Abstracts

Rationale: Anxiety disproportionately affects people with epilepsy (PWE) and leads to poor outcomes. Yet, risk factors are not well understood especially among underserved groups. This cross-sectional study aimed to identify epilepsy-specific predictors of anxiety disorders in predominantly African American and Caribbean American PWE. Methods: The prevalence of anxiety disorders was established via diagnostic interview (Mini International Neuropsychiatric Interview). We identified the extent to which aspects of seizure burden (seizure frequency, seizure severity, convulsive vs. non-convulsive seizures), seizure worry, and perceived epilepsy stigma were associated with anxiety disorder diagnosis. Finally, logistic regression assessed the overall and independent contributions of significant risk factors. Results: There were 60 participants (62% women, 52% African American, 27% Caribbean American, 20% Hispanic/Latino) with an average of 2 seizures per month. Over a quarter endorsed moderate-to-severe anxiety and nearly half of the sample (43%) qualified for ≥ 1 anxiety disorder, with 62% of affected individuals qualifying for agoraphobia. Those with anxiety disorders tended to have convulsive seizures (p = 0.037) and endorsed greater seizure worry (p = 0.012), more general symptoms of anxiety (p = 0.005), and worse perceived epilepsy stigma (p = 0.003). Logistic regression accounted for 28 to 37.6% of the variance in anxiety disorder diagnostic status and correctly classified 73% of cases; however, only perceived epilepsy stigma made a unique contribution (OR = 2.058, 95% CI = 1.053, 4.059, p = 0.035). To this end, each standard deviation increase in perceived epilepsy stigma corresponded to a greater than two-fold likelihood that respondents had an anxiety disorder, independent of general symptoms of anxiety (p = 0.132), seizure type (p = 0.056), and degree of seizure worry (p = 0.150). Conclusions: Anxiety disorders were prevalent in these predominantly African American and Caribbean American PWE. Epilepsy-specific risk factors included convulsive seizures, seizure worry, and perceived epilepsy stigma. Interventions aimed at treating anxiety disorders in diverse PWE may especially benefit from targeting stigma beliefs. Funding: No funding