Abstracts

Rationale:
Approximately two years ago our pediatric epilepsy clinic initiated depression screening in accordance with the national clinical care guidelines for epilepsy centers. This poster will provide an update of our findings, as, to date, an additional 724 screeners have been administered and the minimum age of patients screened has been lowered from 15 years to 12 years of age. Additional goals are to explore patient demographic and clinical variables to better understand the relationship between seizure variables and depressive symptoms, and assess the effectiveness of our current behavioral health protocol.
Method:
The Patient Health Questionnaire-9 (PHQ-9, Adolescent Version) is administered via an Ipad to pediatric patients ages 12-18 years during their routine epilepsy clinic visit. Exclusion criteria include patient refusal, intellectual disability, or other factors that prohibit the patient from providing valid responses. When a patient’s PHQ-9 score is elevated beyond the range of mild depressive symptoms, and/or they endorse suicidal ideation, a behavioral health protocol that is embedded in the clinic workflow is initiated. This typically includes, but is not be limited to, providing behavioral health referrals, encouraging follow up with a mental health provider, and/or suicide risk assessment by psychologist or social worker. The screening results and behavioral health protocol response is documented in the patient’s medical record. Demographic (e.g., gender, race, age) and clinical variables (e.g., number of clinic visits, seizure diagnosis, seizures frequency, polytherapy vs. monotherapy, , etc.) are retrieved from the patient’s electronic medical record following the completion of the screener and  included in a comprehensive database to be used for simple descriptive and statistical analyses.
Results:
Since our 2018 analysis and report of depression screening data from our pediatric epilepsy clinic, approximately 743 additional screeners have been administered to youth with epilepsy. Of those screened during the second analysis, 14% of patients screened fell into the moderate to severe depressive symptoms range. Additionally, 5.8% of patients rated that they experienced serious thoughts about harming themselves over the past month.
Conclusion:
Although the screening age was lowered and several more screeners have been administered, the youth served in our pediatric Epilepsy Center continue to demonstrate rates of depression similar to those identified in prior research studies and our own previous analysis of depressive screening data. This continues to support the importance of regular behavior health screening during routine clinic visits, development of a behavioral health response protocol within an epilepsy clinic, and further investigation into demographic and/or clinical factors that might be correlated with depressive symptoms. Future analyses will determine if there are any associations between demographic or clinical variables and depressive symptoms. Future analyses will also determine if youth with more than one screening data point experienced an increase or decrease in depressive symptoms, and, if those who were previously provided with behavioral health referrals followed through with recommendations, received appropriate care, and/or experienced a reduction in depressive symptoms. Based on the findings, we will determine if additional processes should be added to the current behavioral health protocol (e.g., follow-up call after referral to assess barriers to accessing behavioral health care, brief in-clinic intervention and/or addition of psychoeducational handouts in clinic materials).
Funding:
:None.