Abstracts

Rationale: Patients with epilepsy have two to four times increased mortality compared to the general population. Depression has been found to be 7-15 times higher in patients with epilepsy and is likely to be under recognized and under treated. While the presence of depression has been consistently reported in association with epilepsy, it remains unclear weather the presence of epilepsy affects the therapeutic response to treatment. Methods: A retrospective review study, conducted during 2006-2008 of all the patients evaluated by the child and adolescent psychiatry C/L service in the pediatric epilepsy monitoring unit (n=68), twenty six of them were diagnosed with MDD. This group was matched by age, gender and ethnicity to a group of inpatient child and adolescent patients diagnosed with depression without epilepsy. All patients from both groups were treated with SSRI’s. A Brief Psychiatric Rating Scale (BPRS)-children version was used to measure symptomatology, suicidality and depression in both groups. After using univariate methods to identify possible significant associations, subsets of those variables whose associations are believed to be clinically meaningful were used in a multivariate analysis. Results: Patients with epilepsy and depression had higher scores of the BPRS (p=0.002) compared to the group of depression patients, even though the patients in the depression group were recruited from an inpatient psychiatry setting. The group with the two comorbidities was more difficult to treat compared to the depression group (p=0.001). Conclusions: This is one of the first studies to assess the efficacy of SSRI’s in this common comorbidity. We found that patients with epilepsy have both more severe depression and impaired response to SSRI’s compared to patients without epilepsy. Early recognition of the depressive symptoms and early intervention may lead to a better quality of life in patients with epilepsy.