BACKGROUND: Quality of life (QOL) is an important topic in current international research of epilepsy. In countries other than China, QOL in epilepsy has been well studied, and many assessment scales or QOL of epilepsy have been developed and used in the clinical practice. In China, concern for QOL of epilepsy patients is very recent, and QOL assessment scales, which correspond to China's basic conditions, are still needed. OBJECTIVE: This review aimed to analyze the primary influencing factors and assessment scales of QOL in epilepsy, to investigate the topics of current and future research for QOL of epilepsy patients, and to highlight the importance of QOL for epilepsy patients, according to China's basic conditions. RETRIEVAL STRATEGY: Using the terms "quality of life in epilepsy", we computer-retrieved from the PubMed (http://www.ncbi.nlm.nih.gov/PubMed) database human studies published between January 1998 and April 2007 in the English language. A total of 745 manuscripts were searched, of which 243 were review papers. At the same time, we computer-searched the China National Knowledge Infrastructure with the terms "epilepsy and quality and life" in the Chinese language for studies published between 2002 and 2007. Altogether, 181 Chinese literatures were retrieved, 32 of which were from high-impact journals. LITERATURE EVALUATION: The retrieved manuscripts were initially selected, but 50 were kept for further analysis. The selected manuscripts were as follows: 31 Chinese and/or English studies addressed the influencing factors of QOL for epilepsy patients, as well as assessment scales for QOL in different populations of epilepsy patients, of which 5 were review articles and the remaining 26 were clinical studies; and 19 Chinese and/or English literatures were rejected, because they were not in accordance with the inclusive criteria. DATA SYNTHESIS: QOL for epilepsy patients is an emerging field. At present, "the Liverpool group model for determining QOL in people with epilepsy" is used as the theoretical basis for studying QOL of epilepsy patients. Studies have demonstrated that the influencing factors for QOL in epilepsy are gender, age, attack frequency, adverse reactions to drugs, and social and psychological factors. QOL for epilepsy patients was evaluated by the Scales method. According to Spilker, when evaluating QOL for epilepsy, generic and specific QOL scales should be divided. Generic QOL scales are used for comparing psychosocial traits between epilepsy or other disease patients and healthy controls. They have also been used for studying the relationship between QOL and disease. In the last 10 years, among the generic QOL scales, "Profile of Mood States" and "Short-Form-36" are the most commonly used. The specific scales have consisted of certain items from a generic scale, as well as certain items directly aimed at epilepsy. For this reason, the specific scale is more sensitive than the generic scale. CONCLUSION: The enhancement of standard diagnostics and treatments for epilepsy is important for controlling epileptic seizures and improving the QOL for epilepsy patients. It is crucial to address the QOL of epilepsy patients and to develop assessment scales that are appropriate for China's basic conditions.
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