Abstracts

Rationale: New York City is home to 1.2 million Asian Americans, with the Chinese population being the largest Asian subgroup in NYC. The prevalence of epilepsy is similar in China and in Western countries. Despite ongoing efforts to identify factors that influence clinical outcomes and quality of life in people with epilepsy (PWE), little is known about Chinese PWE in the United States. In addition to established correlates of quality of life (e.g., seizure frequency, depression), acculturation, language barriers, social support, and stigma may be important considerations in this group. This study explored associations between behavioral, cultural, and psychosocial factors and quality of life in a sample of Chinese PWE in NYC. Methods: Adult Chinese-American PWE were recruited from epilepsy clinics at Bellevue Hospital and NYU Langone Health in NYC. Medical records were reviewed and participants completed validated self-report questionnaires in English, Mandarin or Cantonese.Data included demographic characteristics (gender, age, education, employment, income, marital status), cultural factors (nativity, primary language, English proficiency, health literacy, stigma), clinical variables (seizure frequency in the last 30 days and in the last 12 months), depressive symptoms (Patient Health Questionnaire [PHQ-9]), psychological stress (Perceived Stress Scale), quality of life (QOLIE-10), social support (Interpersonal Support Evaluation List), and self-reported adherence to antiepileptic drugs (AEDs). Pearson correlations and t-tests were performed to examine associations between these variables.  Results: The sample included 16 Chinese-American PWE of whom 43.8% were foreign-born (China or Hong Kong), and 37.5% reported limited health literacy. The mean age was 40.5 ± 15.4 years old, 62.5% of participants were female, 31.3% were married and 37.5% were working for pay. The majority of participants reported poor AED adherence (62.5%) and having had a seizure in the last 30 days (62.5%). More participants reported suicidal ideation (31.3%) than elevated depressive symptoms (PHQ-9 =10; 25.0%). Those who reported suicidal ideation were younger (p=.03), more likely to be unmarried (p=.016) and US-born (p=.002), and reported lower quality of life (p=.044), higher perceived stress (p=.024) and somewhat higher stigma (p=.073) compared with those who did not. Suicidal ideation was not related to gender, years living in the US, duration of epilepsy, AED adherence or side effects, or social support.  Conclusions: Social, psychological and acculturation variables may interact in complex ways to influence quality of life and mood in Chinese-American PWE. Identifying the most important predictors of poor quality of life and depression in Chinese American PWE will inform the development of culturally tailored interventions and self-management tools to improve outcomes in this understudied and vulnerable group. Funding: Finding a Cure for Epilepsy and Seizures (FACES)