medical in-patients: a validation study of the hospital anxiety and depression scale (HAD). Rev Saude Publica. 1995;29(5):359-63. Portuguese. https://doi.org/10.1590/S0034-89101995000500004
• 23 Silva TI, Ciconelli RM, Alonso NB, Azevedo AM, Westphal-Guitti AC, Pascalicchio TF, et al. Validity and reliability of the Portuguese version of the quality of life in epilepsy inventory (QOLIE-31) for Brazil. Epilepsy Behav. 2007 Mar;10(2):234-41. https://doi.org/10.1016/j.yebeh.2006.08.022
• 24 World Medical Association – WMA. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013 Nov;310(20):2191-4. https://doi.org/10.1001/jama.2013.281053
• 25 Moritz JL, Mameniškienė R, Rimšienė J, Budriūnienė A, de Almeida Calado G, Rigon IB, et al. Control perceptions in epilepsy: A transcultural case-control study with focus on auras. Epilepsy Behav. 2018 Nov;88(1):130-8. https://doi.org/10.1016/j.yebeh.2018.09.005
• 26 Tedrus GM, Fonseca LC, Fagundes TM, Silva GL. Religiosity aspects in patients with epilepsy. Epilepsy Behav. 2015 Sep;50(1):67-70. https://doi.org/10.1016/j.yebeh.2015.06.003
• 27 Tedrus GM, Fonseca LC, Höehr GC. Spirituality aspects in patients with epilepsy. Seizure. 2014 Jan;23(1):25-8. https://doi.org/10.1016/j.seizure.2013.09.005
• 28 Lee SA, Ryu HU, Choi EJ, Ko MA, Jeon JY, Han SH, et al. Associations between religiosity and anxiety, depressive symptoms, and well-being in Korean adults living with epilepsy. Epilepsy Behav. 2017 Oct;75(1):246-51. https://doi.org/10.1016/j.yebeh.2017.06.005
• 29 Giovagnoli AR, Meneses RF, Silva AM. The contribution of spirituality to quality of life in focal epilepsy. Epilepsy Behav. 2006 Aug;9(1):133-9. https://doi.org/10.1016/j.yebeh.2006.04.002
• 30 Nakken KO, Brodtkorb E. [Epilepsy and religion]. Tidsskr Nor Laegeforen. 2011 Jul;131(13-14):1294-7. Norwegian. https://doi.org/10.4045/tidsskr.10.1049
• 31 Wolf P. Epilepsy and metaphors in literature. Epilepsy Behav. 2016;57(Pt B):243-6. https://doi.org/10.1016/j.yebeh.2015.12.029
• 32 Devinsky O, Lai G. Spirituality and religion in epilepsy. Epilepsy Behav. 2008 May;12(4):636-43. https://doi.org/10.1016/j.yebeh.2007.11.011