Abstracts

Rationale: Depression is a common co-morbidity in patients with epilepsy. Depression is thought to be related to the underlying neurobiology of seizures and is not thought to be reactive. We sought to analyze the frequency of depression in our epilepsy specialty clinic and to determine if refractory epilepsy is associated with a higher frequency of depression. The Neurologic Disorders Depression Inventory for Epilepsy (NDDI-E) is a six item questionnaire designed to quickly screen for depression in people with epilepsy. Scores greater than 15 correlate with other measures of depression including structured interviews (Gillam FG et al Lancet Neurol 2006;5(5):399-405). Methods: We have been using the NDDI-E to routinely screen for depression in our adult (age 18 and older) epilepsy clinics since May 2007. Scores were obtained in 1608 unique patients and are tracked in an electronic medical record (EMR). The most recent NDDI-E score was used for analysis. All patients have epilepsy ICD-9 codes entered in the EMR by the treating physician. Our epilepsy clinics include patients referred for refractory epilepsy, well-controlled epilepsy and recent onset seizures (including single seizures). Since November 2008, ICD-9 codes are verified by one of the clinical investigators (JPS) by reviewing the clinical history. Patients were assigned a refractory code (i.e. xxx.x1) if they had seizures in the 3 months prior the visit. For this study, we assessed epilepsy control and the NDDI-E scores for all patients seen from January 1, 2009 and April 30, 2009. Results: Depression (NDDI-E scores > 15) were seen in 302 of the 1608 patients (18.8%). From January through April 2009, 692 patients had NDDI-E scores; 622 were epilepsy patients. Depression was seen in 21.7% of the refractory patients and 17.4% of the non-refractory patients (p = 0.03, chi-square). Depression (NDDI-E scores > 15) were seen in 302 of the 1608 patients (18.8%). From January through April 2009, 692 patients had NDDI-E scores; 622 were epilepsy patients. Depression was seen in 21.7% of the refractory patients and 17.4% of the non-refractory patients (p = 0.03, chi-square). No difference was seen in the frequency of depression between partial onset and generalized onset epilepsy patients. Conclusions: Refractory epilepsy was associated with a higher frequency of depression. No difference was seen in the frequency of depression between partial and generalized epilepsy syndromes.