Abstracts

Rationale: (Author 1 and 2 have equally contributed to the project) Mood disorders are commonly under-diagnosed and under-reported co-morbidities in PWE, when compared to general population. Prior studies have shown prevalence of depression to be 20% to 55% in patients with recurrent seizures, 3% to 9% in patients with controlled epilepsy as compared to 8.7% in general population without seizures (Kanner A.M, Epilepsy and Behavior 2009.) Mood disorders adversely affect overall quality of life in PWE. In this study, we aimed to study the prevalence of depression and/or anxiety in PWE following the University Of Toledo Medical Center (UTMC), by using PHQ-9 and GAD-7 questionnaires. In addition, we also proposed to analyze the interrelationship of subjective mood complaints, diagnosed mood disorders and suicidal ideation with PHQ-9 and GAD-7 scores. Methods: This was an IRB-approved, cross-sectional, questionnaire-based study on 100 cognitively-able PWE (≥ 18 years of age) following the UTMC Epilepsy Clinic. After random selection, each subject completed the ‘Study questionnaire' in one of the outpatient clinic rooms. Verbal consent was obtained prior to participation and the study investigators were available to answer any project-related questions. Data was analyzed using ‘R-statistical software'. Results: In our population, 34% PWE reported subjective depression, 32% had a prior diagnosis of depression while the overlap between the two was 76.47 %. Similarly, 35% PWE reported subjective anxiety, 27% had a prior diagnosis of anxiety while the overlap between the two was 68.56 %. Using PHQ-9, 20% PWE had scores ≥ 10 (moderate depression or worse), while GAD-7 showed 15% PWE with scores ≥ 10 (moderate anxiety or worse). The mean PHQ-9 scores were significantly higher in PWE with diagnosed depression than without (7.63 ± 7.01 versus 3.88 ± 4.90), and in those with subjective depression than without (9.18 ± 6.75 versus 2.97 ± 4.05.) Similarly, GAD-7 scores were significantly higher in PWE with diagnosed anxiety than without (8 ± 7.41 versus 2.77 ± 3.89), and in those with subjective anxiety than without (8 ± 6.87 versus 2.12 ± 3.23.) Moreover, PHQ-9 and GAD-7 scores were significantly higher in PWE who reported suicidal ideation when compared to those who did not (p<0.05.) Household income, educational level or body-mass index did not have any influence on either scale. Conclusions: Overall, our study indicated that prevalence of mood disorders in PWE following UTMC was similar to that shown in previous studies. There was a remarkable overlap between those with subjective mood problems and those with a diagnosed mood disorder. This suggested that PWE with depression and/or anxiety are not optimally treated. Additionally, there was a strong correlation of PHQ-9 and/or GAD-7 scores in PWE with subjective and/or diagnosed mood disorders. PHQ-9 and/or GAD-7 scores were also significantly higher in PWE reporting history of suicidal ideation. Hence, it is prudent to use these screening tools for better management of mood disorders in PWE in the outpatient setting.