Abstracts

Rationale: Emotional problems, such as depression, are frequent in adolescents with epilepsy. Multiple factors could be contributing to increased risk of depression in pediatric epilepsy. These factors could be biological, e.g. produced by the seizures or induced by antiepileptic medications. Alternatively, psychosocial factors, such as stigma of having epilepsy and loneliness could be contributing to risk of depression. The Seizures and Outcomes Study in Children (SOS-KIDS) examined correlates of depressive symptoms in children with epilepsy to elucidate which factors are more likely to be contributing to depression. Methods: SOS-KIDS is a cohort study of pediatric epilepsy patients and their caregivers living in DC and evaluated at Children's National Health System. Patients are recruited during a routine clinic appointment. As part of data collection, cognitively able children with epilepsy (CWE) age 12-17, and their caregivers, complete a survey about the child's epilepsy and outcomes including child's social and emotional functioning. Symptoms of depression were assessed using the PROMIS pediatric short form. Anxiety was measured using GAD score. Stigma and applied cognition were measured using the NeuroQOL scales. Loneliness was assessed using a 3-question standard scale. Additional questions were asked about being bullied and bullying others. Finally, parents reported seizure severity, seizure frequency and the number of AEDs used. Pearson's correlations were calculated using Social Science Statistics software (www.socscistatistics.com). Results: There were 29 CWE, 17 females and 12 males, and their caregivers, who completed necessary questionnaires. More than 50% were from families earning < $25,000 per year. Mean age of CWE was 15 years at enrollment. Mean duration of epilepsy was 6.4 years and 34% were seizure free in the previous 6 months. Mean depression score was 52 (SD=17). Additional characteristics about the CWE included 38% repeated a grade at school and 73% received educational support services. As expected, depression and anxiety significantly correlated (r=0.54, p=0.003). Depression also significantly correlated with experiences of loneliness (r=0.72, p < 0.0001) and anger (p=0.59, p=0.0007). In addition, depression significantly correlated with lower cognition (r=-0.55, p=.002), being bullied (r=0.44, p=0.02) and having stigma against epilepsy (r=0.633, p=0.002). Interestingly, depression did not correlate with measures of epilepsy severity and seizure frequency. Conclusions: Our data shows that depressive symptoms in adolescents with epilepsy did not correlate with frequency and severity of seizures but correlated significantly with psychosocial factors, such as stigma, experience of being bullied and loneliness. Our data supports the need for education to reduce stigma and bullying as well as for mental health services, such as therapy, to alleviate loneliness in children with epilepsy. Funding: This study was supported by the Centers for Disease Control and Prevention.