Abstracts

Rationale: Depressive disorders are identified by the World Health Organization as a priority mental health disorder of adolescence because of its high prevalence, recurrence, ability to cause significant complications and impairment. Across the globe, the lifetime prevalence for major depression in adolescence is 15% to 20%. With a recurrence rate of 60% to 70%; often resulting in suicide, school dropout, pregnancy, substance abuse; progressing into adult depression, functional disability and significant impairment. In Puerto Rico the estimate prevalence rate for depression in children and adolescents is 3.0%. Multiple epidemiological studies have shown that depression is the most frequent comorbid psychiatric disorder in patients with epilepsy. Prevalence rates range from 20% to 55% in patients with recurrent seizures and 6% to 8% in patients with well controlled seizures. Methods: The Beck Depression Inventory-Second Edition(BDI-II) is a 21-item self report instrument for the assessment of symptoms corresponding to criteria for diagnosing depressive disorders listed in the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition(DSM-IV). The BDI-II was administered to 37 adolescents aged 13-18 years old with the diagnosis of epilepsy attending to the epilepsy clinic of University Pediatric Hospital in Puerto Rico. Information was obtained from the medical records and parents interview, regarding to time with epilepsy; frequency of seizures; epilepsy classification; medications; previous diagnosis of depression; and age at onset of epilepsy. Inclusion criteria included chronological age 13 to 18 years old, diagnosis of epilepsy, and treatment with, antiepileptic drugs; vagal nerve stimulator; surgery; or observation. Patients with mental retardation were excluded from the study. The BDI-II cut-off points used are the following: 0-10:normal; 11-19:mild depression symptoms; 20-27:moderate depression symptoms; 28-66:severe depression symptoms. Results: Mean age was 15.5±1.9 years (56.8% female and 43.2% male). Mean BDI-II score was 11±12 (median value: 6). Twenty-two (59.5%) patients did not present depressive symptoms and 15(40.5%) patients were positive for symptoms of depression, according to the BDI-II. Of the 15 patients with symptoms of depression, 18.9% presented symptoms of mild depression, 8.1% symptoms of moderate depression, and 13.5% symptoms of severe depression. Conclusions: Depressive symptoms were detected in 40.5% of the sample. Of 15 patients with depressive symptoms only 4 patients were previously diagnosed with depression; indicating possible underdiagnosis of depression in adolescents with epilepsy. Findings suggest a possible association between frequency of seizures, time with epilepsy, and depression. However, study’s limitations, specifically sample size, did not allow to explore this further. Future studies are needed to better understand factors associated to depression in adolescent patients with epilepsy. The BDI-II could be a good screening instrument for depressive symptoms in adolescents with epilepsy.