Factors associated with illness representations in adults with epileptic and functional seizures: A systematic review

Illness representations refer to a person's beliefs about their health condition and are thought to influence clinical outcomes. By understanding factors related to illness representations, potentially modifiable targets for psychological intervention can be identified. The aim of this systematic review was to synthesise the literature on factors associated with illness representations in people with epilepsy and functional seizures. Three electronic databases (Psychinfo, EMBASE, and Proquest (Theses and dissertations)) were searched for studies that reported on associations between Illness Perception Questionnaire scores (or variations thereof) and biopsychosocial factors in people with epilepsy or people with functional seizures. Seventeen studies met inclusion criteria and were assessed with a bespoke quality appraisal tool. Overall, there was moderately strong evidence for an association between more threatening illness representations and poorer clinical outcomes relating to seizure characteristics, distress, coping, and quality of life; the evidence for these relationships was stronger for people with epilepsy than functional seizures. There was no clear difference between the illness representations of the two groups. The results of this review highlight the clinical importance of illness representations in people with seizure disorders, as well as opportunities for further research.