Authors :
Presenting Author: Erica Johnson, PhD, FAES – University of Washington
Elaine Kiriakopoulos, M.D., MSc, MPH – Assistant Professor, Neurology, Dartmouth Geisel School of Medicine; Farren Briggs, Ph.D. – Associate Professor, Department of Population and Quantitative Health Sciences, Case Western Reserve University; Joy Yala, B.S. – Research Assistant, Psychiatry and Neurology, Case Western Reserve University; Martha Sajatovic, M.D. – Professor, Psychiatry and Neurology, Case Western Reserve University; Cam Escoffery, Ph.D. – Professor, Rollins School of Public Health, Emory University; Ross Shegog, Ph.D. – Professor, School of Public Health, University of Texas-Houston; Barbara Jobst, M.D. – Professor, Neurology, Dartmouth Geisel School of Medicine; Tanya Spruill, Ph.D. – Associate Professor, Department of Population Health, NYU; Mary Janevic, Ph.D. – Research Associate Professor, School of Public Health, University of Michigan; Janelle Wagner, Ph.D., FAES – Research Associate Professor, Comprehensive Epilepsy Center, Medical University of South Carolina
Rationale:
There is limited data on psychosocial functioning in young adults with epilepsy (YAWE) despite myriad milestones achieved during this influential stage (e.g., post-high school education, vocational achievement, romantic relationships, independent living).
The purpose of this study was to address the current research gap in YAWE by using aggregate data from the Managing Epilepsy Well Network Integrated Database (MEW-DB) from 15 self-management studies across the US to examine depression and QoL in this vulnerable population. Study aims were to: (1) describe sociodemographic characteristics and (2) analyze sociodemographic and depression variables as predictors of QoL of YAWE aged 18-29. The study hypotheses were: 1) After controlling for sociodemographic variables, the presence of suicidal ideation will be associated with lower QoL in YAWE, and 2) In YAWE, the cognitive aspects of depression will predict greater variance in QoL compared to the somatic symptoms of depression, extending understanding of the role of a cognitive phenotype of depression in YAWE.
Methods:
The MEW-DB was queried for all young adults ages 18-29 with completed standardized psychosocial measures of QoL (QoLIE-10), depression (PHQ-9), and sociodemographic information. Of 418 young adults, n=237 had analyzable data. PHQ-9 items were categorized into cognitive (COG) and somatic (SOM) symptoms according to two phenotypes of depression in epilepsy. Zero-order correlation coefficients were calculated on all variables of interest. Subsequent analyses were conducted: (1) bivariate correlation analysis of COG and QoL; (2) bivariate correlation analysis of SOM and QoL; and (3) stepwise regression analyses of predictors of QoL (in this order: demographic variables; and, in four separate analyses, PHQ-9 suicidality item; PHQ-9 COG; PHQ-9 SOM; and PHQ-9 total score).
Results:
YAWE averaged 23.6 years old (range 18-29) and were primarily female (67.1%). The majority identified as White (79.3%) and not Hispanic or Latino (88.9%); 18% as African American. Most (77.2%) were not yet married or cohabitating. The majority (67.4%) reported at least some college education, and (64.8%) reported annual income < $25,000 per year. Depression had a strong relationship with QoL (r=0.703); all other relationships were weak (r > -0.21 and < 0.21). Multiple regression analyses indicated the best model was total depression symptoms; suicide ideation, COG symptoms, and SOM symptoms alone did not better predict QoL.