Depression Symptom Experience Among Patients with Epilepsy Reporting a Diagnosis of Focal Onset Seizures (FOS): A Patient-Reported Outcomes Study
Abstract number :
1.364
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2025
Submission ID :
714
Source :
www.aesnet.org
Presentation date :
12/6/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Joanne Wagner, PhD – Xenon Pharmaceuticals Inc.
Bhagyashree Oak, PhD – Trinity Life Sciences, LLC
Brittany Smith, MPH, MBA – Trinity Life Sciences, LLC
Amod Athavale, PhD, MS – Trinity Life Sciences, LLC
Alvin Ong, PharmD – Xenon Pharmaceuticals Inc.
Cynthia Harden, MD – Xenon Pharmaceuticals Inc.
Rationale: Depression among people with epilepsy (PwE) is frequent but often goes unrecognized by physicians. While 24%-33% of PwE are diagnosed with major depressive disorder (MDD), < 50% of PwE with self-reported moderate-severe symptoms of depression report a formal diagnosis of depression. To receive a diagnosis of MDD, a PwE must report 5 or more features of depression during a 2-week period, with at least one of the features being depressed mood or anhedonia (loss of pleasure). Despite growing evidence of the mental health burden in epilepsy, there remains a gap in understanding the depression symptom experience reported by PwE, even among those without a formal diagnosis of depression.
Methods: A quantitative, cross-sectional, web-enabled survey was conducted from July to September 2023 to understand the burden of illness for patients reporting FOS. Patients were recruited via patient panels or point-of-care physician referrals. Eligible patients were United States residents and 18 to 80 years old, with a physician-confirmed diagnosis of FOS for >1 year, >1 seizure per month, past or present use of >2 anti-seizure medications (ASMs), and currently receiving an ASM for >1 month. Data was collected via a custom questionnaire and validated tools like the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 consists of questions that assess depression symptom severity based upon the DSM-5 criteria for MDD with higher scores indicating more severe symptoms. Using the PHQ-9, patients self-reported how often they were bothered by depression symptoms over the previous 2 weeks.
Results: Of the 170 patients reporting a diagnosis of FOS who completed the survey, the mean (SD) PHQ-9 score was 11.1 (5.2) out of 27, and 63.5% of patients had a score > 10, suggestive of moderate-severe depression. Of the 102 patients reporting no physician-diagnosed depression, 55.9% (57/102) reported moderate-severe depression via the PHQ-9 score. 50% (85/170) reported being bothered by > 8 depression symptoms for at least several days a week, with depressed mood (“feeling down, depressed, or hopeless”) and anhedonia (“little interest or pleasure in doing things”) reported by 80.6% (137/170) and 81.8% (139/170), respectively. Patients reporting anhedonia were more likely to report experiencing non-seizure symptoms such as cognitive issues (62.6% [87/139] vs 41.9% [13/31]) and social issues (50.4% [70/139] vs 29.0% [9/31]). Suicidal ideation or thoughts of self-harm for at least several days a week was reported by 42.4% (72/170) of patients. 61.8% (105/170) to 91.7% (156/170) of patients reported being bothered by other depression symptoms for at least several days a week.
Conclusions: PwE reporting FOS experience considerable mental health burden, including those reporting no formal diagnosis of depression. Most patients reported depressed mood and anhedonia, core depression features that may be independent of the side effects of medication. These findings support recent guidelines for the routine screening of depression in clinical practice and highlight the potential unrecognized burden of depression in PwE.
Funding: Study supported by Xenon Pharmaceuticals Inc.
Cormorbidity (Somatic and Psychiatric)